Dr. Moritz Bartels

For The Courier-Herald

Making an appointment for an annual checkup with your gynecologist isn’t usually on top of a woman’s list of fun activities. But the time spent checking in with your health care provider is important to staying healthy.

Here are some questions and answers about that annual visit.

How often should I see my gynecologist?

Women should have annual visits to their doctors – and the test associated with those visits – beginning at age 21. Women between the ages of 21 and 29 should get a Pap test every year and then every other year from 30 to 64.

While a yearly Pap smear is usually not necessary after age 30, you should still have an annual pelvic exam to check for other changes or possible infections.

Why do I need to get a Pap smear so often?

The biggest reason to get regular tests is to decrease the risk of cervical cancer. The majority of women diagnosed with cervical cancer have not had a Pap smear in five or more years. By the time these women are diagnosed, they are usually at an advanced stage of cancer.

What changes in my body should I bring to the attention of my doctor?

Go see your obstetrician/gynecologist whenever you have pelvic pain or menstrual cramps severe enough to disrupt your daily routine for even a few days a month.

Bring up any abnormal bleeding or any other pain that is unusual. Any of these symptoms could be symptoms of an infection or a sexually transmitted disease, which could affect your fertility. They could also be symptoms of endometriosis, pelvic inflammatory disease or other reproductive disorders.

And if you think you’re pregnant, see your health care provider to ensure a healthy pregnancy and healthy baby.

Can you give me some tips to make the visit easier?

The best time to schedule your annual pelvic exam and to obtain the most accurate results from your gynecological examination and Pap smear is one or two weeks after your period.

Empty your bladder just before your exam for a more comfortable examination. You may also want to keep a health diary that you can go over with your doctor during your appointment. You can use a calendar to keep track of your periods, any pain experienced or other symptoms that occur during the month.

If getting an annual pelvic exam is the only time you see a doctor, as it is for about one-quarter of women, your gynecologist may order routine tests, such as urinalysis, cholesterol, blood sugar levels, as well as others.

What happens during an annual exam?

The first thing that usually happens during your annual exam is getting checks of your blood pressure, weight, pulse, and often urine. Be prepared to give the nurse the date of your last period. Also go over any concerns that you want to discuss with the doctor.

During your breast examination your physician should discuss monthly breast self exam with you and provide instructions if you are unfamiliar with how to perform BSE. If you are 35 or older, your physician should also discuss mammogram screening for breast cancer.

During the pelvic exam/Pap smear portion of your visit, your health care provider will collect a sample of cervical tissue for your Pap test.

What is the procedure for collecting a Pap smear sample?

Obtaining the Pap smear requires that your gynecologist insert a long cotton swab into your vagina. The cotton swab gently swabs against your cervix so that a sample of cervical cells is retrieved for evaluation by a pathologist. Labs generally require about five days for your test results to return to your gynecologist.

What if My Pap smear Is Abnormal?

An abnormal Pap does not mean you have cancer. It could be caused by a variety of other conditions that include inflammation, the presence of blood or sperm, a yeast infection or other infection.

A Pap is not a diagnostic tool. It is used to indicate when something may not be normal. Your doctor may recommend follow-up tests.

What are the symptoms of cervical cancer?

Symptoms may include vaginal bleeding or a change in your menstrual cycle, or bleeding when something comes in contact with your cervix, such as during intercourse or when you insert a diaphragm. They also could include pain during intercourse or discharge that may be tinged with blood.

Symptoms of more advanced cancer could include anemia, pelvic, leg or back pain or weight loss.

Can cervical cancer be treated?

Cervical cancer caught early can be cured. Treatment choices include surgery, radiation therapy and chemotherapy.

Annual appointments with your health care provider are an important part of maintaining a healthy lifestyle. If you haven’t seen your doctor recently, make an appointment now.

Dr. Moritz Bartels is an obstetrician and gynecologist with MultiCare Health System.