Are you dreading your “annual exam”? Not sure how often you should see a health care provider? Wondering if you can avoid pelvic exams forever? Knowing more about what to expect and how to prepare can help. Even if nothing is wrong, you should still see a provider about your sexual and reproductive health needs every year. Depending on where you live and your insurance, this provider may be someone who specializes in sexual and reproductive health care, such as a gynecologist, nurse midwife, or nurse practitioner, or it may be your regular primary care provider .
Here are the most common questions I hear from patients about annual visits and the answers I give them:
Nothing wrong, why am I here?
The annual check-in with your provider is a low-stress time to ask all your questions, get sexual health tests, like a Pap smear or an STI test, and get general health check, such as a blood pressure check. Doing these “well visits,” or preventive health services, is a great way to find a provider you trust. These visits can also help identify any issues and help take care of them before they become problems.
Even better, under the Affordable Care Act, most of these preventive health services, such as blood pressure tests, Pap smears, and birth control, are covered at no cost to you.
If you don’t have a provider and need to find one, check out Bedsider’s clinic locator. Making an appointment is often as easy as double-checking your insurance coverage with the clinic and telling them why you want to be seen.
If I don’t need a Pap every year, why do I still need to see my provider?
Pap smears screen for cervical cancer and cervical cells that are precancerous. Everyone over the age of 21 should have a Pap smear to check for abnormal cervical cells (sometimes called precancerous cells) that lead to cervical cancer. When these cells are caught early, they can be treated to prevent them from becoming cervical cancer.
In most cases, you don’t need a Pap smear every year. If you have normal results, follow-up Pap smears are recommended every 3 years until you are 30 and then every 3 to 5 years (depending on whether HPV testing is also available) until age 65. If there have been you have an abnormal Pap or a positive HPV test, you may need more frequent testing, so talk to your provider about the schedule that’s best for you. Even if you’re up to date on your Pap, the well visit is a great time to answer all your burning questions about your sexual and reproductive health, make sure you have a birth control method that works for you, -talk about emergency contraception, and sometimes screen for health conditions like high blood pressure, high cholesterol, or diabetes.
My family member has had cervical, breast, ovarian, and/or prostate cancer. Do I need more frequent screenings?
That depends on the type of cancer and who has had it, but it’s a good idea to let your provider know and discuss your family history with them. Here are a few things to keep in mind though:
- In most cases, cervical cancer is caused by HPV infection. So a family history of cervical cancer doesn’t mean you need more frequent Pap screenings. The best way to prevent HPV infection and cervical cancer is the HPV vaccine—and the well visit is a good time to get the HPV vaccine—it’s available for everyone up to age 45.
- Breast, ovarian, and prostate cancer can sometimes be linked to genes that are passed down in families. Depending on your family history, you may want to consider screening for these genes. The well visit is a good time to talk with your provider about your family history and discuss whether these screenings are right for you.
A quick note about breast exams: If you have a concern or risk for breast cancer, such as a family history, providers recommend breast exams, but the truth is there is no good research that shows regular doing breast exams for people who are underage. 25 or more every few years for people under 40 helps prevent breast cancer.
Do I still need a well visit if I’m not at risk for pregnancy now?
Even if you are not at risk for pregnancy because you are not having sex now or have not had penile intercourse, the annual visit is a good time to communicate with your provider about your sexual and reproductive health, such as talking about your chances of getting pregnant in the future and how to avoid STIs. You can also talk about any problems you’re having with your period and discuss whether birth control might help them—people who aren’t at risk for pregnancy often use birth control for other reasons, such as managing of heavy periods and improvement of acne. And anyone with a cervix should keep up with Pap smears, regardless of whether you can get pregnant.
If you’re not having sex right now but are considering having sex in the future, think about whether you’re at risk for pregnancy or STIs. You can then discuss your future birth control and STI prevention needs with your provider during your well visit. That way you can be prepared if you start having sex.
I want to get pregnant, and I’m about to stop my birth control. Do I still need to visit my well?
This is the perfect time for visiting the well! You and your provider can discuss ways to start a pregnancy in the best possible health, such as starting folic acid supplementation before pregnancy to prevent certain types of birth defects. Your provider can order blood tests, review any medications you’re taking to make sure they’re safe to continue during pregnancy, and suggest simple changes you can make to be as healthy as possible before get pregnant This is also a good time to talk to your provider about where you can get prenatal care.
I don’t want to take pelvic exams. Do I have to visit one of the wells?
If you don’t want to get pelvic exams, it’s understandable that you’re nervous about visiting the well. But if you shouldn’t get a Pap smear, you may not need a pelvic exam—in fact, the entire well visit may be a fully clothed conversation with your provider!
If your provider recommends a pelvic exam, it’s still up to you whether you get one. Know that you can ask to discuss the test with them in advance so you know exactly what will happen. Let your provider know if you have a history of sexual assault or have specific concerns about the test. You can ask to bring a friend, play music during the test, and/or have each step of the test explained to you before it happens. You can also ask to stop a pelvic exam (or any exam) at any time, including right in the middle or when it’s about to end.
Bottom line: Most insurance covers an annual health exam, and a well visit can help you cover all your bases. If you need a Pap smear, want to start new birth control (or need refills), have questions about your family’s health history or what tests may be recommended for you, or just want to talk Talk, call your provider and schedule a well visit today!
