Importance of a woman’s annual exam at gynecologist

One of the most dreaded things that is on a woman’s to-do list is going to the gynecologist to have a pap smear. Recently the guidelines for pap smears and annual visits to the gynecologist have changed.

How often does a patient need to see a gynecologist and what exactly is done at an annual exam other than a pap smear?

An annual exam is much more than a pap smear. An annual exam involves a thorough examination and health history. It may also involve a discussion about contraception and sexual health. Oftentimes, underlying problems about bleeding or pain are discovered and will require a follow-up visit.

The examination is head to toe and involves listening to a patient’s heart and lungs, performing a breast exam, and a complete pelvic exam. A complete pelvic exam involves looking at the external genitalia for any abnormalities and performing an internal exam to palpate the ovaries and uterus. A gynecologist looks for signs of prolapse or abnormal descent of the pelvic organs or tissues. If any abnormalities are discovered appropriate imaging, labs or sonograms may be ordered.

A physician also ensures the patient is up-to-date with all of the screening tests that are required depending on her age. These screenings can include a mammogram, colonoscopy or bone density evaluation for osteoporosis. A pap smear may also be performed. A pap smear involves gently collecting cells from both the external and internal portions of the cervix and sending off the specimens for evaluation for precancerous cells or the presence of HPV.

There are three types of cervical cancer screening types: HPV testing — looking for the presence of this virus associated with cervical cancer; Cytologic testing — looking at the cells of the cervix and evaluating for abnormalities; and CO-testing — simultaneously performing both HPV testing and Cytologic testing.

How are the guidelines for cervical cancer screening determined?

The American Society for Colposcopy and Cervical Pathology is one of several organizations that set up guidelines around cervical cancer screening that providers look to, and they assist in determining the cadence and types of diagnostic tests and treatments each patient requires based on her individual needs. We use guidelines in conjunction with talking with and understanding each woman’s risk profile to create a screening schedule and minimize the incidence of cervical cancer. Guidelines can feel complicated because recommendations around screening vary based on risk. What does this mean? A patient’s current and past results are taken into account to determine risk of developing cervical cancer over time, and from there, we use guidelines to help develop a longterm screening plan. Please know confusion around guidelines can be mitigated simply by talking to your doctor about your unique body and circumstances.

So, what does this all mean for your health and your annual well-woman visits?

The long and short of all of this is cervical cancer screening is complicated, but necessary and effective. An annual trip to the gynecologist is still recommended regardless of your individualized pap interval. Be an active participant in your health care as preventative care is integral to leading a healthy lifestyle.