Perimenopause, Menopause, and Post-Menopause Pelvic Exams…..What The Pap?!?!?

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Unlike me, your days are probably not consumed with reading everything you can get your hands on that speaks about health issues relating to the vagina! Therefore, you might have missed the ongoing conversation in the medical world regarding pelvic exams.

I always say when it comes to the vagina, dry is out!  So brace yourself, this subject is a bit dry!

The U.S. Preventative Services Task Force’s (USPSTF) draft recommendation statement, “Gynecological Conditions: Periodic Screening with the Pelvic Examination” is a follows:

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women.”

The American College of Obstetricians and Gynecologists (ACOG) responded to the U.S. Preventive Services Task Force’s draft recommendation statement, “Gynecological Conditions: Periodic Screening with the Pelvic Examination” with the following recommendations:

“As the nation’s leading group of physicians providing health care for women, ACOG stresses that women should see their ob-gyns at least once a year. In addition to the screenings, evaluations and counseling that clinicians can provide, the annual well-woman visit is an opportunity for the patient and her ob-gyn to discuss whether a pelvic examination is appropriate for her. ACOG promotes shared communication and decision making between the patient and the physician regarding pelvic examinations.

The USPSTF’s draft recommendation statement concludes that there is not enough evidence to determine the benefits or harms of performing screening pelvic exams in asymptomatic, non-pregnant adult women for four specific conditions: ovarian cancer, bacterial vaginosis, genital herpes, and trichomoniasis.

ACOG is reviewing the USPSTF’s draft recommendation statement and the evidence upon which it is based to assess whether there is a need to update its guidance on the routine pelvic examination. ACOG recommends annual pelvic examinations for patients 21 years of age or older. However, the College recognizes that this recommendation is based on expert opinion, and limitations of the internal pelvic examination for screening should be recognized.

Notably, there are many women who are likely to benefit from a pelvic exam. For example, women who report or exhibit symptoms suggestive of female genital tract problems, menstrual disorders, vaginal discharge, incontinence, infertility or pelvic pain should receive a pelvic examination.”

The North American Menopause Society is urging public comment on the USPSTF routine pelvic exams draft evidence review. JoAnn V. Pinkerton, MD, NCMP, Executive Director of The North American Menopause Society (NAMS), along with the NAMS Executive Committee responded, “The pelvic exam is needed to screen for conditions such as the genitourinary syndrome of menopause that affects more than 50% of postmenopausal women, neoplasias (abnormal growth of tissue), fibroids, pelvic floor conditions, and dermatologic conditions associated with elevated disease risks. The recommendation to perform pelvic exams only if women complain of problems will lead to missed opportunities to diagnose pelvic issues.”

The opportunity for public comment on the draft review evidence expires on July 25, 2016, at 8:00 PM EST. To comment, go to USPSTF draft evidence review.

Here is my personal take on all of this, and it is not because I love putting on that “gown” and saddling up in those stirrups. My annual gynecologic exam is way more than a pap smear.  I want to be checked for vaginal atrophy, have my breasts examined by a professional (although David thinks he is qualified!) and also make sure that I am having the proper preventative screening labs and immunizations.

I think a healthy patient-doctor relationship, provides the foundation for a healthier me!

ACOG has some wonderful visuals on their current advice on Annual Well Women Healthcare.  They created these visuals with links to further explain each one!

Ages 40-64:
Screening
Laboratory and other tests
Evaluation & counseling
Immunizations

 

Ages 65 Years and older:
Screening
Laboratory and other tests
Evaluation & counseling
Immunizations

 

My motto is:  Suffering in Silence is OUT!  Reaching out is IN!

Download my free eBook MENOPAUSE MONDAYS The Girlfriends Guide to Surviving and Thriving in Perimenopause and Menopause.

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • givemeyouridiots

    As someone who was asymptomatic, but diagnosed with uterine pre-cancer from HPV in my thirties, I’m worried about those “missed opportunities.” I request a screening yearly, since the virus that causes HPV, like Herpes and the Chicken Pox, recedes and can recur. I had a doctor ask me once, “when are you going to stop worrying about it – you’ve had nothing but negative results for years?” I said, “Oh, I’m not worried. Every year I’m screened and know that everything is still fine.” The concern, as I understand it, is damage caused by further tests (that colposcopy was the most painful thing I’ve ever done, and I’ve had three surgeries), but the fact that cancer can be caught so early with such a simple test seems to warrant it’s regular continuation. Or is it a medical industry concern over the testing costs? If so, I wonder if they’ll stop asking men to turn their heads and cough?

  • honest reason

    I wonder if insurance policies would stop paying for the annual well women’s screening test?. Personally I feel that is better safe than sorry. My mother died of cervical cancer in te 70’s because she didn’t go for that annual test in 10 yrs!! We know now that it takes ten yrs for cervical cancer to develop, but back then doctors didn’t push it like now.

    • Thanks for sharing that info with us. I sure hope that our insurance plans don’t stop paying for our annual well women screenings! Grrrrrrrrrrrr!

  • Like mammograms there are different schools of thought on timely checks. I would rather have a root canal than a pelvic but I have had cancer and it is a no brainer to me to woman up and be checked and safe than risk a cancer not being caught in the early stages.

    • I was once invited to a baseball game. My response was, I’d rather have a pap smear!” I never was asked to a baseball game again!

  • One test women should definitely have is a transvaginal ultrasound to detect ovarian cancer. A woman I know runs the Ovarian Cancer Circle because her daughter died from the disease and highly recommends it.

    • Yep! Currently, this is the best test for detecting ovarian cancer

  • sue

    Thanks as always Ellen for keeping us informed. I actually do have regular testing in all areas including mammograms, pap smears. There is always so much new information so thank you for writing about it because most of us wouldn’t even know. Sue from Sizzling Towards Sixty.

    • Glad to hear that you take such wonderful care of YOU!

  • Cheryl Nicholl

    Of course they’re STILL important! My God, our bodies are still changing and there’s soooo much else to discuss. Thank God for people like you that just sort out the FACTS. Ignorance is OUT.

  • Wow, thanks for sharing your story, Linda. And….thank you for your sweet words.

  • Lois Alter Mark

    I love my gynecologist and go to see her every year religiously because I trust her to keep an eye on whatever’s going on. You can never have too much information when it comes to your health.

    • “You can never have too much information when it comes to your health.” So true, Lois!