The Doctor Is In: Let’s Talk About The New Pelvic Exam Guidlines

As you may or may not know, there was a recent recommendation made regarding how often women should be getting pelvic exams. Since most of us are used to getting them yearly and the new recommendation is to get them every 3 years, I asked Dr. Lissa Rankin what she thought. Here is what she has to say:

The American College of Obstetricians and Gynecologists recently announced new recommendations that cut back on Pap smear screening. Why are we recommending cutting back on women’s health screening? Let me fill you in on the news.

New Pap Smear Guidelines:

1. Instead of recommending that Pap smear screening begin after you’re sexually active, new guidelines say that even a sexually active 13 year old should wait until 21 for her first Pap.
2. After 21, Pap smears are recommended every 1-2 years until age 30.
3. After 30, if you’ve had three consecutively normal Pap smears with no history of a seriously abnormal Pap, new guidelines say you only need to do Paps every three years.

Why the Change?

There is evidence to support the changes.  The truth is that you’re unlikely to go from having a normal Pap smear to having cervical cancer in 3 years, even if you contract HPV. Because cervical cancer grows slowly, it’s still likely to be precancerous by the time it gets picked up. And yearly screening does increase the number of procedures performed, and some of those procedures can affect fertility and pregnancy in rare cases.  Plus, cutting back on Pap smears saves health care dollars. And if we’re not saving lots of lives and potentially causing harm by implementing procedures that may not be necessary, why do annual Pap smears?

I understand why they’re recommending pushing back the age of first Pap smear.  HPV, the virus that causes cervical cancer and abnormal Pap smears, is almost ubiquitous among teens. As such, doing Paps will lead to many abnormal results that would require colposocopies, biopsies, and other possible treatments. If left untreated, the issues would resolve themselves, meaning these procedures (and potential risks) are not necessary.

BUT (and this is a gigantic BUT) there is a GINORMOUS problem here that carries far-reaching consequences for women’s health. Though women come to the gynecologist under the guise of their annual Pap smear, they actually come for WAY more than that.

Here are some examples of issues I handle under the guise of an annual Pap smear exam:

* Sexual problems that threaten your relationship
* Debilitating depression and anxiety
* Chronic fatigue that prevents you from living vitally
* Menstrual disorders like hemorrhaging or menstrual cramps that cause you to miss important life functions.
* PMS/PMDD that may be hampering a happy life

And that doesn’t even include the oh-so-necessary annual breast exam, internal pelvic exam to check for ovarian tumors and such, and the opportunity to make sure a woman is up to date on other cancer prevention procedures, such as the HPV vaccine for teens.

If women don’t come in for their annual pap smear, how will they ever fix the other problems that may exist?

The Bottom Line
Based on the information presented, it is totally up to you if you want to get an annual pap smear or stretch it out a few years. Regardless of what you decide, though, please don’t stop seeing a doctor every year. That is the only way to sort out any issues you have, especially those you don’t even know about.

–Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community ( or read more of her writing at Owning Pink (

Holiday Gifts for The Health Freak
Holiday Gifts for The Health Freak
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