Preventative Care Visits

January 8, 2018

Adrian Krause, MD

I was given the honor of writing the inaugural blog post for the Women’s Clinic of Northern Colorado, and I cannot be more excited to start sharing important information with our patients and readers! With so many things to talk about, I felt it was important to start by addressing one of the most common (and important) questions ~ How often should you see your doctor or provider?

There is a lot that will be addressed during a preventative visit. This includes a review of any recent or past medical or surgical issues, a review of medications and supplements, a discussion about diet, exercise, weight, smoking, alcohol, drug use, mental health, contraception or prenatal counseling, and sexual issues ( to name a few!). A yearly review of need for vaccinations, PAP smear screening for cervical cancer or screening for sexually transmitted diseases will be performed and administered, if necessary. As genetic testing for cancer risks or pregnancy risks becomes more widely offered and available, it is ever more important to have a provider review family history or personal risk factors and help determine if genetic testing should be offered or if routine cancer screening needs to be increased.

I also invest a lot of time during this visit to discuss specific issues that women face during different points in their lives. Whether this is about expectations during the menopausal transition, what to expect with normal menstruation, tracking cycles, planning for a pregnancy, or contraception options and management (and more), most of a yearly visit is making sure that all of my patient’s have the information they need to make healthy decisions for themselves.

There is A LOT of conflicting information out there about the necessity of a pelvic exam during a visit focused on preventative health. This is even true amongst providers. Recently, the United States Preventative Services Taskforce (USPSTF) published their conclusion that there is not enough medical evidence to support an annual pelvic exam in asymptomatic (well) women. In turn, the American College of Physicians followed by publishing their recommendation to stop performing pelvic exams for yearly preventative exams. Yet, the American College of Obstetrics and Gynecology (ACOG) still recommends doing so, as determined from expert recommendations. Phew! I can see where this can be confusing! Throw in the frequently changing guidelines for breast and cervical cancer screening, and your head may be spinning.

What it comes down to is that the decision to do a pelvic exam or breast exam comes down to an open discussion with your provider about the risks and benefits of doing so, as well as your age, presence of absence of symptoms (problems) and need for cancer screening. If the looming fear or avoidance of a pelvic exam is what is keeping you from visiting a doctor, rest assured, it would only be done after you have both decided that it is in your best interest.

So, to answer my initial question, we have a lot to talk about! I certainly agree with the current recommendations to have a yearly visit. The components of that exam will be up to you and your provider to agree upon.

Happy New Year! May your year be filled with peace, health and happiness!

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