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Do you need to see your gynecologist every year?

Recommendations no longer support annual visits—but every woman is different.

It feels good to know that we’re staying on top of our health, whether we’re having our teeth cleaned every six months, getting regular eye exams, or seeing our doctor for a check-up. Many of us have come to rely on our annual gynecological visit as a time to check on our health, to make sure our female organs are in good working order.

But do we really need to see our gynecologist each year for a check-up? The answer used to be yes, in part to ensure we got regular Pap tests to screen for cervical cancer. However, new cervical cancer screening guidelines recommend less frequent Pap tests for younger women and no Pap tests for many older women, which may mean many of us no longer need this annual health ritual.

New Pap test guidelines

In 2012, the U.S. Preventive Services Task Force, American Cancer Society, and American Congress of Obstetricians and Gynecologists (ACOG) issued the following revised recommendations on Pap tests:

Women ages 30 to 65 who have had negative Pap test results in the past should have a combination Pap and human papillomavirus (HPV) test once every five years.

Women ages 65 and older do not need to have Pap tests, as long as they have no history of precancerous cells or cervical cancer, and they’ve had either three consecutive negative Pap test results or two consecutive negative Pap/HPV tests within the previous 10 years.

Women who have had a hysterectomy and no longer have a cervix do not need Pap tests, unless they’ve had precancerous cells in the cervix or a reproductive cancer in the past.

The new recommendations stem from a better understanding of how cervical cancer develops, says Dr. Martha Richardson, assistant clinical professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School. “People don’t develop cervical cancer very rapidly. There are very clear precancerous stages that take years to progress,” she says.

Research has shown that most cervical cancers are caused by specific types of HPV, a virus that is sexually transmitted. Dr. Richardson says that, given what we now know about the causes and course of cervical cancers, “to do a yearly Pap test is overkill. And for young women—under 30—in particular, frequent Pap tests have led to way too much diagnosis and treatment for conditions that are not likely to spread.”

Gynecologist visits

When you do see your gynecologist, these tips from Dr. Richardson can help you make the most of your visit.

  • If you haven’t done so already, find a gynecologist you trust—one you feel comfortable calling on when related health issues arise.

  • Keep in touch with your gynecologist in between visits. Ask your doctor if you can email or call with any questions or problems.

  • Before your appointment, write up a list of issues you want to discuss, and tell your doctor about them at the start of your visit. Don’t wait until the doctor is about to leave the room to bring them up.

  • Keep track of your medications and screenings. Tell your doctor whether you’ve had your mammogram, Pap test, vaccinations, colonoscopy, and bone density scan, and find out when you’re due for your next screenings.

Do you still need a yearly pelvic or well-woman exam?

If you’re not having an annual Pap test—and you don’t have any worrisome symptoms—is there any reason to still get a yearly gynecological exam? “The answer is there’s no evidence that it’s valuable,” according to Dr. Richardson. A 2011 article in the Journal of Women’s Health suggests the routine pelvic exam might even be “obsolete.” The article says many of the reasons for doing a pelvic exam—including screening for sexually transmitted infections (STIs) and detecting ovarian cancer early—may not be needed or are covered by other tests.

Even so, ACOG stands behind the annual well-woman visit. The organization says these visits are a time for women and their doctors to discuss

  • personal health and family medical history

  • diet and exercise

  • pelvic prolapse

  • menopause symptoms

  • sexual practices

  • neglect or abuse

  • incontinence

  • height, weight, body mass index (BMI).

Yearly visits might also include

  • a bone mineral density screen

  • a cervical cancer screen

  • a clinical breast exam

  • a colorectal cancer screen

  • a diabetes test

  • a pelvic exam (depending on your age and health)

  • a mammogram

  • a thyroid test

  • tests for STIs.

What should you do?

With guidelines on well-women visits and pelvic exams unresolved, should you visit your gynecologist every year, less often—or not at all? “Do I really think that women need to see a gynecologist once a year? No way,” Dr. Richardson says. “But there are health and quality-of-life issues that may not be optimally addressed if they don’t see a gynecologist. Your gynecologist may be better equipped than your primary care provider to address issues related to hormone therapy, sexual function, and the female reproductive system,” she says.

Ultimately, whether you see a gynecologist—and how often—will be determined by your health history, any current issues you’re having, and your personal preference. You should be visiting at least one doctor—whether it’s your gynecologist or primary care provider—with some regularity to have your blood pressure, body mass index, and cholesterol checked, discuss what screenings you need, and stay on top of other health concerns. And if you have any reproductive symptoms—such as vaginal pain or abnormal bleeding—then it’s definitely time to schedule an appointment.

Posted by: Dr.Health

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