As women, we know to see our healthcare provider annually for our exams. But when should you start and at what age can you stop? What if you’ve had a hysterectomy or always had normal test results? What if your mammograms are always normal?
Well…the American College of Obstetricians and Gynecologists (ACOG) has new advice that came out in the May issue of Obstetrics and Gynecology. They recommend starting your annual exams (including pap and pelvic) at 21 years old or at least 3 years after becoming sexually active – whichever comes first. For example, if you have never had intercourse, then you do not need to begin exams until 21. If you had intercourse at 16 years old then you should have your pap by 19 years old at the latest.
The 21-29 age groups should begin annual pap and pelvic exams. Women under 25 years old that are sexually active should also be routinely screened for Chlamydia and gonorrhea.
For women between 30 and 65 years old, yearly pelvic and pap exams are recommended, however they can be extended to every 2-3 years if (and only if) they have had 3 normal tests in a row, is not immunosuppressed, is not HIV-positive, and was not exposed to diethylstilbestrol (DES) in utero.
For women older than 65 years old, “ACOG recommends an annual pelvic examination. However, cervical cytology may be discontinued if the woman has had 3 or more normal test results in a row, no abnormal test results in 10 years, no history of cervical cancer, no DES exposure in utero, is HIV-negative and immunocompetent, and does not have other risk factors for STDs.”
For women who have had a total hysterectomy that includes their ovaries for non-cancerous reasons, AGOC believes it is reasonable to stop pelvic and pap exams however the external genitalia should still be examined at each annual physical.
An annual physical is different from an annual pap and pelvic exam. The physical consists of the heart, lung, thyroid, abdominal and other exams. Please be advised you should check-in with your healthcare provider yearly for a physical and to use the above advice as guidelines. If you are symptomatic or are in a new sexual relationship, please make an appointment for an exam.
As far as breast health goes, you should be doing your self-breast exam every month! Clinical breast exams (the one done by your healthcare provider) start once you begin your annual exam as its routine with the pap and pelvic exam. The American Cancer Society recommends yearly mammograms beginning at 40 years old.