Annual Gynecology Visit
An annual GYN visit is recommended for everyone who is of reproductive age or older. This visit is essential in monitoring overall health and gives patients an opportunity to discuss concerns or changes in the body, including menstrual cycle changes and other areas of health that have developed over the past year. As your midwife, I am required to keep you up-to-date with routine screening intervals and make referrals for mammograms, sonograms, colposcopies, or bone density scans based on current recommendations, your age, family history and your personal preferences. We may also discuss STI screening, birth control options or changes in methods method, preconception plans and other relevant healthcare issues. A typical visit includes:
Comprehensive physical exam including heart, lung, breast and thyroid check
Pelvic exam including a Pap test and HPV testing, if indicated
Routine bloodwork, including thyroid levels, complete CBC and metabolic screening, lipid panel, vitamin deficiency and STI screening, etc.
Counseling and teaching, including breast self-exams, safe-sex, fertility awareness, preventative care and causes of abnormal bleeding are also routinely discussed according to preference and need
Papanicolaou Test (Pap Test/Smear)
Pap tests are recommended every 3-5 years for people ages 21 - 65. The recommended interval varies depending on age and risk factors. This test is also commonly known as a Pap smear, and is a standard screening method of the cervix used to determine if precancerous or cancerous cells have developed or are in the early stages of development. Co-testing involves a swab to check for the HPV virus, which can indicate a higher risk for developing cervical, vulvar or vaginal cancers. Since this is a screening, abnormal findings are followed by diagnostic testing, including colposcopy or biopsy. These screenings and diagnostics tests have been shown to prevent cervical cancer or catch it at the diseases earliest stages. Cervical cancer is a slow-growing disease and early treatment can be extremely successful at reducing metastatic disease and recurrence.
The Pap procedure involves inserting a small spatula and brush into the cervix to collect cells. Minor cramping during the exam is not uncommon, with some spotting or light bleeding following the procedure. Traditionally the provider performs all these actions but as your midwife, I am happy to work with you in placing your own speculum, have a support person to comfort or assist you, discontinue the test at various points in the procedure, etc. I am trained to work with people who are looking for alternative methods to traditional practices and who feel empowered by the autonomy that self-exams offer. Consent is extremely important to me given that this is your body and I am simply here to support you in your health in any way I can.