Dr. Carolyn's Corner
THE ANNUAL EXAM: IT'S MORE THAN JUST A PAP SMEAR
Since the screening guidelines for cervical cancer have recently changed, most women are no longer recommended to have the “dreaded” yearly pap smear. Because of this, many of us think that we don't need the annual, or well woman exam. However, let's stop for a moment and think about it: the annual exam is more than just a pap smear!
In fact, the pap is just a small part of the exam. The annual visit with the doctor is a great opportunity for other routine screening, evaluations, age-related vaccinations, and counseling to be carried out. These will vary, depending on the patient's age group and personal needs.
The American College of Obstetricians and Gynecologists recommends that the first female health visit occur between ages 13 and 15. This introduces young teenagers to the idea of taking care of their bodies and making good health choices. It also helps establish a relationship with a gynecologist who can provide care for them for many years to come. The first visit does not always involve a physical exam, and only rarely is a pelvic exam done. At the end of the visit, ideally the patient will feel comfortable knowing where she can turn to for reliable information about such things as pelvic pain, irregular periods, sexually transmitted infections, and contraception.
Annual breast and abdominal exams should begin at age 19, and routine pelvic exams and pap tests begin at 21. Of course, pelvic pain, menstrual problems, and sexual activity may make it necessary to have these exams sooner.
Women 30 years of age and older who have had normal routine pap tests should continue to have them every 2-3 years, but still have an annual gynecological exam. This includes a clinical breast exam, as well as a pelvic exam that involves a careful inspection of the external genitalia (vulva), examination of the vagina and cervix (using a speculum), and a bi-manual examination of the uterus, ovaries and rectum (none of which can be seen, but rather are palpated for possible abnormalities).
The well woman visit should be looked upon as a very important part of preventative healthcare. Nutrition, exercise, sexual activity, tobacco, alcohol, and drug use all contribute to one's health and overall wellbeing. Each of these may be addressed at the visit.
Find a physician that you feel comfortable with when discussing personal and intimate issues. It's much easier to get through the exam if you aren't also battling a case of nerves and embarrassment! Remember that you and your doctor are partners when it comes to your health. Do your part to keep up this relationship by making and keeping your annual exam appointments.