Which standard to use for scheduling pelvic exams?
May 23, 2011 3:55 AM
Pelvic exam every 6 months or every year, that is the question.
Here's the deal. I'm living in South Korea. I just had my first pelvic done in the last 6 years. It's extremely difficult for me as a sexual abuse & assault survivor to have these done.
I'm not sexually active. My pap and breast exams were clean. I'm 35, overweight (but losing) and just had a bunch of blood work come back clean (liver/kidney/diabetes/lipid panel). Basically I'm fat but healthy.
So, do I go along with the standard here and go again in 6 months (which fills me with dread, the one last week left me with an upsurge of ptsd symptoms) or wait a year like I'd do back in the states?
Here's the deal. I'm living in South Korea. I just had my first pelvic done in the last 6 years. It's extremely difficult for me as a sexual abuse & assault survivor to have these done.
I'm not sexually active. My pap and breast exams were clean. I'm 35, overweight (but losing) and just had a bunch of blood work come back clean (liver/kidney/diabetes/lipid panel). Basically I'm fat but healthy.
So, do I go along with the standard here and go again in 6 months (which fills me with dread, the one last week left me with an upsurge of ptsd symptoms) or wait a year like I'd do back in the states?
Good news for you: every 3 years. (But. DO go every 3 years. If you feel like you'll just stop going if you wait that long, then go more frequently.)
posted by anaelith at 4:33 AM on May 23, 2011
posted by anaelith at 4:33 AM on May 23, 2011
Standard practice is to get these done when you have your annual physical. There's no reason to make a special trip.
posted by valkyryn at 4:56 AM on May 23, 2011
posted by valkyryn at 4:56 AM on May 23, 2011
Standard practice is to get these done when you have your annual physical. There's no reason to make a special trip.
See what consitutes standard practice very much depends what country you live in - 3 countries in the last 10 years in my case and 3 times the recommended frequency and when and how you were called in for screening was different as was who'd do the screening. But standard screening interval in the UK was 3 years and that was the longest interval for any of the places I lived. So there definitely isn't any need to go twice a year unless you notice a change you want to have checked out.
posted by koahiatamadl at 5:55 AM on May 23, 2011
See what consitutes standard practice very much depends what country you live in - 3 countries in the last 10 years in my case and 3 times the recommended frequency and when and how you were called in for screening was different as was who'd do the screening. But standard screening interval in the UK was 3 years and that was the longest interval for any of the places I lived. So there definitely isn't any need to go twice a year unless you notice a change you want to have checked out.
posted by koahiatamadl at 5:55 AM on May 23, 2011
I went every 6 months for a while after having cervical cancer, but then got the ok to go back to annual. If you have no risk factors, you can go every three years as stated above.
posted by JoanArkham at 6:40 AM on May 23, 2011
posted by JoanArkham at 6:40 AM on May 23, 2011
kathrynm, physically, if there's nothing wrong with you, you can have them once a year or once every three years, as stated above.
But mentally and emotionally, as you hadn't had a pelvic done in 6 years due to your traumatic past experiences, and now feel the need to ask this question, I think you might consider whether putting off these physicals for as long as possible makes them loom even larger in your mind and harder to face when the time comes to have another.
And, you know, that would be perfectly understandable. But it's also something you might want to seriously consider talking to someone about. So if you aren't seeing a therapist to help you, as an abuse survivor, navigate difficult situations like this one, I strongly urge you to consider it, okay?
posted by misha at 6:52 AM on May 23, 2011
But mentally and emotionally, as you hadn't had a pelvic done in 6 years due to your traumatic past experiences, and now feel the need to ask this question, I think you might consider whether putting off these physicals for as long as possible makes them loom even larger in your mind and harder to face when the time comes to have another.
And, you know, that would be perfectly understandable. But it's also something you might want to seriously consider talking to someone about. So if you aren't seeing a therapist to help you, as an abuse survivor, navigate difficult situations like this one, I strongly urge you to consider it, okay?
posted by misha at 6:52 AM on May 23, 2011
I don't know where you're from, but if you're from the US I would strongly urge that you go to a Planned Parenthood clinic next time you're in the US. They will help you get over your fears and make recommendations for frequency of checkups based on your health. Good luck.
posted by mareli at 7:04 AM on May 23, 2011
posted by mareli at 7:04 AM on May 23, 2011
I also find the experience of a pelvic exam to be very traumatic and I don't have a history of any sort of abuse. I'm not a doctor, but going every six months seems excessive. I would wait a year (or possibly longer).
I also found the exams to be much less traumatic with my new doctor. Somehow this doctor helps distract me from what's going on and I feel much better than I used to feel. It also might not be a bad idea to ask your doctor for anti-anxiety medication you can take before the exam.
posted by parakeetdog at 12:33 PM on May 23, 2011
I also found the exams to be much less traumatic with my new doctor. Somehow this doctor helps distract me from what's going on and I feel much better than I used to feel. It also might not be a bad idea to ask your doctor for anti-anxiety medication you can take before the exam.
posted by parakeetdog at 12:33 PM on May 23, 2011
In the US, the standard is yearly unless you have a history of abnormal pap smears. And I believe the relevant medical associations are now considering changing the recommended standard of care to every two or three years.
I'm not a medical professional, but I'd say that if you're not sexually active (or really, haven't been sexually active for at least a year), you may need them even less frequently. Pap smears test for cervical abnormalities caused by strains of HPV, which is an STI. If you can't have been exposed to HPV in years, it's somewhat pointless to keep getting tested for it. This is something you should ask your doctor about.
I absolutely don't think you need to be getting a pap smear every six months unless your doctor has specifically told you that you need to have them that often.
posted by Sara C. at 5:27 PM on May 23, 2011
I'm not a medical professional, but I'd say that if you're not sexually active (or really, haven't been sexually active for at least a year), you may need them even less frequently. Pap smears test for cervical abnormalities caused by strains of HPV, which is an STI. If you can't have been exposed to HPV in years, it's somewhat pointless to keep getting tested for it. This is something you should ask your doctor about.
I absolutely don't think you need to be getting a pap smear every six months unless your doctor has specifically told you that you need to have them that often.
posted by Sara C. at 5:27 PM on May 23, 2011
If you want cervical cancer screening, the standard in the US is to have a pap test every three years. If you find pap testing traumatic, consider doing self-swabs for HPV instead (this is more effective as a primary method of screening if you are not currently sexually active and have not been for some time, or are in a long-term monogamous relationship).
For God's sake, if you don't have any symptoms, STOP with the bimanual pelvic exams and clinical breast exams. There's absolutely no evidence that they actually reduce mortality in asymptomatic people. You're putting yourself through a horrible, triggering experience for something that has never been proven to have medical benefit! There's no reason to do that to yourself. Pap tests have clinical benefit, yes, but not bimanuals or clinical breast exams. So, ideally, get pap tests every three years, but don't ever get a bimanual or a breast exam unless you are evaluating symptoms.
Researchers Say 3-Year Intervals Are Safe for Cervical Cancer Screening Tests
For healthy women with no symptoms of disease, a pelvic exam serves little purpose
An earlier review of the literature recommended against
the use of pelvic examination as a screening test in asymptomatic women.
At present, screening by breast self-examination or physical examination [by a trained health worker] cannot be recommended
The only people who should be getting pap tests every six months are those monitoring abnormal results.
posted by Violet Hour at 11:58 PM on May 23, 2011
For God's sake, if you don't have any symptoms, STOP with the bimanual pelvic exams and clinical breast exams. There's absolutely no evidence that they actually reduce mortality in asymptomatic people. You're putting yourself through a horrible, triggering experience for something that has never been proven to have medical benefit! There's no reason to do that to yourself. Pap tests have clinical benefit, yes, but not bimanuals or clinical breast exams. So, ideally, get pap tests every three years, but don't ever get a bimanual or a breast exam unless you are evaluating symptoms.
Researchers Say 3-Year Intervals Are Safe for Cervical Cancer Screening Tests
For healthy women with no symptoms of disease, a pelvic exam serves little purpose
An earlier review of the literature recommended against
the use of pelvic examination as a screening test in asymptomatic women.
At present, screening by breast self-examination or physical examination [by a trained health worker] cannot be recommended
The only people who should be getting pap tests every six months are those monitoring abnormal results.
posted by Violet Hour at 11:58 PM on May 23, 2011
Thank you all. Putting it off makes it worse, so I think I'll settle on going yearly. I have a family history of breast and uterine cancer, so I'm not entirely risk free.
I also asked my boss about it. She laughed and said she would never go every 6 months, even if that's what the standards say. She goes every year. So I think that's an OK thing to do.
As for the counseling, I've done it. Extensively. It's possible that it might help again, but being in Korea makes finding an English speaking therapist a bit difficult (I've looked around my area). I do have a great psychiatrist who speaks English. I actually chose the gyn because his office is right next to my p-docs. After the exam I was able to go over there and get something instantly to stop the panic attack.
Consider yourselves all marked as best answers.
posted by kathrynm at 3:47 AM on May 24, 2011
I also asked my boss about it. She laughed and said she would never go every 6 months, even if that's what the standards say. She goes every year. So I think that's an OK thing to do.
As for the counseling, I've done it. Extensively. It's possible that it might help again, but being in Korea makes finding an English speaking therapist a bit difficult (I've looked around my area). I do have a great psychiatrist who speaks English. I actually chose the gyn because his office is right next to my p-docs. After the exam I was able to go over there and get something instantly to stop the panic attack.
Consider yourselves all marked as best answers.
posted by kathrynm at 3:47 AM on May 24, 2011
uterine cancer
Just FYI, uterine cancer and cervical cancer are different cancers. Cervical cancer is caused by HPV and has little/nothing to do with family history. Pap smears do not test for uterine cancer.
posted by Sara C. at 5:42 AM on May 24, 2011
Just FYI, uterine cancer and cervical cancer are different cancers. Cervical cancer is caused by HPV and has little/nothing to do with family history. Pap smears do not test for uterine cancer.
posted by Sara C. at 5:42 AM on May 24, 2011
I have a family history of breast and uterine cancer, so I'm not entirely risk free.
I hear you, but manual breast exams and bimanual pelvic exams don't reduce the mortality from either of those cancers, and study after study has shown that doing paps every three years is just as effective as annually.
If it's better for your mental health to go every year, that's a consideration, but otherwise please rethink it.
posted by Violet Hour at 5:44 AM on May 24, 2011
I hear you, but manual breast exams and bimanual pelvic exams don't reduce the mortality from either of those cancers, and study after study has shown that doing paps every three years is just as effective as annually.
If it's better for your mental health to go every year, that's a consideration, but otherwise please rethink it.
posted by Violet Hour at 5:44 AM on May 24, 2011
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posted by camyram at 4:30 AM on May 23, 2011