I’m a healthy woman. Why do I need to see a Medical Provider?
July 27th, 2012
Guest Author: Juliette Blount, MSN, ANP
President of Nurse Practitioners of New York
The relationship that women have with their Women’s Health provider is an extremely important and intimate relationship built on trust- similar to a hair stylist! The ideal time to establish a relationship with your Medical and Women’s Health Provider is when you are healthy.
What can I expect from my Well Woman Annual Visit?
– Cervical Cancer Screening
In March 2012 the United States Preventative Services Task Force (USPSTF), made changes to recommendations for cervical cancer screening:
Pap Tests are not recommended for women under the age of 21, regardless of sexual history
These recommendations are based on the fact that cervical cancer is rare in young women, abnormal cells usually return to normal over time and follow-up treatment is unnecessary and possibly harmful.
Women ages 21-65 should be screened at least every 3 years
Women ages 30- 65 may elect to have a Pap test AND HPV Testing to extend the screening interval to every 5 years.
These guidelines do not apply to women with an increased risk of cervical cancer
A statement from American Congress of Obstetricians & Gynecologists (ACOG) reads, “The well-woman visit has always been more than just a “Pap smear,” and the decreased need for cervical screening actually constitutes a minor change to an important aspect of a woman’s health care”. Common practice is to continue to offer annual cervical cancer screening to women in spite of the guidelines. It is important for women to understand the guidelines in order to have a conversation with their women’s health provider and make informed decisions about their care.
– Human Papilloma Virus (HPV) Vaccine
The HPV Vaccine should be offered to women up to age 26, who have not already received it.
Many women may have HPV, but very few of these women will ever get cervical cancer. In most cases the body fights off the virus, and the infection goes away without any treatment. In some women however, the infection lasts and can cause cervical cancer. Even though HPV is an important risk factor for cervical cancer, research suggests other factors, such as smoking, infection with other sexually transmitted infections and diet, may play a part in the development of cancer. The HPV vaccine protects against several of the most common types of HPV.
– Sexually Transmitted Infection (STI) Screening
Annual screening for Chlamydia is recommended for all sexually active women ages 25 and younger.
Women older than 25 with new or more than one partner since their last visit should also be screened.
– HIV Test must be offered.
In 2010 voluntary HIV testing became part of New York’s State Public Health Law. The law requires health care professionals to offer all patients between the ages of 13 to 64 a voluntary HIV test.
Screening for other STIs, such as Gonorrhea, Syphilis or Genital Herpes, should be discussed with your provider
– Clinical Breast Exam (CBE)
Common clinical practice is to follow American Cancer Society (ACS) guidelines which recommend CBEs at least every 2 years and screening Mammograms starting at age 40. Any findings during screening exams should be referred for additional testing. Anyone with a 1st degree relative (mother or sister) history of breast or ovarian cancer should consult with a Breast Specialist for screening recommendations.
– Preconception and/ or Contraception Consultation
Women need to consume 400- 800 micrograms of Folic Acid daily regardless of plans for conception. Folic Acid is a B vitamin that prevents Anemia, prevents birth defects and may also play a role in heart health. Sources of Folic Acid include: Fortified cereal, Leafy Vegetables, Citrus Fruit, Beans, Whole Grains, most Multivitamins, Multivitamins for Women, and Prenatal Vitamins.
Not ready to start a family? There are many options for contraception. Method selection is based on individual medical history and personal preferences. Start by conducting research and use credible sources as opposed to Google and scary stories from friends! After learning about the options, schedule an appointment with your women’s health provider for additional information and a prescription if indicated. An excellent resource can be found at www.arhp.org/methodmatch
“If I have my Women’s Health Exam every year, why do I need a Routine Physical?”
Your provider will obtain a detailed personal and family medical history in addition to conducting a thorough physical exam. Recommended screening tests, vaccines and/or referrals will be based on information gained from your history and physical exam.
“What screening tests may be done during the Physical Exam?”
– Blood Pressure Screening
Your blood pressure should be checked at least every 2 years if normal (Less than 120/80), or annually if greater than 120-139/80-90.
- Body Mass Index (BMI) is a calculation of heart disease risk based on Height & Weight
- Cholesterol Screening
If you smoke, are obese, have high blood pressure, diabetes, personal history of heart disease or family history of premature heart disease.
- Diabetes Screening is recommended if you have a history of high blood pressure
- Hepatitis C Screening may be recommended if you were born between 1945- 1965
- Bone Mineral Density/ Osteoporosis screening should be done at least once at age 65 or older
- Colorectal cancer screening is recommended starting at age 50. Earlier for African-Americans and those with a family history
“What recommendations may be made to keep me healthy?”
Vaccines
- You should receive a Tdap (Tetanus, Diptheria & Pertussis) one time booster and a Tetanus shot (Tetanus & Diptheria- Td) every 10 years thereafter.
- Influenza (Flu Shot) is recommended Annually
- HPV Vaccine is recommended for all women up to age 26
- Pneumococcal Vaccine is recommended if you have a chronic condition such as Asthma, Diabetes, a condition associated with immunosuppression or are a smoker
- Varicella Vaccine may be recommended if you have never had chickenpox
- Travel Vaccines are location specific and will be determined during a travel consultation
Your provider may also have a conversation about things you can do to remain healthy such as quit smoking, limit alcohol to no more than 1 drink per day, exercise 30 minutes per day and make healthy food choices. By establishing a relationship with your provider you can become partners in maintaining your overall health and wellbeing.
