Although it’s not an appointment that most women look forward to, an annual gynecologic exam is an important part of a woman’s health care. For some women it may be the only medical exam that she has all year. For this reason, it should be more than just a pap smear and breast exam. The relationship that develops between a woman and her healthcare provider should be one of respect, trust and confidence. A Certified Nurse Midwife is a skilled health care professional who is trained to provide gynecologic services for women of all ages.

The age at which a girl begins gynecologic exams depends on her menstrual history and sexual activity. Ideally, after discussing her situation with a parent or trusted adult, a girl should consult a gynecologic provider to assure accurate information, health screenings and guidance. According to the American College of Obstetricians and Gynecologists, a woman should begin gynecologic exams including Pap smear screenings, by age 21 or within three years of becoming sexually active. A Pap smear is designed to screen for cervical cancer. It is a simple, relatively painless test that samples cells from the cervix in order to identify early stage cellular changes before they become truly abnormal. Along with the Pap smear, it is highly recommended that women get tested for high risk HPV (human papilloma virus). This can be accomplished from the same sampling as the Pap smear. Pap smear screening plus HPV dramatically improves the predictability of cervical health. The frequency of pap smear screening depends on a patient’s results, personal medical history, and sexual activity.

Along with a complete pelvic exam, a woman can be tested for sexually transmitted infections. While cervical infections can cause symptoms such as vaginal discharge, irritation, and pelvic pain, more than 60% of women with an infection experience no symptoms at all. Chlamydia, Gonorrhea, trichomonis, bacterial vaginosis, Group B strep and yeast can all be tested.

Assessing the state of pelvic floor strength and degree of uterine and vaginal prolapse should also be a part of every gyn exam. Many women experience urinary problems such as stress incontinence or urgency and frequency. Discussing these concerns with your provider can lead to successful interventions and alleviation of symptoms.   

The gynecology visit should also be a time to discuss concerns about menstrual cycle changes, PMS, perimenopausal or menopausal symptoms. Many of these issues can be addressed through saliva hormone testing. Screening tests such as mammograms, breast thermograms, bone density (Dexa) scans and pelvic ultrasounds can all be arranged if needed. Other general tests that should be scheduled include cholesterol, blood sugar and thyroid laboratory screening for women over age 20. Colorectal exams should begin at age 50. A Certified Nurse Midwife can arrange for all of these important tests.

An annual gynecologic visit is a perfect time to address many other health issues and lifestyle concerns. Your medical provider should review your immunizations and ensure that you are up to date on vaccine schedules. Discussing life and health goals can also be a part of a thorough gyn exam. Clearly, contraceptive options and family planning is often discussed at a gyn exam. Take advantage of this visit, however, to review optimal nutrition, weight, body composition, and stress management.   

Think of a gynecologic visit as a time to focus on optimal health and wellness planning. A relaxed and personalized visit should make this an appointment to look forward to, not to dread.