With all the various and seemingly conflicting recommendations out there, it’s no wonder there’s confusion over how often you should see your gynecologist.
You go to your dentist twice a year, your general practitioner annually, make it to your dermatologist for your yearly birthday suit checkup… and you were equally diligent about making it to your gynecologist. But now, various new recommendations have left you confused about if an annual appointment is a necessity or not. And the truth is, there’s not one right answer for all women.
First things first — you should see your gynecologist regularly if:
- You don’t have a primary care physician. Many women prefer to see their gynecologists regularly as opposed to a general practitioner. If you fall in this camp, it’s important to see your OB/GYN annually and be sure to tell her you would like her to perform basic primary care tests, such as blood pressure checks and cholesterol screenings.
- You are trying to get pregnant. Your doctor can check to make sure you’re in optimal health to get pregnant and can discuss any genetic screenings that you and your partner may want to consider.
- You are pregnant. Your gynecologist can confirm a pregnancy and recommend an obstetrician for prenatal care throughout your pregnancy and delivery.
- You have any period problems, such as unusually heavy, painful or irregular periods. If your period is suddenly different that it once was, you should make an appointment to see your gynecologist and not wait for your next annual visit.
- You have multiple sexual partners and/or have unprotected sex and you’re not in a monogamous relationship. Some STDs, including various forms of HPV, gonorrhea and syphilis, don’t always have symptoms. Your doctor can perform a screening or test to make sure you don’t unknowingly have a STD.
- You are experiencing any pain or burning with intercourse or have growths on or around your vagina. If in fact, you have any of these symptoms, you should see your doctor immediately, regardless of if you’re due for your annual visit or not, for correct diagnosis and treatment.
The American College of Gynecologists (ACOG) currently recommends:
- Pap tests every three years to look at changes in the cells of the cervix that could potentially be precancerous or cancerous. This recommendation is for women between the ages of 21 and 39 years old.
- HPV (human papillomavirus) testing every five years for women 30 and older.
- Chlamydia and gonorrhea testing annually if you are sexually active and 24 years old or younger, and annually if you are 25 years and older with multiple sexual partners.
And remember that it doesn’t have to be your gynecologist that performs these tests.
“General well-woman exams, including pap smear and HPV testing, can be done by your primary care doctor,” said Sharon E. Orrange, MD, clinical associate professor of medicine at Keck School of Medicine of USC and primary care physician at Keck Medicine of USC. “Generally, your routine gynecologic care (mammography, pap smear and HPV co-testing) can be handled by your internist or family medicine doctor, so there is no need to visit a gynecologist unless your primary doctor refers you for abnormalities (abnormal pap smear or postmenopausal bleeding) or you are having active issues not addressed by your primary care doc.”
Here’s where the confusion comes in. The U.S. Preventative Services Task Force recommended that for “asymptomatic, nonpregnant adult women who are not at increased risk for any specific gynecologic condition,” that “the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic women for the early detection and treatment of a range of gynecologic conditions.”
So does this mean if you’re a healthy, monogamous woman who is not trying to get pregnant that you can forgo the pelvic exam and annual visit when you’re not due for any screening tests?
Not necessarily. ACOG issued a practice advisory that stressed that the Task Force findings were not a recommendation against regular pelvic exams and that “it does NOT mean that women should forgo seeing an obstetrician-gynecologist at least once a year for well-woman care. This preventive service visit also provides an opportunity for the patient and her obstetrician-gynecologist to discuss whether a pelvic examination is appropriate for her (shared decision making).”
If you are local to Southern California and are in search of a primary care physician, call (800) USC-CARE (800-872-2273) or visit www.keckmedicine.org/request-an-appointment/ to schedule an appointment.