Annual Exams
An annual women’s wellness exam visit is a great opportunity to take charge of your health. Routine annual wellness exams can help detect problems early and prevent health problems before they even occur. If problems are found early, they may be easier to treat and less likely to pose serious risks to your health.
Many screening protocols have changed over the years but most women should have a cervical cancer screening every 1-3 years, a pelvic exam and breast cancer screening as appropriate depending on individual risk factors and age.
Talk to your provider about other screening tests that may be appropriate for you like cholesterol testing, diabetes screening, osteoporosis screening, and colon cancer screening.
STD (Sexually Transmitted Diseases) Testing and Treatment
Sexually transmitted diseases (STDs) are caused by infections that are passed from one person to another during sexual contact.
These infections often do not cause any symptoms. Medically, infections are only called diseases when they cause symptoms. That is why STDs are also called "sexually transmitted infections." But it’s very common for people to use the terms "sexually transmitted diseases" or "STDs," even when there are no signs of disease.
There are many kinds of sexually transmitted diseases and infections. And they are very common. More than half of all of us will get one at some time in our lives.
The good news is we can protect ourselves and each other from STDs! Consistently practicing safer sex will reduce your risk of getting sexually transmitted diseases. And if you're worried that you might be at risk of infection, a simple blood or urine test can tell you if you and your partners need treatment. Sexually active young adults should consider routine STI screening twice a year since many young men and women do not display infection symptoms for many weeks.
HPV Testing: Who Should be Tested and Why
Human papilloma virus (HPV) is the known cause for virtually all cases of cervical cancer. At least 80% of sexually active adults will have HPV during their lifetimes. Most people infected with HPV will simply clear the disease on their own without any complications. Some, however, may have persistent disease which can lead to an increased risk for certain kinds of HPV related cancers like cervical or esophageal cancer.
HPV testing in women is usually conducted as part of routine cervical cancer screening. Women under 21 years old are presumed to have HPV and therefore routine cervical cancer screening is not recommended if you are under 21. Routine pap testing should start at age 21 but don’t be alarmed if you discover that you have an HPV infection even if you’ve been vaccinated! These infections are usually not a cause for alarm and experience now tells us that most HPV infections will just go away without any treatment.
So What is an HPV Test and Who Needs One?
The HPV test checks for the genetic material (DNA) of the human papillomavirus. Like a Pap test, an HPV test is done on a sample of cells collected from the cervix .
There are many types of HPV. Some types cause warts that you can see or feel. Other types do not cause any symptoms. Most people do not know they have an HPV infection.
This test will show whether a high-risk type of HPV is present. High-risk types of HPV (such as types 16, 18, 31, and 45) can cause changes in the cells of the cervix that can be seen as abnormal changes on a Pap test. Abnormal cervical cell changes may resolve on their own without treatment. But some untreated cervical cell changes can progress to serious abnormalities and may lead to cervical cancer over time if they are not treated.
Although HPV is found in both men and women, this test is not used on men. The HPV test is usually used to detect only high-risk types of HPV. Your doctor may diagnose genital warts that are seen during a physical exam. This test is not used to diagnose genital warts caused by low-risk types of HPV which are generally harmless.
If you are under 30, you don’t need a routine HPV test. HPV testing will be done if your pap smear shows atypical cells. If your pap smear shows low grade changes, then it is assumed that this is due to HPV and additional testing is not usually offered. If your pap test shows high grade changes, then you will need additional testing to determine whether or not a pre-cancerous condition is present.
In women under 25, these types of minor pap abnormalities are usually followed up by repeat pap testing within the year. If you are 25 or older, talk with your provider about what type of additional screening tests they might recommend for you. If you are told that you have high grade findings on your pap test, you will need close follow up to ensure that your condition does not progress to a serious pre-cancerous condition.
Women who are 30 and older should have a combined pap and HPV testing as part of their routine health maintenance. It is possible to have a completely normal pap smear and still have a positive HPV test. If the HPV test is positive, then women in this category should continue with yearly pap smear screening tests rather than every 3-5 years. Talk with your provider at your next annual check up about HPV screening to see if the test is right for you.
