Episode 10: Do I need a pap smear every year?

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Hi, I'm Dr. Tabatha, the Functional Gynecologist. I'm a board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, Then you've come to the right place. I want to be your functional gynecologist. So welcome. All right. So here is the question of the week: Should I have a pap smear? Do I need a Pap smear every year? I get this question all the time, and I hesitate to answer because if I say no, people assume that they don't need an exam every year. So really, the question is wrong. The question should be, should I have an exam every year? And the answer to that is definitely a yes. So let me explain the difference. A Pap smear is just part of a GYN exam. A Pap smear is taking cells, the dead cells, off the end of your cervix with a little brush to send to the pathologist to look under the microscope to see if you have any changes in the cells on your cervix. So that is just one little test, one part of the GYN exam. You still need a full breast exam and pelvic exam. So I definitely recommend having a GYN exam done every year. So according to ASCCP guidelines, that stands for the American Society of Colposcopists and Cervical Pathologists, they write the guidelines for how often you should have Pap smears. The recommendation is every 3 years from ages 21 to 65, or if you are doing HPV testing along with the Pap smear, you can go every 5 years from age 30 to 65. But here's the problem with that guideline. Many women fall outside of that category. If you've had abnormal Pap smears, you don't necessarily follow those guidelines. If you've had HPV, you don't necessarily follow those guidelines. We might need to repeat those tests sooner. So that's why it's important to have an established gynecologist That tracks your results and knows when you need what test repeated. But here's the bigger deal. That is one little part of your exam. Even if you've never had an abnormal Pap smear and you don't need a Pap smear again for 5 years because they just did the HPV test along with it, you still have breasts and ovaries and a vagina and a bladder and a rectum and skin and all of these things that need to be examined on a regular basis. I would argue that women of all ages should always have a gynecologist. I often hear, oh, I don't need to see you anymore, I'm done having babies, or I don't need to see you anymore, I went through menopause. Those are all misconceptions. I would say if you are female, you should have a gynecologist. You should see them annually at minimum for The remainder of your life. There are so many things that happen to women after pregnancy and after menopause that a gynecologist can identify and help with. Things start to fall down there in the vaginal area. You can get prolapse of your bladder and your rectum or your uterus or cervix. You can get skin changes. You can get vaginal atrophy. You can get Chronic infections that you don't realize. You can have HPV changes on the vulva or vagina. It's not just a cervix issue. And those are usually just identified visually by the gynecologist. You can get something called lichen sclerosus that many women are misdiagnosed as having chronic yeast infections because it just feels irritated and itchy. On and off. You can get cancer on the skin of the vulva and vagina, just like you can the rest of your body. And even if you've had a hysterectomy, especially if you still have your ovaries, you should have a pelvic exam every year so that we can feel your ovaries and make sure they feel small and normal and that nothing's going on in there. Actually, the average age of ovarian cancer is 63, so most women are menopausal and no longer going to the gynecologist, and they are at the highest risk of developing ovarian cancer. So you definitely need a pelvic exam after menopause on a regular basis because there are no good tests to identify ovarian cancer early. Its average stage is stage 3 when it's diagnosed, unfortunately. So you want to stay on top of these things. I also recommend women see their gynecologist at least every year because it opens the door to discussion about things that women are probably suffering with in silence and not necessarily dealing with. You know, we as women, we always seem to put ourselves last, and we may be suffering with urinary leakage or painful intercourse or Feeling like something's falling out of the vagina. We have a bulge that's irritating us all the time. We might have some chronic itching, like I said. All of these issues need to be addressed, and I would argue that if you have an annual exam every year, you're more likely to go address those issues and take care of yourself and have that discussion than if you just. Wait to make a problem visit, because most of us put that off until it's really bad. Am I right? So get in the habit of just seeing your gynecologist every year. And if they are telling you they don't need to see you every year, then I would argue you should probably find a different gynecologist because they're not being very comprehensive and realizing what they need to be doing for you. I personally do a full skin exam on women during their annual GYN exam because most women don't get naked for any other doctor, and most women don't go to the dermatologist regularly. You know, where I live, it takes a year and a half to 2 years to get in to see the dermatologist, so it's my job as a gynecologist to do that full-body scan and make sure there's no abnormal lesions that I see. It's also a great way to address any physical trauma or issues going— possible domestic issues going on with women. So I could go on and on about the benefits of an annual GYN exam, but I just want you to know that you are worth the time to go and have that done every year. So if you hear your friends say, I don't need to have a Pap smear, I don't need to go to the gynecologist, you tell them that I said otherwise, that you should all go every year, minimally, to have a full body scan and evaluation. Prevention is key. You want to catch this stuff early when things are just starting. It's so much easier to deal with a precancerous lesion, lump, or bump than it is to deal with invasive cancer. It's easier to treat some mild vaginal atrophy than it is to treat something full-blown that is no longer even functioning. So to answer the question, no, you don't need a Pap smear every year, but yes, you need a GYN exam every year. So I hope that information was helpful. Definitely share this with your friends. If you think that this is worth listening to, I would love for you to give me a review and a 5-star rating. That lets everybody out in the podcast world know that you want to hear this information, and then I can keep putting it out there for you. Now go out and have an awesome day and do something good for yourself. I need to make my mammogram appointment, so I'm gonna go do that today. All right, have an awesome day.