FAQs about an OB-GYN visit
Throughout May, the Women's Health and Gynecology team at SIU Medicine has been celebrating Women's Health Month with our patients, colleagues and community. We're continuing the celebration by sharing information about important tools that are available for women as part of their personal health tool kits.
Here are some honest answers to frequently asked questions about OB-GYNs, Pap smears and related women's health topics.
What is an OB-GYN?
An OB-GYN is a medical doctor who specializes in obstetrics (the field of medicine focusing on pregnancy, childbirth, and the care of pregnant and postpartum women) and gynecology (the field of medicine focusing on female reproductive health).
How often should women visit their OB-GYN and why is this important?
"Women 21 and older should visit their OB-GYN every year to share information and discuss health care," says SIU Medicine OB-GYN Jeffrey Olejnik, MD. These visits are invaluable opportunities for any female to discuss a range of issues related to her personal and reproductive health. The discussions often go into more detail and scope than what would be talked about with a primary care doctor, whom many healthy women do not see every year.
For women over the age of 65, Medicare typically allows an OB-GYN breast and pelvic exam every two years, Dr. Olejnik says. Mammograms should still be performed every year.
Women younger than 21 usually don’t need to see a gynecologist, as their pediatrician can usually take care of most of their health issues. "However, if the need arises, the pediatrician may make a referral to the gynecologist for specialty care," says Olejnik.
What happens during a typical visit?
At the OB-GYN, a woman can expect services and education about topics such as:
- The different forms of birth control available
- Common health concerns such as high blood pressure, overweight or obesity, heavy menstrual cycles, uterine cramping, breast issues, libido issues or pain during intercourse
- What is needed for planning a healthy pregnancy
- How to perform a proper breast self-examination
- Ways to prevent sexually transmitted infections, including the HPV vaccine
- Screening for sexually transmitted infections, cervical cancer (e.g., Pap test) or other conditions based on personal risk and health history
- Breast and pelvic examination from the OB-GYN
During a visit with the OB-GYN, your doctor can also assess for other conditions or issues that may warrant a referral to other specialists, including acne or other skin disorders, enlarged thyroid, heart rhythm abnormalities, mood issues and urologic issues such as incontinence.
What is a Pap test? How often should a woman receive one?
A Pap test or Pap smear cytology is a cervical cancer screening tool. It is used to look at the cells of the cervix and determine if any of them look abnormal and could possibly turn into cancer.
Based on current best evidence, Pap test cytology screening is recommended starting at age 21 and then every three years until age 29. In Dr. Olejnik's professional experience, many women in this age group also want to know if they are positive for human papilloma virus (HPV), a virus that can cause cervical cancer. For these women, HPV DNA screening is often performed or "co-tested" along with Pap smear cytology.
In women aged 30 to 65, Pap smear cytology and HPV DNA screenings are generally recommended every three to five years. It is customary to stop performing cervical cancer screening after a hysterectomy or after age 65, unless a woman belongs to a high-risk category. Characteristics that might make a woman considered high-risk include:
- A personal history of high-grade cervix precancerous lesion or cervical cancer
- A previous exposure to diethylstilbestrol (used during 1940-1971)
- A weakened immune system due to HIV-positive status or another reason
Routine Pap tests and cervical screenings have made a tremendous difference in the lives of American women, says Dr. Olejnik. "It is important to remember that as recently as 80 years ago, cancer of the cervix and uterus caused more deaths in women than breast, lung or ovarian cancer." Beginning in the 1940s, cervical cancer screenings have greatly reduced the number of women diagnosed with cervical cancer.
Why should I be concerned about HPV?
According to the U.S. Office of Women's Health, human papilloma virus is the most common type of sexually transmitted infection in the United States. More than 80% of adults will have HPV at some point during their lifetime.
Unlike some other viral infections, HPV (which is passed by skin-to-skin contact) is usually transient and can resolve on its own without treatment over several years. Most types of HPV are considered "low-risk" and can cause benign warty lesions.
However, certain forms of HPV are responsible for cervical, vaginal, vulvar, anal, penile and oral pharyngeal cancers, and we now know that it takes many years for cervical cancer to develop after the initial HPV infection. This is why it's still important to be screened for it on a routine basis.
If a woman receives abnormal results from a Pap test or HPV DNA screening, what are the next steps?
Many women who receive an abnormal test may be encouraged to repeat their Pap smear and HPV DNA screening annually to monitor the resolution of the HPV infection. Usually, three consecutive years of negative cytology and negative high-risk HPV screening can allow women to return to the usual cervical cancer screening frequency.
However, if a Pap test result persistently suggests a high-grade cancerous lesion, diagnostic cervical biopsies should be performed. Depending upon the cervix tissue biopsy results, ongoing annual screening cytology and high-risk HPV testing may be recommended. Surgical treatment of the cervix to remove the cancerous or pre-cancerous cells may also be recommended. Usually, this can all be done during outpatient visits to the OB-GYN office, without having to go to the operating room.
Do you have more questions about women's health?
SIU Medicine drives innovative, forward-thinking research and best-practice clinical care for women from all walks of life. If you have concerns about your health or are advocating for a female loved one, contact SIU Medicine today by calling 217-545-8000 to schedule an appointment.