Gynecology FAQ

According to newer recommendations by the American College of Obstetricians & Gynecologist, a first pap should be done at the age of 21 or three years after the onset of sexual activity, whichever occurs first.  If, however, you are thinking of becoming sexually active, we at Oasis would like to see you as soon as possible to discuss contraception, sexually transmitted diseases, etc.

A well woman exam is a check-up for a person who is not having problems.  A physical is performed to look for any potential problems for which the patient may not be able to detect.  Screening tests, such as a pap smear, mammogram and others may be ordered to screen for other abnormalities.  If you are having gynecologic problems, please ask to schedule a problem visit.  Many women believe that if they schedule a well woman exam, their problems will be able to be addressed.  However, this would be similar to scheduling a hair appointment for a cut, but then asking for a color when you show up for your appointment.  We try to schedule visits for appropriate amounts of time.  Most problems cannot be adequately addressed in the time frame allowed for well woman visits.

A pap smear is a scraping of cells from the cervix which is then sent to the pathologist to look under the microscope at the cells in order to detect any abnormal cervical changes, eg. precancerous change.  This is a screening test.  Paps are not done with all speculum exams.  These are not the same.

HPV is a virus that is transmitted sexually.  It is very common to the American population.  Approximately, 60% of Americans have it at any one time and as many as 90% have had it.  It is a virus that we are not able to get rid of, but we can take care of any problems it may cause.  Most people’s own bodies will rid themselves of the virus with time.  However, the virus can cause genital warts and cervical abnormalities, such as precancer and cancerous change.  Fortunately, pap smears can help detect the more serious cervical abnormalities.  HPV testing can be done at the time of pap smears.  If you test negative for HPV and have a normal pap and if you are over the age of 30, you may defer pap testing for three years.  If your pap is normal, but you test positive for HPV, you should repeat a pap in one year.  At Oasis, we have the lab automatically test for HPV if your pap is abnormal, as diagnostic recommendations vary depending on the presence of HPV.

There is a vaccination for HPV and it is recommended girls and women between the ages of 9-26 have the vaccination.  Older women may have the vaccine, as well, but insurance may not cover it.  It is given in a series of three injections at 0, 2, and 6 months.  Finally, HPV is a complex subject and much can be discussed regarding this interesting virus.  For more information, go to Gardasil.com.

A woman’s period may last from 2 to 9 days.  If you are taking birth control pills, your period may be very light and short.  Some women even stop menstruating when they are taking birth control pills.  In fact, pills can be intentionally taken in a way to prevent monthly flow.  Too much, irregular, or prolonged bleeding may or may not be normal.  Even if nothing serious is causing abnormal bleeding, there is much that can be done to eliminate the abnormal bleeding to improve one’s lifestyle.

Birth control pills have a very safe track record.  Side effects include: breast tenderness, nausea, bloating, migraines.  There are some serious side effects that may rarely occur, however.  These include stroke, heart attack, or blood clots to the legs or lungs.  If these rare complications occur, it is usually in somebody with a blood clotting abnormality which then makes the pills more dangerous.  You may be more at risk if you have family members who have had stroke, heart attack, or blood clots to the legs or lungs at an early age (less than 50).  Fortunately, most people taking birth control pills have absolutely no side effects and experience many of its beneficial effects, such as; less bleeding, less cramping, improved mood, decreased risk of ovarian and cervical cancer.  They do not increase your risk of breast cancer.

No.  IUD’s work primarily by thickening cervical mucous making it difficult for sperm to pass through and by decreasing the motility of the fallopian tubes making it difficult for the egg and sperm to meet.  Interestingly, IUD’s are even more effective at preventing pregnancy than birth control pills.