By Shyama S. Mathews, MD
“When should my daughter have her first gynecology visit?”
“How often should a woman be screened for cervical cancer?”
“Do I need to see the gynecologist every year?”
There can be a lot of questions and sometimes confusion when it comes to gynecological health. In many cases, women will simply do what their mothers did.
However, gynecologic care has advanced over the years, and what was right for mom back when may or may not be right for her daughter today.
If you have questions about your gynecologic health, don’t be shy. Talk to your doctor for advice.
In the meantime, you may wish to consider the following:
When should my daughter have her first gynecology visit?
The fact is, there isn’t a universal age when an appointment should be made with a gynecologist or primary care physician to discuss gynecologic health. Determining the best time to schedule an initial appointment depends on your daughter’s menstrual cycle and whether she is experiencing any problems. Often your pediatrician or family physician can help guide you in determining if your daughter should see a gynecologist.
Experiencing heavy, irregular, or painful periods is an important reason to schedule a visit. These symptoms can be signs of hormonal imbalances, endometriosis, ovarian cysts, and other conditions that can be treated and should be medically monitored.
Other reasons for an initial visit can include:
—Early or late onset of menstruation.
—Wishing to use a tampon but having difficulty placing one, which can be a sign of structural issues that can and usually should be corrected to prevent complications with intimacy in the future.
—The need for an open discussion about sexual activity, safety and contraception.
An initial gynecology visit usually does not involve any type of invasive exam.
When should a woman have her first Pap test?
The Pap test, also called a Pap smear, is a screening test used to find changes in the cells in the cervix that could lead to cervical cancer.
The American College of Obstetricians and Gynecologists (ACOG) recommends that women start having regular Pap screenings at age 21.
How often should a woman be screened for cervical cancer?
Here’s where it gets a little complicated.
Cervical cancer, which affects thousands of women each year, is most often caused by a common, sexually transmitted infection called HPV.
Most cases of HPV go away on their own and a woman will never even know that she had it. But, in some cases, the infection can stick around and lay dormant for years until it starts causing problems.
So, how often you should have cervical cancer screening, and which tests you should have, depends on your age and health history. Here are ACOG’s recommendations:
• Women who are 21 to 29 should have a Pap test alone every three years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
• Women who are 30 to 65 have three options for testing. They can have a Pap test and an HPV test (co-testing) every five years. They can have a Pap test alone every three years. Or they can have HPV testing alone every five years.
• After age 65, you can stop having cervical cancer screenings if you have never had abnormal cervical cells or cervical cancer. You can also stop testing if you’ve had two or three negative screening tests in a row, depending on the type of test, and if you do not have any new risks factors for HPV.
Because there are different options, it is especially important that you talk with your doctor about a screening schedule and approach that fits your individual needs.
Do I need to see the gynecologist every year?
Just because you may not have a Pap test every year, does not mean you should not go for an annual gynecologic check-up.
As ACOG states, the gynecologic visit is crucial for your overall health, and cervical cancer screening is just one small — but important — part of your exam.
During a routine visit, you and your doctor can discuss any concerns you may have about your gynecologic health, including pelvic pain, irregular bleeding, sex, and birth control.
Your doctor can also perform a breast and pelvic exam if necessary, and help you manage perimenopause and menopause.
How can I protect against HPV?
The best way to protect against HPV and reduce the risk for cervical cancer is to get the HPV vaccine before you become sexually active and are exposed to the virus.
The ideal age for HPV vaccination of girls and boys is 11 or 12, but it can be given starting at age 9 and through age 45.
The vaccine is a series of two or three shots. When the series is completed, it can reduce the risk of cervical cancer and genital warts (another condition caused by HPV) by 99 percent, according to ACOG.
The most common side effect of the HPV vaccine is soreness and redness where the shot is given. There have been no reports of severe side effects or bad reactions to the vaccine.
In addition to the vaccine, using protection during sex can also help reduce the risk of HPV infection.
What if I missed my annual exam or routine screening because of COVID-19?
You’re not alone. Over the past 18 months, a lot of people skipped their screening exams for a wide variety of health issues, including cervical cancer. The medical community is anticipating that this will result in missed or late diagnoses of many conditions.
Now, as more people are vaccinated and life is opening up a bit more, it is time to schedule your annual wellness and screening visits.
Penn Medicine Princeton Health has taken extra steps to make sure all care environments are safe for patients and providers. Waiting rooms and patient care areas are regularly and rigorously cleaned and disinfected; masks are required for all staff, patients and visitors; physical distancing is practiced; and new processes such as contactless check-in and check-out have been implemented.
Additionally, all employees and clinical staff are required to be vaccinated against COVID-19 by Sept. 1.
To find a physician with Penn Medicine Princeton Health call 888-742-7496 or visit www.princetonhcs.org.
Shyama S. Mathews, MD is a board certified gynecologist, minimally invasive gynecologic surgeon, and a member of the medical staff at Penn Medicine Princeton Health.