Dr. Birdie on the New Women's Health Guidelines

By , SparkPeople Blogger
Being healthy is about far more than the number on your scale. Just because you lost weight and look fabulous does not guarantee you're healthy on the inside.  As a physician, I have seen many people who are thin and look healthy, but are actually sicker than many overweight and obese people. 

The best way to stay healthy for years to come is to prevent illness.  Focusing on diet and exercise is an important part of being healthy and preventing illness, but there are other aspects of your health that can't be managed with diet and exercise alone. Some areas of your health require regular visits to a qualified medical professional, especially for women. 

So, women of SparkPeople, when was the last time you visited your gynecologist? 

Can I see a show of hands?  Do you know how often you are supposed to get a Pap smear? How about a mammogram?  You are probably thinking I’m trying to trap you into the wrong answer. 

Of course, I am!  Most of you probably said you need to get an annual Pap smear and an annual mammogram starting at age 40.  Right?  Not anymore.

The rules we've all heard have changed, and I'm here to explain the new recommendations for Pap smears, mammograms, and more.

For more information about the reasoning behind the changes, read this New York Times article.

Pap Smear:
Before: yearly between the ages of 21 and 65
Now: every 3 years

Why the change?
For years, we doctors have preached to women to get these tests done yearly, no matter what, between the ages of 21 and 65.
Cervical cancer is relatively slow-growing, and it can be caught in its early stages with screening every three years rather than yearly. When women are screened yearly, there is an unacceptable number of false-positive screening tests, leading to unnecessary procedures which can lead to harm such as infertility. 

Before: Yearly after age 40
Now: Every two years between the ages of 50 and 75

Why the change?
This is a very controversial issue.  The United States Preventative Services Task Forces has recommended mammograms every two years starting at age 50 and stopping at age 75.  Women at high risk (such as those with a family history of breast cancer) should start screening earlier. 

Some groups, such as the American Cancer Society, still recommend yearly mammograms starting at age 40.   

Why the difference?  The reasons are similar to those for the change in the Pap smear recommendations. The risks (women harmed by invasive testing prompted by false-positive screening tests) outweigh the benefits (the number of deaths prevented by yearly testing is relatively low).

What should you do? How often you get screened should be a decision made between you and your physician. 

If you are still confused about when to start mammogram screening--especially with high-profile women in their 40s getting diagnosed with breast cancer--I understand. Knowing your options empowers you to make a more informed decision about when to start your personal screening program.  

Breast self-exams
Before: Monthly
Now: No need to do them.

Why the change?
I remember being reminded every year--and taught--how to do a breast self-exam by my own gynecologist.  Self-exams are no longer recommended because they have not been found to reduce breast-cancer mortality. 
According to the American Cancer Society, breast exams are no longer a part of the screening recommendations because research does not show they provide a clear benefit. However, they suggest that all women be familiar with how their breasts normally look and feel and report any changes to their health care provider right away.

So, what do these changes mean for you?  Does this mean that you get to skip your annual physical? 


My intended message of highlighting these screening changes is to let you know what is currently recommended.   I think we should use this discussion as an opportunity to question your relationship with your health-care provider and learn how to make that relationship more productive. 

You still need to visit your primary-care physician regularly to monitor your overall health.  The number one cause of death in America is heart disease, and you still need to monitor your risk factors and “know your numbers" in order to decrease your risk of heart disease and stroke. 

I know you may be thinking that if your primary-care physician spends only about 5 minutes with you that they can’t possibly accomplish adequate preventative care.  I am not denying that this is an issue.  The current structure of the health-care system in the United States makes it difficult to receive the primary care that you deserve.  Take charge of your own health and demand the care that you need.  Know which screenings you need and when--and "know your numbers."  Go to your primary-care physician prepared to ask for what you need.  If your primary-care physician is threatened by your assertiveness, then you can exercise your right find another physician.  A good physician will be supportive and impressed with your efforts to take charge of your health to prevent future disease. 

So are annual physicals necessary and to they improve health outcomes?  

I believe that preventing disease is one of the best gifts that you can give to yourself and your family.  Keeping that once a year appointment can serve as a reminder of your commitment to your health and early detection leads to better outcomes.  So, continue your annual physicals and continue to eat healthy, exercise, and enjoy your life! 

What is the bottom line?  Even though the latest recommendations allow for less vigorous screening for cervical and breast cancer it does not mean that you should stop seeking annual medical care.   Keeping your yearly appointment is a commitment to preventing future disease and is a gift to all of those who love and depend on you!

Keep Sparking, everyone!

What do you think about the new recommendations?

Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider.