We've prepared a quick pop quiz for you, dear readers. Ready?
Let's begin!
1) How often should a healthy, sexually active person in their reproductive years get a pelvic exam?
a) Every six months, like visiting the dentist
b) Once a year, unless you are having any abnormal symptoms
c) Every three years, based on the CDC recommendation for how often you should receive a Pap smear
d) If you are healthy, you do not need a pelvic exam
2) When you go to visit the OB/GYN, all providers will offer you the same services:
a) True
b) False
3) Standard sexually transmitted infection (STI) screenings include (check all that apply):
a) Every possible STI
b) HIV
c) Herpes
d) Chlamydia
e) Gonorrhea
f) Syphilis
g) HPV
4) When you go for a regular women’s health checkup, you will be required to (check all that apply):
a) Take off your clothes and put on a paper gown
b) Step on a scale to get weighed
c) Get screened for STIs
d) Get a Pap test
e) Allow the health care provider to share your medical information with parents or partners
f) All of the above
g) None of the above
5) Your health care provider will sleuth out your health concerns. If you don’t mention something, they'll probably figure it out anyway.
a) True
b) False
Feeling confident that you know the answers?
In order to get to the bottom of some of these classic myths about visiting the OB/GYN, I interviewed Dr. Lauren Streicher.
Streicher is an associate clinical professor of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine in Chicago, Illinois and the medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.
With her help, let’s clear up the previous questions.
1) How often should a healthy, sexually active person in their reproductive years get a pelvic exam?
Answer: b) Once a year, unless you are having any abnormal symptoms
In 2012, the CDC released new guidelines for how often a person should receive a Pap test. Women aged 21 to 29 years old should receive one every three years. Women aged 30 to 65 should receive a Pap and HPV test together every three to five years.
There is a common misconception that recommendations for receiving a pelvic exam also changed. It is still best if you visit your health care provider for a pelvic exam once each year.
A Pap test is not the only test that a doctor/nurse practitioner likes to do during your checkup. From doing — or better, teaching YOU to do — breast exams to determining your risk for contracting an STI, to discussing how you are feeling about your own mental health, a visit with a health care provider is a very important time for assessing your general wellness.
Once every three years is not enough.
Keep in mind that a primary care visit for a general physical exam is also very important. OB/GYNs and women’s health nurse practitioners are trained to focus on your reproductive and sexual health, but primary care providers are better suited to manage any questions or concerns about general health.
Moreover, if you believe something is wrong, don’t wait to get it checked! Clinics and doctors offices usually save time in their schedules every day for urgent appointments — for example, suspected bladder infections or exposure to a sexually transmitted infection.
2) When you go to visit the OB/GYN, all providers will offer you the same services
Answer: b) False
If you have been to more than one doctor in your life, you KNOW that each medical professional practices with their own style. They have their areas of strength and expertise, their own manners of approaching various issues and their own standard care practices. This does not necessarily mean that some health care providers are BETTER than others, just that you may find a style that best matches your preferences.
For example, I prefer to see a female provider that asks me questions about my sexual activity without assuming that I am monogamous or heterosexual, and who collects my medical history while I am still wearing my own clothes. She would explain everything that she is doing and the rationale behind it before she actually does it, and she will be able to provide me care before and during pregnancy and delivery.
YOU may have totally different preferences! So do your research for providers that meet YOUR needs.
3) Standard sexually transmitted infection (STI) screenings include (check all that apply):
Answer: THIS IS A TRICK QUESTION! The answer is that it TOTALLY depends. (See above… each provider practices differently!)
There is truly no standard set of screenings that are offered, so as a patient, we cannot assume that we are being tested for each specific infection (or even tested at all!) unless we ask about it.
One example: As discussed above, many people are confused about whether they will automatically receive a test for human papillomavirus (HPV) as part of a Pap test or regular pelvic exam.
HPV is the most common STI and certain strains have been found to cause cancer ... but it is NOT automatically included in your lab workup. So advocate for yourself and ASK if you aren’t sure what tests you are receiving.
Some STIs are very rare, very expensive to test for, and/or very distinctive in their presentation. If you don’t meet the risk factors for exposure and are not experiencing any symptoms, it is very likely that you will NOT be tested for some of these less common STIs. UNLESS you ask.
Chlamydia and gonorrhea tend to be asymptomatic, especially in women. They are also extremely common. It is very possible you will be tested for these during a Pap smear.
Herpes on the other hand, though common in some forms, is rarely tested for unless a patient describes specific symptoms, concern about exposure, or is pregnant. Some providers test every single person that walks through their doors for HIV as a precaution, some do not. Again — do your research!
4) When you go for a regular women’s health checkup, you will be required to (check all that apply):
Answer: g) None of the above
None. I repeat. None. Of these items is required of you. If you do not want to remove your clothes, you do not have to. Many health care providers are happy to examine you with your own clothes on, as long as they can access the areas of your body that they need to.
Streicher emphasized that if you do not want to step on a scale or discuss your weight, you do not have to. There are a few cases — but not many — where your weight will be medically relevant to your reproductive and sexual health. You can choose to discuss any concerns about this in a different appointment.
As discussed in previous questions, it is not guaranteed or expected that you will receive a Pap test or be tested for STIs during your annual visit. If you have specific concerns that suggest either of these tests might be appropriate, it is likely your health care provider will recommend them, but STILL — it is your right to accept or refuse EVERY SINGLE test, exam or inquiry.
Finally — this is a biggie — although different states have different legal requirements about what kind of medical information can be disclosed to a minor’s parents, there are very few specific cases in which health care providers are REQUIRED to report any specific health information to anyone that isn’t the patient.
Many STIs however must be, by law, reported to the health department.
Health records are private and your provider should make sure you are comfortable with and aware of any disclosure laws. If they don’t do this, ask!
If you want to read more about states’ policies regarding parental notification in case of a minor’s medical records, please check out the Advocates for Youth website.
5) Your health care provider will sleuth out your health concerns. If you don’t mention something, they'll probably figure it out anyway.
Answer: b) False
Surprise, surprise! Doctors and nurses have many different scientific lab tests and pre-scripted examinations in their tool kits, but they don’t yet know how to read your mind.
Unless you are candid and honest and open with them, it is likely they will not recognize that you have been incontinent since you gave birth, that you have experienced pain during intercourse, that you are the victim of a violent relationship, that you are using alcohol to self-medicate for your depression, that you are experiencing abnormal side effects of your birth control, etc., etc., etc.
Your visit is time-limited, and there are only so many probing questions that a health provider can ask.
So advocate for yourself!
Be upfront about the reason you are REALLY coming for an appointment. Often, patients feel nervous about explaining why they are seeking a medical opinion, and don’t mention their concerns until the very end of the visit.
This gives your provider less time to truly investigate what might be wrong. Set both of you up for success. Be brave, speak up.
So, bottom line — don’t assume that the care you receive is automatic or inflexible. Ask for what you need, do your research, and be your own best advocate. Feel free to post questions and comments below!
Reviewed December 1, 2016
by Michele Blacksberg RN
Edited by Jody Smith