I was hoping you could provide some clarity regarding reproductive health. Princeton is far from my hometown, so I don’t know how often I’ll be able to visit my gynecologist anymore… and I know I’m getting to the age where I should be getting things like pap smears and other screenings regularly. Can I get these at Princeton? And can you explain what should be on my radar?
– Paranoid about Prevention
Dear Paranoid about Prevention,
First of all, you’re not paranoid – it’s great that you’re starting your college career being proactive about your sexual and reproductive health! Let’s begin by going over some of the most common forms of preventative screenings for women and when you should start them.
- Pap smear: A Pap smear or a Pap test is the screening test for cervical cancer and is recommended for anyone with a cervix. It is done by your collecting a sample of cells from the cervix with a small brush. Pap comes from Dr. Georgios Papanicolaou who came up with the simple procedure. Guidelines suggest that Pap smears should be done every three years beginning at age 21, regardless of whether or not the individual is sexually active. At age 30, the frequency of screening can decrease to every 5 years with the addition of an HPV test.
- Pelvic exam: A pelvic exam typically consists of 3 parts: an external exam, a speculum exam, and a bimanual exam. During the external exam your clinician looks at the outside of the vulva which includes the clitoris, labia, vaginal opening, and anus. A speculum, which is an instrument made of plastic or metal, is then carefully inserted into the vagina to allow the clinician to examine the vaginal canal as well as the cervix. The pap smear will take place during the speculum exam. After the speculum is removed, a bimanual exam is done. Your clinician will place one or two gloved fingers into the vagina and their other hand on your abdomen below your belly button to examine your uterus and ovaries. Most healthcare providers agree that the first pelvic exam should take place at age 21 or upon the appearance of symptoms (e.g., pelvic pain, abnormal discharge), but there are certainly other reasons for the exam to take place.
- Well-woman exam: A well-woman exam is an annual exam which includes a breast exam, pelvic exam. Pap smears are usually done during this exam if it is time for your screening.
- HPV: HPV stands for the human papillomavirus. HPV is the most common sexually transmitted infection. There are more than 100 types of HPV, and most are harmless. However, some types of HPV can lead to cervical or other cancers. While guidelines don’t recommend HPV tests before age 30, there is a way to protect yourself from the most dangerous strains of the virus. The current HPV vaccine protects against 9 strains known to be associated with cervical cancers and genital warts. It is recommended to be given before becoming sexually active starting at around age 11 or 12, however, you can still get the vaccine if you have already started having sex.
- STI screenings: It’s recommended that everyone between age 13 and 64 be tested at least once for Human Immunodeficiency Virus (HIV) and that all sexually active people young than 25 years old be tested for chlamydia and gonorrhea annually. For individuals at increased risk, syphilis testing is also recommended.
- Mammograms: A mammogram is an x-ray of the breast used to screen for breast cancer. In women at average risk of breast cancer, mammograms are not recommended until at least age 40, after which they should take place every 1-2 years. Women with a family history or who are at risk for a genetic mutation placing them at higher risk will need to begin mammogram screenings earlier and should talk about this with their clinician.
I hope that helps!
Good luck and stay safe,
Recommendations provided by the United States Preventative Services Task Force and the Center for Young Women’s Health (CYWH) at Boston Children’s Hospital. Information regarding HPV provided by Planned Parenthood.