This is a very common infection that is transmitted through sexual contact (oral, vaginal, and anal). There are numerous strains of HPV, some of which are linked to genital warts, which are non-cancerous growths that occur on the genital region. Other strains of HPV have the potential to cause certain types of cancer, including cervical, vaginal, and vulvar cancer.
Most sexually active people contract HPV at some point in their lives (any many people don’t know it!). However, most people who have HPV do not experience any symptoms and may clear the infection on their own without treatment. People who are young, healthy, and do not smoke are more likely to clear the infection. However, in some cases, the virus can persist and lead to abnormal cells that can become cancerous over time. Routine pap smear screening is so essential because it helps us detect these changes as early as possible.
Safe sex practices like using a barrier protection (condoms) and limiting your number of sexual partners can help reduce the risk of HPV transmission but does not eliminate risk altogether, because the virus can infect areas that condoms may not cover.
You may also be eligible for HPV vaccination (Gardasil). This vaccine protects you against the strains of HPV that are highest risk for causing cervical cancer. We recommend you discuss this with your doctor if you are under the age of 45, sexually active, and not previously vaccinated to see if you are a candidate for this.
Breast cancer is the most common type of cancer in women. Regular breast cancer screening with mammograms and breast exams in the clinic are meant to detect cancer at its earliest (and thus most treatable) stage.
Studies haven’t found any proven interval at which you should be doing self-breast exams at home, but we do promote breast self-awareness. What we mean by this is that no one knows your breasts better than you yourself, so make sure you’re well acquainted with how your breasts generally look and feel. If you do notice any changes, we encourage you to come see us!
We generally recommend mammograms beginning at age 40. Mammograms are breast x-rays. During a mammogram, flat plastic plates are used to compress the breast tissue while the x-ray pictures are taken, so this can be achy and uncomfortable, but know that this is generally short lived.
It is VERY common to be called back after a mammogram, especially if you haven’t had a mammogram before. This is because all people have irregularities in their breast tissue and doesn’t necessarily mean that the radiology team is concerned about cancer. In these cases, they’ll perform additional imaging to get better views of your breast tissue to make sure they’re not missing anything. This is even more common for people who have “dense” breasts. When you get your yearly mammograms going forward, the radiologists compare your new pictures to your prior ones to make sure things aren’t changing.
It’s important to know that these recommendations are for people at “average” risk, meaning that you may need more frequent or earlier screening if close family members have had breast cancer or if you carry certain genes that put you at higher risk.
There is a wonderful reference for all types of birth control, bedsider.org
A pap smear is a screening test that is used to detect any abnormalities in the cells of the cervix. It is a test specifically designed to tell us about cervical cancer risk. Unfortunately, this does NOT tell us about other reproductive tract cancers, like ovarian or uterine cancer. During a pap smear, your OB/GYN will gently place a speculum into your vagina and look at your cervix, then use a small brush to gently sample the cells of the cervix. This sample is then sent off to the lab for the cells to be looked at more closely.
Depending on your age or pap smear results in the past, your pap smear may also involve testing for a virus called human papilloma virus (HPV). This is a very common virus that is transmitted through sexual contact. Certain strains of this virus are known to be the cause of cervical cancer and pre-cancerous changes.
You do NOT necessarily need a pap smear every year. If all your pap smears and HPV tests have been normal in the past, we may recommend repeating testing for you in 3 to 5 years. However, we still do recommend coming to see us every year for your annual visit to make sure that you are otherwise doing well. If your pap smear results are abnormal, we will review these with you and make sure to let you know if you need more frequent pap smears or any additional testing.
The purpose of the annual exam is to assess and monitor the health of your reproductive system and screen for any potential issues. This includes a review of your medical history, pregnancy history, menstrual history, sexual activity, and discussion of any concerns. Your provider will perform a physical exam, which usually includes both a breast examination and pelvic exam.
The pelvic exam may consist of a few parts, including (1) a visual inspection of the external genital region for any signs of irritation, infection, or other abnormalities, (2) an internal exam using a speculum, which is an instrument that gently spreads the vaginal walls to allow your provider to examine the cervix and collect samples if necessary, and (3) a bimanual examination, where your provider may insert gloved, lubricated fingers into the vagina while gently pressing on the abdomen to assess the size, shape, and position of the uterus and ovaries.
Your provider will make sure that you are up to date on appropriate screening tests, which may include pap smears, testing for sexually transmitted infections (STIs), mammograms, bone density scans, and colonoscopies. If you are of reproductive age, your healthcare provider may discuss contraception options and provide guidance on choosing a suitable method based on your preferences and health considerations.
Throughout the exam, the healthcare provider will explain each step, answer any questions, and address concerns. Because the annual gyn exam is meant to be primarily for health maintenance, if you have any health concerns that require additional testing or a more in-depth discussion, your OB/GYN may recommend scheduling a separate GYN or “problem-focused” visit to ensure that your concerns get the time and attention they deserve