A well woman exam typically includes a pap smear, pelvic, breast, heart, lung and thyroid exam. The American Cancer Society guidelines advise women to begin annual screening at the age of 21. The recommendations to complete the annual pap smear test has changed over the years. The accumulation of research identifying that abnormal cells found on pap smears unlikelihood of turning into cancer rapidly has been one of the reasons for the changes of annual screening. Women who have had 2-3 consecutive normal pap smears can opt to complete the pap smear every 2-3 years. HPV (Human Papilloma Virus) is often tested at the same time. HPV is linked to cervical cancer and is the cause for most abnormal pap smears. The additional negative HPV test only strengthens the case for the unnecessity of screening sooner. There are numerous strains of HPV and only a few are actually linked to cancer. The pap smear testing we do at East Valley Naturopathic Doctors includes HPV typing which allows us to specifically identify a more harmful or serious HPV strain, which is not commonly ascertained with your general pap smear. This allows us to determine a very individualized course of action if the pap smear does come back abnormal.
Another service provided during the well woman exam is checking for sexually transmitted infections (STI). If you are currently sexually active, have multiple partners, or a history of multiple partners, it is important to be screened. The most common STIs are Chlamydia, Gonorrhea, Herpes, HPV, Trichomoniasis and HIV. HPV testing is often done in conjunction with the pap smear as it can predict future risks for cervical abnormalities.
It is important to understand that you can be positive for Chlamydia and Gonorrhea and not have any symptoms. STIs not treated with an antibiotic, such as Chlamydia, can cause scarring of the fallopian tubes leading to infertility. It should be understood that birth control pills, diaphragms and cervical caps including condoms, do not protect you from getting a STI.
The pap smear is not the only reason why women have their well woman exams completed. Breast exams should be performed by a clinician yearly to note if there are any lumps present. The pelvic exam can often detect masses, prolapse or melanomas on the vulva. Referrals for Mammograms and Bone density scans will be given out at the appointment when appropriate. We also discuss other additional ways to evaluate breast health. I often use the dtectdx Breast test which evaluates through blood an elevation of cancer markers if cancer is present as well as breast thermography, which detects cancer by its presence of heat which is highlighted on the test. We also use this appointment to discuss other ways to be pro-active with your health through. General labs are often recommended at this time as well.