By George Abate, DO
Obstetrics & Gynecology, Blanchard Valley Obstetrics & Gynecology

A woman’s annual exam with her OBGYN remains vitally important.

As Pap smear guidelines have changed, women assume they don’t need to see their OB/GYN every year. But, your preventive visit is about much more than periodically screening for cervical cancer with a Pap smear.

Below are just a few of the benefits of seeing your OBGYN each year:

Counseling you about maintaining a healthy lifestyle and minimizing health risks. Experts agree there is substantial individual and system-wide cost-savings in prevention. Nutrition and fitness remain the foundation of weight management, prevention of cardiovascular disease and certain cancers.

Screening for sexually transmitted disease (STD) which can lead to sterility or life-long pelvic pain.

Discussing your bone health; building and maintaining bone through one’s life can substantially reduce risk. Osteoporosis remains a leading cause of disability in seniors.

Evaluating your cardiovascular risk factors (hypertension, obesity, diabetes, elevated lipids) and encouraging tobacco cessation.

Discussing sexual function/abuse/domestic violence.

Explaining your contraceptive options.

Reviewing your immunization status based on age and risk factors.

Screening for breast, ovarian, uterine, vaginal and vulvar cancer.

Generally, a physical examination will incorporate vital signs, such as checking blood pressure. The earlier high blood pressure is diagnosed, the better the prognosis. The exam also includes determining body mass index (BMI), checking the abdomen and lymph nodes, pelvic exam and clinical breast exam.

Here are some arguments for including a pelvic exam with your annual:

Vaginal cancers will be missed without a speculum exam. No one objects to your dentist screening you twice a year for oral cancer. More than 3,000 cases of vaginal cancer are diagnosed each year. Regular screening can help detect this type of cancer earlier. If cancer is detected early (stage 1), five-year survival rates are 84 percent. With advanced stages, survival rates drop to about 50 percent.

Vulvar pre-cancer and cancer often have no symptoms and may only be detected as part of a thorough preventive exam. Unfortunately, vulvar cancer is more likely to be diagnosed at a later stage in older women.

An examination may reveal hidden problems which patients are too embarrassed to bring up, such as bladder prolapse or urinary incontinence.
Perimenopausal women may have dry vaginal tissue seen on exam. Therapy can be started before symptoms worsen.

Women with a history of precancerous changes of the cervix, vagina or vulva should also have a regular pelvic exam to ensure disease has not returned.

Finally, cost should no longer be a barrier to your screening. The Affordable Care Act now requires coverage of women’s preventive care at no cost to the patient. That means no co-pay, co-insurance or deductible. Please check with your insurance carrier to determine what your plan covers.

Patients are always allowed to decline a pelvic exam. A pelvic exam is recommended if a patient has symptoms suggestive of female genital tract problems (pain, bleeding, discharge or prolapse).

Gynecologists are experts in areas such as contraceptive counseling, breast care, reproductive planning, sexually transmitted infection screening and cervical cancer screening.

Your annual exam should assess your risk factors. Some risks will be missed without a pelvic exam.

In summary, an annual well-woman exam with a pelvic exam helps maintain a healthy lifestyle and helps detect disease early which lengthens your life and adds life to your years.