Tamara R. Pringle, MD, FACOG
Bon Secours Richmond Ob-Gyn
You are not a cookie, so you shouldn’t have cookie cutter healthcare! While physicians use evidenced-based “recipes” to achieve the best possible outcomes for our patients, your healthcare should also be personalized to your specific needs and circumstances.
An important part of obtaining personalized health care is the annual well woman visit. This visit should include screening, counseling, and immunizations based on your age and risk factors. Not only is the visit valuable as preventive medicine, it is also important for developing the patient-provider relationship.
An annual well woman exam may also include a pelvic exam that can help identify factors contributing to heavy periods, incontinence, and sexual dysfunction. A pelvic examination can allow for evaluation of infections, cervical cancer screening and recognition of abnormal conditions. The decision to perform a pelvic examination should be a shared decision between the patient and the health care provider.
While annual well woman visits are important, annual Pap smears are no longer recommended for low-risk patients. The updated screening intervals are designed to facilitate the prevention and early detection of cervical cancer, while reducing the risk of unnecessary interventions,
According to the 2012 American Cancer Society (ACS) and American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines, cervical cancer screening should begin at age 21. Between 21 and 29 years old, women should have a Pap smear every three years. From 30 until 65 years old, the preferred screening schedule is a Pap smear and a high-risk HPV (human papillomavirus) test every five years. Alternatively for this group, a Pap smear with no high-risk HPV test could be obtained every three years. Women over 65 years old or who have had a total hysterectomy (with removal of the cervix) may no longer need cervical cancer screening.
However, these guidelines do not apply to individuals who are immunocompromised, have cervical cancer or pre-cervical cancer changes, or have been exposed to DES (diethylstilbestrol).
In summary, while Ob-Gyns and healthcare professionals have recommended guidelines for providing annual health assessments for women, it is important to discuss your individual plan with your provider and make sure that it is properly tailored to you, and not just cookie cutter care.
Dr. Pringle is an Ob-Gyn with Bon Secours Richmond OB-Gyn at the St. Francis Medical Center. She is board certified in Obstetrics and Gynecology, a fellow of the American Congress of Obstetricians and Gynecologist and has been practicing since 2005.