As a women, do you understand the results of the exams you receive from your gynecologist?
There seems to be a misunderstanding that might be exacerbated by new guidelines that women should have a pap smear done every three years.
This leads some women to think they don’t need to visit their gynecologist for 3 years, when in fact, the annual exam covers several body parts including the uterus, breasts and ovaries as well as other preventive healthcare checks including STD screenings, mammograms, blood pressure checks and weight checks.
Listen as Megan Fish, NP clears up some of the confusion and discusses the importance of yearly preventive health screenings for women.
Selected Podcast
Preventive Health Screenings for Women
Featured Speaker:
Megan Fish, NP
Megan Fish, NP is a Nurse Practitioners in Women’s Health Hendricks Regional Health Medical Group. Transcription:
Preventive Health Screenings for Women
Melanie Cole (Host): New guidelines recommending that women should have a Pap smear done every three years has led some women to think that they don’t need to visit their gynecologist for three years, when, in fact, the annual exam covers several body parts including the uterus, breasts, ovaries and more. My guest today is Megan Fish. She’s a nurse practitioner with Hendricks Regional Health. Welcome to the show, Megan. So, let’s start with some of those new guidelines recommending that women have their Pap smear done every three years. Give us a little background on why this happened, and why you’re finding that it’s so confusing for women.
Megan Fish (Guest): In 2009, Pap smear guidelines changed to start screening at age 21. We do Pap smears from age 21 to 30--just the Pap smear only. And then, from age 30 to 65, we do a Pap smear and an HPV. We know that cervical cancer is a very slow growing cancer and so studies have shown that we can decrease the interval of screening and still catch cervical cancer in a precancerous state by doing it every three years.
Melanie: So, why do you think women have been confused that going to their gynecologist every year was just all about their Pap smear?
Megan: Most women associate their annual exam with the Pap. So, they think, “Well, if I don’t have to have a Pap smear, then why do I have to go and have my annual done?” So, so many women have thought, “Well, if I only have to have my Pap smear done every three years, then I only have to go to my gynecologist every three years” and that’s not true.
Melanie: Yes. So, it’s been confusing and now with the advent of HPV in its relation to cervical cancer, and the need for these guidelines as a result of some of this. What do you tell women about HPV? Certain women under 26 now are getting the vaccine, Megan. So, now it adds a whole another layer of confusion.
Megan: Well, we recommend the vaccine for all women aged 9 to 26, and it’s actually recommended for boys to get that vaccine as well. It does help to protect and decrease women’s chances of getting HPV. It’s not 100% but it can decrease their risk and eventually that will decrease cervical cancer risks tremendously.
Melanie: Now, what about some other tests that are important for women? I mean, one thing that the gynecologist does at that annual is also give us an exam for our breasts. If they’re not old enough to have a mammogram yet, what do you tell women about self breast exams?
Megan: Correct. We usually start doing a breast exam around the same time that we start doing Pap smears, around age 21, unless they’re complaining of breast pain or breast lumps, sometimes we’ll do them sooner. But I definitely teach them how to do a breast exam, and I recommended doing them every couple months after their period, and then we start mammograms at age 40.
Melanie: Okay. So, what other tests do you think are important for people to note--for women to note—besides, obviously, our Pap smear and an HPV and self exam. What else would you like women to be getting every year--that you think is important?
Megan: In addition to the Pap smear, the annual exam, we’re also listening to their heart and lungs, looking at their skin. Sometimes we can find an abnormal mole that could possibly be a melanoma. Sometimes we’re the only healthcare provider that these women see on an annual basis so if we see something abnormal, we’ll get them in the right direction where they need to go. We’re also feeling the size of their uterus and ovaries and looking at the outside as the vulva. There’s such a thing as vulva cancer, so if there’s anything ever abnormal on the outside, we’re addressing those concerns as well.
Melanie: Megan, do you also see that it’s important--when you see women and they come in--and you’re a nurse practitioner, so you see women as your patients, do you see that sometimes they want to talk about depression or their weight or alcohol use or relationships or any of these other things as an important adjunct to that yearly physical?
Megan: Absolutely. I do so much mental health and domestic violence screening and I treat a lot of depression and anxiety and refer them for counseling and get them in the direction that they need to go. This is definitely a place for them to talk about uncomfortable conversations that they can't always feel comfortable talking with other providers about.
Melanie: What do you tell them when they ask you about blood tests and checking cholesterol and A1C or fasting blood glucose to see if they’re maybe pre-diabetic, because this is a very common thing now and obesity is such a problem in our country. So , what do you tell them about these kinds of checkups and how important they are to prevent heart disease?
Megan: We always want to make sure that someone is checking those whether it’s their primary care provider or through their employer--a lot of employers do wellness screening. If no one is checking those, then we will order them for them and just counsel them, “If they come back abnormal, then we won't treat them just because that’s out of the scope of our practice but we will get you in the right direction and get you set up with someone that can treat you.” So, we’re more than happy to order and screen for these things even though we don’t necessarily treat them. So, we do age-appropriate age appropriate screenings and just make sure than the women are getting all the care that they need. Colonoscopies, we start those at age 50, and sometimes sooner based on their family history.
Melanie: That’s a great point to make that you would help them screen or refer them to where they can go to get more information. What about something like a bone mineral density test because women want to know about osteoporosis now. What do you tell them about that test?
Megan: That changed a couple of years ago and the newest recommendation actually says not to start it until age 65, unless they have a lot of risk factors for that. But that's something different. So, now, we’re just more, kind of, counseling on prevention and talking to them about how much calcium and vitamin D that they need and promoting weight bearing exercise and those like that.
Melanie: That is so important. Another thing that we’ve been hearing about is baby boomers and hepatitis C. If they ask you about this test and why they might need it, what do you tell them?
Megan: Yes, it is recommended to screen for that, and it’s also recommended to offer HIV testing annually to every woman. So, we can offer that in addition to hepatitis C.
Melanie: So then, wrap it up for us, Megan. What do you want women to know as the most important bits of information about their annual screenings, whether they’re gynecological in nature or to prevent heart disease or control obesity or depression? What do you want to know? What do you tell women every single day?
Megan: That this is just a visit that we can make sure that you are getting the appropriate screenings that you need, vaccines, whether it’s contraception or preconception counseling, domestic violence screening or just getting them help that they need, and addressing any of their medical concerns.
Melanie: Thank you so much for being with us today. You’re listening to Health Talks with HRH, Hendricks Regional Health. And for more information, you can go to www.hendricks.org. That’s www.hendricks.org. This is Melanie Cole. Thanks so much for listening.
Preventive Health Screenings for Women
Melanie Cole (Host): New guidelines recommending that women should have a Pap smear done every three years has led some women to think that they don’t need to visit their gynecologist for three years, when, in fact, the annual exam covers several body parts including the uterus, breasts, ovaries and more. My guest today is Megan Fish. She’s a nurse practitioner with Hendricks Regional Health. Welcome to the show, Megan. So, let’s start with some of those new guidelines recommending that women have their Pap smear done every three years. Give us a little background on why this happened, and why you’re finding that it’s so confusing for women.
Megan Fish (Guest): In 2009, Pap smear guidelines changed to start screening at age 21. We do Pap smears from age 21 to 30--just the Pap smear only. And then, from age 30 to 65, we do a Pap smear and an HPV. We know that cervical cancer is a very slow growing cancer and so studies have shown that we can decrease the interval of screening and still catch cervical cancer in a precancerous state by doing it every three years.
Melanie: So, why do you think women have been confused that going to their gynecologist every year was just all about their Pap smear?
Megan: Most women associate their annual exam with the Pap. So, they think, “Well, if I don’t have to have a Pap smear, then why do I have to go and have my annual done?” So, so many women have thought, “Well, if I only have to have my Pap smear done every three years, then I only have to go to my gynecologist every three years” and that’s not true.
Melanie: Yes. So, it’s been confusing and now with the advent of HPV in its relation to cervical cancer, and the need for these guidelines as a result of some of this. What do you tell women about HPV? Certain women under 26 now are getting the vaccine, Megan. So, now it adds a whole another layer of confusion.
Megan: Well, we recommend the vaccine for all women aged 9 to 26, and it’s actually recommended for boys to get that vaccine as well. It does help to protect and decrease women’s chances of getting HPV. It’s not 100% but it can decrease their risk and eventually that will decrease cervical cancer risks tremendously.
Melanie: Now, what about some other tests that are important for women? I mean, one thing that the gynecologist does at that annual is also give us an exam for our breasts. If they’re not old enough to have a mammogram yet, what do you tell women about self breast exams?
Megan: Correct. We usually start doing a breast exam around the same time that we start doing Pap smears, around age 21, unless they’re complaining of breast pain or breast lumps, sometimes we’ll do them sooner. But I definitely teach them how to do a breast exam, and I recommended doing them every couple months after their period, and then we start mammograms at age 40.
Melanie: Okay. So, what other tests do you think are important for people to note--for women to note—besides, obviously, our Pap smear and an HPV and self exam. What else would you like women to be getting every year--that you think is important?
Megan: In addition to the Pap smear, the annual exam, we’re also listening to their heart and lungs, looking at their skin. Sometimes we can find an abnormal mole that could possibly be a melanoma. Sometimes we’re the only healthcare provider that these women see on an annual basis so if we see something abnormal, we’ll get them in the right direction where they need to go. We’re also feeling the size of their uterus and ovaries and looking at the outside as the vulva. There’s such a thing as vulva cancer, so if there’s anything ever abnormal on the outside, we’re addressing those concerns as well.
Melanie: Megan, do you also see that it’s important--when you see women and they come in--and you’re a nurse practitioner, so you see women as your patients, do you see that sometimes they want to talk about depression or their weight or alcohol use or relationships or any of these other things as an important adjunct to that yearly physical?
Megan: Absolutely. I do so much mental health and domestic violence screening and I treat a lot of depression and anxiety and refer them for counseling and get them in the direction that they need to go. This is definitely a place for them to talk about uncomfortable conversations that they can't always feel comfortable talking with other providers about.
Melanie: What do you tell them when they ask you about blood tests and checking cholesterol and A1C or fasting blood glucose to see if they’re maybe pre-diabetic, because this is a very common thing now and obesity is such a problem in our country. So , what do you tell them about these kinds of checkups and how important they are to prevent heart disease?
Megan: We always want to make sure that someone is checking those whether it’s their primary care provider or through their employer--a lot of employers do wellness screening. If no one is checking those, then we will order them for them and just counsel them, “If they come back abnormal, then we won't treat them just because that’s out of the scope of our practice but we will get you in the right direction and get you set up with someone that can treat you.” So, we’re more than happy to order and screen for these things even though we don’t necessarily treat them. So, we do age-appropriate age appropriate screenings and just make sure than the women are getting all the care that they need. Colonoscopies, we start those at age 50, and sometimes sooner based on their family history.
Melanie: That’s a great point to make that you would help them screen or refer them to where they can go to get more information. What about something like a bone mineral density test because women want to know about osteoporosis now. What do you tell them about that test?
Megan: That changed a couple of years ago and the newest recommendation actually says not to start it until age 65, unless they have a lot of risk factors for that. But that's something different. So, now, we’re just more, kind of, counseling on prevention and talking to them about how much calcium and vitamin D that they need and promoting weight bearing exercise and those like that.
Melanie: That is so important. Another thing that we’ve been hearing about is baby boomers and hepatitis C. If they ask you about this test and why they might need it, what do you tell them?
Megan: Yes, it is recommended to screen for that, and it’s also recommended to offer HIV testing annually to every woman. So, we can offer that in addition to hepatitis C.
Melanie: So then, wrap it up for us, Megan. What do you want women to know as the most important bits of information about their annual screenings, whether they’re gynecological in nature or to prevent heart disease or control obesity or depression? What do you want to know? What do you tell women every single day?
Megan: That this is just a visit that we can make sure that you are getting the appropriate screenings that you need, vaccines, whether it’s contraception or preconception counseling, domestic violence screening or just getting them help that they need, and addressing any of their medical concerns.
Melanie: Thank you so much for being with us today. You’re listening to Health Talks with HRH, Hendricks Regional Health. And for more information, you can go to www.hendricks.org. That’s www.hendricks.org. This is Melanie Cole. Thanks so much for listening.