Dreading your annual exam? Here’s why you should go

Are you dreading your “annual exam”? Not sure how often you need to see a health care provider? Wondering if you can avoid pelvic exams forever? Knowing more about what to expect and how to prepare can help. Even if there’s nothing wrong, you should still see a provider about your sexual and reproductive health needs every year. Depending on where you live and your insurance, this provider might be someone who specializes in sexual and reproductive health care, like a gynecologist, nurse midwife, or nurse practitioner, or it could be your regular primary care provider.

Here are the most common questions I hear from patients about annual visits and the answers I give them:

There’s nothing wrong, so why am I here?

An annual check-in with your provider is a low-stress time to ask all of your questions, get sexual health screenings, like a Pap smear or a STI test, and get general health screenings, like a blood pressure check. Doing these “well visits,” or preventative health services, is a good way to find a provider that you trust. These visits can also help identify any issues and help take care of them before they become a problem.

Even better, under the Affordable Care Act, most of these preventative health services, like blood pressure screenings, Pap smears, and birth control, are covered at no cost to you.

If you don’t have a provider and need to find one, check out Bedsider’s clinic finder. Making an appointment is usually as easy as double-checking your insurance coverage with the clinic and telling them why you want to be seen.

If I don’t need a Pap every year, why do I still need to see my provider?

Pap smears screen for cervical cancer and cervical cells that are precancerous. Everyone over the age of 21 should get a Pap smear to check for abnormal cervical cells (sometimes called precancerous cells) that lead to cervical cancer. When these cells are caught early, they can be treated in order to prevent them from becoming cervical cancer.

In most cases, you don’t need a Pap smear every year. If you have normal results, follow-up Pap smears are recommended every 3 years until you are 30 and then every 3 to 5 years (depending on whether HPV testing is available as well) until age 65. If you’ve had an abnormal Pap or a positive HPV test, you may need more frequent testing, so talk to your provider about the schedule that is best for you. Even if you’re up to date on your Pap, the well visit is a great time to answer all your burning questions about your sexual and reproductive health, make sure you have a birth control method that is working for you, talk about emergency contraception, and sometimes screen for health conditions like high blood pressure, high cholesterol, or diabetes.

My family member had cervical, breast, ovarian, and/or prostate cancer. Do I need more frequent screening?

That depends on the type of cancer and who had it, but it’s a good idea to let your provider know and discuss your family history with them. Here are some things to keep in mind though:

• In most cases, cervical cancer is caused by an HPV infection. So a family history of cervical cancer doesn’t necessarily mean you need more frequent Pap screening. The best way to prevent HPV infection and cervical cancer is with the HPV vaccine—and a well visit is a great time to get an HPV vaccine—it’s now available for everyone up to age 45.
• Breast, ovarian, and prostate cancer can sometimes be related to genes that are passed down in families. Depending on your family history, you may consider screening for these genes. The well visit is a great time to talk to your provider about your family history and discuss whether these screenings are right for you.
  

A quick note about breast exams: If you do have a concern or a risk for breast cancer, like a family history, providers recommend a breast exam, but the truth is there isn’t good research that shows doing breast exams regularly for people under 25 or more than every few years for people who are under 40 helps prevent breast cancer.

Do I still need a well visit if I’m not at risk for pregnancy right now?

Even if you are not at risk for pregnancy because you aren’t having sex right now or don’t have penis-in-vagina sex, an annual visit is a good time to check in with your provider about your sexual and reproductive health, like talking about your chances of getting pregnant in the future and how to prevent STIs. You can also talk about any problems you’re having with your period and discuss if birth control might help with them—people who aren’t at risk for pregnancy often use birth control for other reasons, like managing heavy periods and improving acne. And anyone who has a cervix should keep up with Pap smears, regardless of whether you could become pregnant.

If you’re not having sex right now but you’re considering having sex in the future, think about if you’ll be at risk for pregnancy or STIs. You can then discuss your future birth control and STI prevention needs with your provider during your well visit. That way you can be prepared if you do start having sex.

I want to get pregnant, and I’m going to stop my birth control soon. Do I still need to have my well visit?

This is the perfect time for a well visit! You and your provider can discuss ways to start a pregnancy in the best health possible, such as starting folic acid supplementation before pregnancy to prevent some types of birth defects. Your provider may order blood work, review any medications you’re taking to make sure they’re safe to continue during pregnancy, and suggest simple changes you can make to be as healthy as possible before getting pregnant. It’s also a good time to talk to your provider about where you can get prenatal care.

I hate getting pelvic exams. Will I have to get one at a well visit?

If you hate getting pelvic exams, it makes sense that you’d be nervous about a well visit. But if you’re not due for a Pap smear, you may not need a pelvic exam at all—in fact, the entire well visit could be a fully-clothed conversation with your provider!

If your provider does recommend a pelvic exam, it’s still your choice whether you get one. Know that you can ask to discuss the exam with them beforehand so that you know exactly what’s going to happen. Let your provider know if you have a history of sexual assault or specific concerns about the exam. You can ask to bring a friend, play music during the exam, and/or have each step of the exam explained to you before it happens. You can also ask to stop a pelvic exam (or any exam) at any time, including right in the middle or when it’s almost over.

Bottom line: Most insurance covers an annual health exam, and the well visit can help you cover all your bases. Whether you need a Pap smear, want to start a new birth control (or need refills), have questions about your family health history or what tests might be recommended for you, or you just want to talk, call your provider and schedule a well visit today!