Gynecological Health

Understanding Women's Unique Health issues

Annual Well Woman Exam

The annual exam is an important one.  There are many things that are done during that exam other than your pap smear (cervical cancer screening).

Teens should see a provider for "the talk" between the ages 13 and 15, hopefully prior to becoming sexually active. Women should have an annual exam beginning at the age of 18.

If you see me for an annual exam it will consist of the following:  

  • Weight and blood pressure check

  • Evaluating what immunizations are needed

  • Assessment of the menstrual cycle

  • Depression screening

  • Thyroid screening

  • Birth control options,

  • STI testing and breast exam


In addition, a head to toe physical exam and pap smear if indicated.  Please take this time to ask any questions you have concerning your health. If you have noticed something during your monthly self breast exam, this is a good time to bring it up. Trust me, I have heard it all,  and you should not be embarrassed to discuss anything.

Pap Smear

There is a lot of confusion about pap tests and Human Papilloma Virus  (HPV) tests. I have included a link to chart below which can be helpful.

A pap smear is a screening for cervical cancer.  That's it.  It is NOT a screening for ovarian cancer, uterine cancer, yeast infections, bacterial infections or sexually transmitted infection (STI). 

Pap testing should be done starting at the age of 21 and every three years thereafter if you have had no abnormal paps. Even though you may not be due for a pap smear, you should still have your annual exam. Annual exams are a great time to talk with your provider about menstrual problems, menopause, vaginal concerns and you also need your breast exam. Remember, your provider is only going to do a pap test unless you specifically ask for other screenings. When you have your annual exam, and you have questions regarding being screened for these things, you should ask about each thing specifically. It is my belief that women should be screened yearly for STI. 


HPV is a virus. 98% of us have come into contact with HPV.  When we are healthy, we can clear the HPV virus from our system just like we can other viruses. If you smoke, or have multiple partners, and do not practice safe sex, you will have a higher chance of holding on to the virus, and the virus can turn into cervical cancer. There are over 100 strains of HPV. Nine of the strains are the most concerning.  If you are between the ages of 11-26 (male or female) you can get the Guardasil vaccine to protect yourself from these 9 important strains. Men are the silent carriers so they should get the vaccine as well. Guardasil 9 protects against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58.


If you have a normal pap and a +HPV take Vitamin C 1000mg.  Vitamin C is an antioxidant that can help clear the virus from your system.


Click here to view Pap Guidelines.

Sexually Transmitted Infections (STI)

They don't discriminate!  They are alive and well and spreading from person to person in all ages and all walks of life.

The most common age during one's lifetime of having an STI is between the ages of 15-24 years old. I believe woman should be routinely screened for STIs with their annual exam if they are sexually active.The only way to prevent and STI is to abstain from sex. Yes, abstinence is 100% effective birth control AND STI prevention. It does a body good!

For a complete list, please visit the American Sexual Health Association website.

Expedited Partner Treatment (EPT): The State of Indiana endorses and recommends expedited partner treatment. This means if you are diagnosed with an STI your partner can receive treatment without an examination.

Additional resources are available from CDC: Sexually Transmitted Infections -  Know the Facts

Pelvic Floor Health

The pelvic floor is very important to women. Pay attention to it! Yes, get a mirror and look at yourself. There are many variations of normal. Things to be concerned with would be bumps that do not go away, freckles that are getting larger and darker in color, any kind of rash or irritation. These things are superficial involving mostly the outside and the skin.


Your pelvic floor muscles help with pooping (everybody poops), and urinating, sexual pleasure, bladder, uterus, vagina and rectal muscles.


When you do your monthly breast exam, it would benefit you to do a pelvic floor exam as well. The more you know about your health and the unique characteristics of your body, the more likely you are to catch something that may be of concern.


Click here for a great article about pelvic floor muscles and health.


Mammograms and Colon Cancer Screenings

Mammograms are recommended annually at the age of 40, unless you have a close family member (mother, aunt, sister) that was diagnosed with breast cancer. Then the first screening should be done 10 years prior to when your family member was diagnosed. If you have implants, you still need your mammogram.


Colon cancer screening by detecting blood in stool and/or colonoscopy should begin at age 50.  How often you get your colonoscopy will depend on your family history and what is found when they do the colonoscopy.