There is so much confusion and even disagreement in the medical community regarding annual gynecological exams. If the primary outcome measure is detection of cervical cancer only, then exams begin at age 21 and should occur every 3 years going to 5 years after age 30 conditioned upon all normal results. If results are abnormal or a woman has tested positive for exposure to high risk HPV, she should have annual screenings or a colposcopy as indicated. The guidelines vary depending on the results and age of patient so make sure you understand your individual situation and test results.
So what happens to the annual exam if the Pap smear is negative? Although I understand many patients would prefer a root canal to an annual exam, let me dispel some myths. If you are lucky to be a patient with a negative Pap history, we can opt to skip the pelvic exam and take that opportunity to focus on other important aspects of female health. This may include a discussion of birth control needs, fertility concerns, safe sexual practices, immunizations, nutrition optimization, exercise and weight control, familial risks, colonoscopies, mammograms and screening blood work.
I am not a fan of avoiding a routine annual check up for 3-5 years. Maybe it’s my age or the rapid changes I see in my female children that remind me how much can change in a year much less 3-5 years. Often, I am on the front lines diagnosing thyroid abnormalities, poor cholesterol profiles, depression, adult onset diabetes and cardiovascular disease.
A routine check up with your gynecologist is an important opportunity to review whole health. For women, this is particularly important as study after study repeatedly show the discrepancies in women’s health issues. With my young ladies we often talk about safe romantic relationships, how to balance blossoming careers and stress management. My moms…oh so many overlooked health issues for busy moms and so little time. We cover family planning, relationship counseling, nutrition and personal mental health. For those making biological life transitions there is much to review on hormones and whole health optimization as well as recommended preventive screenings. Many of my menopausal women “graduate” to an internist, but we are always available should a Gyn concern arise.
My recommendations… One, be your own health advocate by knowing your test results and your family history. Two, don’t skip an annual exam even if you are a candidate to skip the Pap. Three, come prepared with your list of health concerns to make the most of a routine check-up. Four, discuss timing of your next check-up.
I hope you see you soon. To schedule an appointment, click here or call the office at 512-83-OBJEN.