Do You Need to Visit Your Gynecologist Annually?

With all the various and seemingly conflicting recommendations out there, it’s no wonder there’s confusion over how often you should see your gynecologist.

You go to your dentist twice a year, your general practitioner annually, make it to your dermatologist for your yearly skin checkup — and you were equally diligent about making it to your gynecologist. But now, various new recommendations have left you confused about whether an annual appointment is a necessity or not. And, the truth is, there’s not one right answer for all women.

First things first — you should see your gynecologist regularly, if:

• You don’t have a primary care physician. Many women prefer to see their gynecologist regularly, as opposed to a general practitioner. If you fall into this camp, it’s important to see your OBGYN annually, and be sure to tell them you would like them to perform basic primary care tests, such as blood pressure checks and cholesterol screenings.
• You are trying to get pregnant. Your doctor can check to make sure you’re in optimal health to get pregnant and can discuss any genetic screenings that you and your partner may want to consider.
• You are pregnant. Your gynecologist can confirm a pregnancy and recommend an obstetrician for prenatal care throughout your pregnancy and delivery.
• You have any period problems, such as unusually heavy, painful or irregular periods. If your period is suddenly different than it once was, you should make an appointment to see your gynecologist and not wait for your next annual visit.
• You have multiple sexual partners and/or have unprotected sex, and you’re not in a monogamous relationship. Some sexually transmitted diseases (STD), including various forms of human papillomavirus (HPV), gonorrhea and syphilis, don’t always have symptoms. Your doctor can perform a screening or test to make sure you don’t unknowingly have an STD.
• You are experiencing any pain or burning during intercourse or have growths on or around your vagina. If in fact, you have any of these symptoms, you should see your doctor immediately, regardless of whether you’re due for your annual visit or not, for correct diagnosis and treatment.

Screening recommendations

The American College of Obstetricians and Gynecologists (ACOG) currently recommends:

• For women between the ages of 21 and 29, a Pap test every three years, to look at changes in the cells of the cervix that could potentially be precancerous or cancerous.
• For women 30 and older, a Pap test and HPV test every 5 years or a Pap test alone every 3 years.
• Chlamydia and gonorrhea testing annually, if you are sexually active and 24 years old or younger, or if you are 25 years and older, with certain risk factors such as multiple partners.

And, it doesn’t have to be your gynecologist that performs these tests.

“General well-woman exams, including Pap and HPV testing, can be done by your primary care doctor,” says Sharon Orrange, MD, a primary care physician with Keck Signature Care, part of Keck Medicine of USC. “Generally, your routine gynecologic care (mammography, Pap smear and HPV co-testing) can be handled by your internist or family medicine doctor, so there is no need to visit a gynecologist, unless your primary doctor refers you for abnormalities (abnormal Pap smear or postmenopausal bleeding), or you are having active issues not addressed by your primary care doctor.”

Pelvic examinations

Here’s where the confusion comes in. The United States Preventative Services Task Force says that for asymptomatic, nonpregnant adult women who are not at increased risk for any specific gynecologic condition, the current evidence is insufficient to recommend screening pelvic examinations for the early detection and treatment of a range of gynecologic conditions.

The verdict?

So, does this mean if you’re a healthy, monogamous woman, who is not trying to get pregnant, that you can forgo the pelvic exam and annual visit, when you’re not due for any screening tests?

Not necessarily. ACOG issued a practice advisory that stressed that the Task Force findings were not a recommendation against regular pelvic exams and that “it does NOT mean that women should forgo seeing an obstetrician-gynecologist at least once a year for well-woman care. This preventive service visit also provides an opportunity for shared decision-making, wherein the patient and her obstetrician-gynecologist discuss whether a pelvic examination is appropriate for her.”

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