What’s the deal with annual exams? Do you need one?
When should you schedule an Annual Exam or Pap Smear?
One of the biggest complaints I got from patients when I was working in a high volume practice was how hard it was to get an appointment for an annual exam- they would call the office and the receptionist would tell them they didn't need annual exam!
After all, it is called an ANNUAL exam!
I am here to clear the air and (hopefully) answer the million dollar question: Do you need an Annual Exam and Pap Smear every YEAR?
If you have a question or concern, you should feel empowered to schedule an Annual Exam Appointment
First and foremost, if you feel like you need or want to see your healthcare provider, then you should feel empowered to have a visit! If you have questions or issues you want addressed, by all means, schedule an annual exam AND if the receptionist gives you ANY push back then stand your ground.
Besides covering your questions, the actual physical exam and which tests (like a pap smear) need to be performed by your healthcare provider are going to depend on a number of variables that I will discuss below.
Recommendations for Annual exams and Pap Smear testing has changed
Recent changes to recommendations for pelvic exams and pap smear testing has confused the picture and this is most likely the reason you are receiving push back from the receptionist when trying to schedule your annual exam appointment.
While it would be ideal if your care provider was up on these new recommendations, the truth is that the guidelines have been changing every few years as more information about testing evolves – and not all practitioners are keeping up with the changes fast enough.
Not All Practitioners are Keeping up with the Changing Guidelines for Pap Smears
As of this post, Here Are the Guidelines:
***Cervical cancer screening (Pap Smear) should begin at age 21. Women under age 21 should not be screened***
Women between ages 21 and 29 should have a Pap test every 3 years. HPV testing should not be used in this age group unless it is needed after an abnormal Pap test result.
Women to 30 and 65 years of age should have a Pap test every 3 years OR a Pap plus high risk HPV testing every 5 years OR a new option which is high risk HPV testing alone every 5 years. It’s your choice.
Women over age 65 who have had regular cervical cancer testing with normal results, and no personal high risk for cervical cancer, should not be tested for cervical cancer as long as she’s had 3 normal Paps, in the past 10 years, with the most recent testing within the last 5 years. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
A woman who has had her uterus plus her cervix removed for reasons not related to cervical or uterine cancer and who has no history of cervical or uterine cancer or serious pre-cancer should not be tested.
A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
If you have a history of abnormal pap smears, then your health care provider should have reviewed what your new pap smear schedule looks like.
The TAKE HOME MESSAGE (THM) on Annual exams and Pap Smear Appointments:
The take home message (THM) here is if you have an issue, question or concern you would like addressed, then scheduling an annual exam with your trusted Midwife, Nurse Practitioner or Physician is very reasonable. Whether a pelvic exam and pap smear is warranted depends on your age, past history of abnormal pap smears and current symptoms.
Here are some excellent questions to bring with you to your Annual Exam Appointment:
Top 5 questions to ask at your Annual Exam visit:
1. Do I need a pap smear this year?
2. How is my blood pressure?
3. Do I get enough sleep?
4. Does my family history put me at risk?
5. What is the top thing I can do to improve my health?
Do you have questions, concerns or want to get advice on how to optimize your wellness?
About The Author
Dana Ramsey is a Certified Nurse Midwife and has spent the past 15 years helping women navigate their gynecology, pregnancy, postpartum and menopausal challenges. Dana is dedicated to helping her patients overcome conditions impacting their ability to conceive and maintain a successful pregnancy.
