Many women consider an annual appointment with the gyno to be a given, as essential to responsible self-care as a twice-yearly trip to the dentist or a flu shot in the fall. But other women . . do not. Less than half of American women see a gynecologist or OB-GYN yearly, and that percentage has been declining. If you’ve been wondering how often to see the gynecologist, and what’s in it for you, check out these five little-known factoids.
You might not need a Pap smear.
Thinking about the OB-GYN probably calls to mind placing your feet in cold metal stirrups, and the pinching of the Pap smear that follows…and ranks right up there in the delightfulness quotient as getting a tooth yanked. But an annual Pap smear is so last century. According to the American College of Obstetricians and Gynecologists (ACOG), women in their twenties only need a routine Pap test every 3 years, while women aged 30-65 can stretch that interval out to 5 years if they have an HPV test at the same time. Certain strains of HPV, or human papillomavirus, are associated with virtually all cases of cervical cancer, so if your HPV test is negative that means you don’t need to worry about cervical cancer or precancerous changes for a while. And most women over the age of 65 can skip the test entirely.
If you’re really squeamish about those stirrups, one option is to test yourself for HPV in the privacy of your own home. Home HPV test kits allows you to swab your vagina yourself, then break the tip off the swab off, insert it into a special container, and mail it in to a lab for analysis. If it turns out you are carrying at least one of the high-risk strains, you can go see a gyno in-person for additional screening like a Pap smear.
A pelvic exam is different from a Pap smear.
It’s easy to get confused, but they are actually two very different things. A Pap test screens for cervical cancer. Your gyno uses a small spatula and brush to collect cervical cells, then sends them off to a laboratory for analysis. A pelvic exam looks for signs of fibroids, ovarian cysts, or even ovarian cancer. Your gyno inserts two fingers into your vagina and then places her hand on the outside of your belly to check your cervix, uterus, ovaries and fallopian tubes.
While docs used to recommend all women get pelvic exams every year, the thinking on that, like Pap smears, has changed. The American College of Physicians and ACOG now say that if a woman is healthy and not complaining of any symptoms like pelvic pain or bloating, she may not even need one. They’re not very effective at picking up conditions like early-stage cancer, they’re uncomfortable, and they may also raise your risk of having other medical tests or even surgery that turn out to be unnecessary.
Your gyno can be your primary care doctor.
At this point you may be thinking, “If I don’t need an annual Pap or pelvic exam, why see a gyno at all?” but there are still good reasons to see one regularly. In fact, if you’re healthy, your gyno can serve as your primary provider. Groups like ACOG recommend OB-GYNs do things like check your height, weight and blood pressure, take a careful family history, screen you for depression, make sure you’re up to date on all your vaccinations, and, if it’s appropriate, send you off for bone mineral density or colorectal cancer screening. (You can find a list of age-appropriate evaluations and screenings here.) Just keep in mind that if you do have a chronic disease, such as high blood pressure or type 2 diabetes, your OB-GYN may refer you to an internist (someone who focuses on primary care) or a specialist for your condition.
You need to ask for STI testing.
Less than half of women aged 15-24 get screened for common sexually transmitted infections such as chlamydia or gonorrhea, even though they should. The federal government’s Centers for Disease Control and Prevention has set specific guidelines for screening if you’re a sexually active female. They include:
- If you’re under age 25, get tested for gonorrhea and chlamydia every year.
- If you’re over 25 but have a new partner, or multiple sex partners, get tested for gonorrhea and chlamydia every year.
- You should be tested at least once for HIV if you’re in your teens or 20s. If you’ve had unsafe sex with someone and you don’t know their HIV status, you should also get screened.
- If you’re pregnant, you should be tested for syphilis, HIV, and hepatitis B early in pregnancy.
OB-GYNs don’t always test for STIs if you don’t ask, so if you’re sexually active and your doctor doesn’t raise the issue you should. You can also test yourself for common STIs with a home test kit.
There’s no need to be embarrassed, ever.
When it comes to your below-the-belt woes, your gyno has seen and heard honestly everything. So, while you may be mortified that your nether regions seem to smell like a fish market, or by the fact that you pee whenever you cough or sneeze or feel pain in a certain sex position, she won’t bat an eye. It’s also important to tell her about these pesky signs, since they could indicate a potentially serious condition such as a vaginal infection or something like a fibroid. Oftentimes, these problems are also easily fixable and can be solved with something as simple as a medication change or a few sessions of pelvic physical therapy.
You also shouldn’t sweat it if you haven’t had time for a close shave or a bikini wax, because your gyno is more focused on your lady bits rather than, er, all your trimmings. Ditto if your period and check-up coincide. You won’t gross your gyno out—for her your most private goings on are just another day on the job.
About the Author
Hallie Levine is an award-winning journalist who has covered health and wellness for more than twenty years for publications including Consumer Reports, The New York Times, Health, Prevention, Time, Reader’s Digest, Parents, Good Housekeeping, and Redbook.
This blog provides information about telemedicine, health and related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.