How Often Do You Really Need Pelvic Exams and Pap Smears?

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If your parents first sent you to an OB/GYN when you were a teenager, chances are you've been familiar with those uncomfortable yearly visits for a while now. You know what we're talking about: Feet up in the stirrups, some pushing and prodding on your doctor's end, maybe a blood test and a birth control prescription, and hopefully confirmation you're healthy and don't have to come back for another year.

While the age at which each woman or person with a vulva first sees an OB/GYN varies, an alarming new study published in JAMA Internal Medicine found up to 1.4 million patients between the ages of 15 and 20 are subjected to unnecessary pelvic exams within a year. This comes on the heels of a 2009 recommendation by the American College of Obstetrics and Gynecology, which states in most cases, women under age 21 do not need a pelvic exam.

With so much conflicting information out there, the results of this new study begs the question: When do you really need your first pelvic exam and pap smear? And do you need to get them every year? We asked OB/GYN Stephanie McClellan. Here's her take on it.

Meet the Expert

Dr. McClellan is a board-certified OB/GYN with 30+ years of experience founding and managing best-in-class integrative women's care practices. She's the Chief Medical Officer at Tia.

The Necessary Age of a First Pelvic Exam Varies

According to Dr. McClellan, the "age of first pelvic exam and pap smear" question is not a simple one. "If a woman [or person with a vulva] has no specific need based on pelvic or menstrual problems, I advise the first exam by age 21," she explains.

Dr. McClellan adds that in general, she's in agreement with the American College of Obstetrics and Gynecology's revised guideline—and that the new guideline points to a larger problem within medicine. "We are now recognizing the need for personalized medicine in the context of population-based and epidemiological data," she explains. "These revised guidelines are a reflection of that, and I'm in agreement. We must be thoughtful about the cost benefit issues in modern health care while simultaneously developing authentic focus on health and wellness."

Do I Really Need Yearly OB/GYN Visits?

If you'd rather skip the OB/GYN if medically possible, you're not alone—many of us get anxious before doctor's appointments (ever heard of white coat syndrome?). And as medicine is ever-changing and evolving, it's becoming clearer how often we really need to get certain checkups. According to Dr. McClellan, frequency of pelvic exams and pap smears is highly individualized. "It really depends on the specific patient's needs and complaints," she says. So if you're dealing with pelvic pain, heavy or irregular periods, or have any other specific concern come up, it's a good idea to visit the OB/GYN more frequently.

In general, though, Dr. McClellan says most women or people with vulvas do not need a yearly pelvic exam and pap smear. "The problem with these revised guidelines is that the annual exam is linked in most patient's mind with needing a pap and pelvic exam." McClellan sees the evolving world of medicine as an opportunity to redefine what this yearly OB/GYN visit means. "This could be an opportunity to address wellness, not simply an opportunity to evaluate potential pathology," she says. If you ask us, having a speculum and needle-free visit to the OB/GYN once in a while sounds pretty fantastic.

The Bottom Line

Unfortunately, the answer to the pelvic exam and pap smear question is a complicated one, and as with most things it's important to trust your intuition. Do your best to develop an open and honest dialogue with your OB/GYN, and pay close attention to any pain or irregularities. You should never be afraid to tell a doctor if you think something is off with your body, regardless of your age or the last time you saw your OB/GYN.

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