What if I’m not due for my pap, do I still need an annual exam?
While you may not need a pap test done every year, it’s still recommended to visit your gynecologic provider yearly for an annual ‘well woman exam.’ At this visit, your clinician will check your blood pressure and weight, screen you for STI’s, review other recommended screenings based on your age, and discuss birth control or reproductive concerns. We also recommend discussing with your provider any issues you have related to your sexual experiences. Such as if you’re experiencing any pain or have any concerns about desire, arousal or orgasms. Many women do not feel comfortable bringing these topics up with their gynecologic providers, but it’s important to do so. Additionally, your clinician will likely do a breast and a pelvic exam at this visit, although that may be changing in the future. The pelvic exam consists of inserting a speculum so that the clinician can visualize the vaginal walls and cervix. After the speculum exam, the clinician then inserts 2 fingers into the vagina and places her other hand on your lower abdomen. She then presses her hands together to feel the cervix, uterus and ovaries in between her two hands. For many women, the speculum and bimanual exam are very uncomfortable. And now there is new information stating that these exams don’t yield any important information in most women, and therefore, may not be necessary.
Several years ago, an expert panel appointed by the American College of Physicians published new guidelines that healthy, low-risk, asymptomatic women do not need to have pelvic exams done annually. The panel based this new recommendation on a comprehensive, systematic review of prior studies, which found that not only was there NO benefit to doing a pelvic exam in asymptomatic women, but that it actually could cause harm, not only in discomfort/distress to the patient, but that it even led to unnecessary surgical procedures. A pelvic exam continues to be universally recommended for women who ARE experiencing gynecologic, reproductive, or pelvic concerns. For these women, the exams can yield crucial information.
It is important to note that the American College of Obstetricians and Gynecologists (ACOG) continues to recommend an annual pelvic exam for all women, even though ACOG does acknowledge that there is not enough evidence to support this practice. Most OB/GYN’s follow the guidelines of their governing body, which is ACOG, so your provider may not have adopted these new recommendations. However, information is evolving; if you are a healthy, asymptomatic, low-risk women, please discuss this with your provider.