Q&A: Gynecologic exams not necessary for all adolescent girls

May 5, 2018 by From Mayo Clinic News Network, Mayo Clinic News Network

Dear Mayo Clinic: At what age should a teenage girl have her first Pap smear and gynecologic exam? Should this be done by a pediatrician or another provider?

A: Pelvic exams and Pap smears are not necessary in healthy, adolescent girls who are not sexually active and who do not have gynecologic symptoms or other concerns. The recommended age for young women who have not previously needed a Pap smear to begin having the test is 21. Primary care providers, such as those in family medicine or internal medicine, can perform that exam, or a gynecologist can perform the exam.

In the past, many providers used to recommend that teens have a Pap smear at 16 or 18. Now, however, the American College of Physicians does not recommend any routine gynecologic exams for teens at low risk of having the HPV or other sexually transmitted infections.

The purpose of a Pap smear—a procedure that collects cells from the cervix—is to check for changes in those cells that could be a sign of and look for the presence of high-risk types of HPV that are known to cause .

HPV is the most common in the U.S. Although most cases of HPV do not cause symptoms or lead to problems, certain strains of the sexually transmitted HPV are considered high risk, and can lead to cancer and potentially be deadly if left untreated. Two strains of the virus cause 70 percent of all cervical cancer. You can greatly reduce your risk of HPV and cervical cancer by getting the HPV vaccine. This anti-cancer vaccine most effectively builds immunity when it's given between ages 9 and 14.

If you are not sexually active as a teen, in most cases there is no need for a Pap smear because your risk of cervical cancer is low, and you have no risk of HPV or other sexually transmitted infections. Once you begin having sex, a Pap smear may be appropriate. But even in many of those situations, Pap testing still may not need to begin until 21.

Traditionally, some required a pelvic exam—an evaluation of the vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for any abnormalities—before they would prescribe contraceptives. Again, that is no longer the case. A pelvic exam is not needed to obtain birth control. For most healthy women, the first pelvic exam also can wait until 21.

For young women whose medical history puts them in a higher risk category for infection or cancer, a Pap smear or pelvic exam may be recommended at an earlier age. Those risk factors include a weakened immune system due to chemotherapy, organ transplant or long-term corticosteroid use; exposure to the medication diethylstilbestrol, also known as DES, before birth; and HIV infection.

Some symptoms also may trigger a pelvic exam, such as heavy, painful periods; pelvic pain or pressure; abnormal bleeding or discharge; and itching, pain or lesions in the vulva or vagina. In those situations, a pelvic exam may be necessary, but a Pap smear typically is not required.

When it is time to get a pelvic exam and Pap smear, it's best to work with a health care provider you know and trust. Before the exam, ask your health care provider about what will happen during the and what you can expect. Some providers have anatomical models they can use to describe the procedures beforehand, so you can clearly see what will happen. These procedures are important exams, but they need not be a source of anxiety or fear. If you have questions or concerns, talk to your health care provider.

Explore further: Study questions reasons for routine pelvic exams

3 shares

Related Stories

Study questions reasons for routine pelvic exams

December 14, 2012
The pelvic exam, a standard part of a woman's gynecologic checkup, frequently is performed for reasons that are medically unjustified, according to the authors of a UCSF study that may lay the groundwork for future changes ...

5 things you should know about cervical cancer

December 1, 2017
(HealthDay)—A little knowledge can go a long way in the fight against cervical cancer.

Facts women and men should know about cervical cancer

January 22, 2018
January is Cervical Cancer Awareness month and the message from the Centers from Disease Control and Prevention is that "no woman should die from cervical cancer."

Specialist explains why age 13 to 15 is ideal for the first gynecologist visit

January 17, 2018
Most parents are well-versed in schedules for their kids. They know to schedule an annual physical—or else the school nurse will call, or their child can't join the soccer team. They know when their kids need to start dental ...

New Pap smear schedule led to fewer chlamydia tests, new study suggests

July 20, 2015
It's a tale of two tests: one for early signs of cervical cancer, the other for a sexually transmitted disease. But a new study suggests that a change in the recommended schedule for one may have dramatically lowered the ...

Researchers find bimanual exam doesn't accurately screen for ovarian cancer

April 2, 2015
The most commonly performed ovarian cancer screening test—the bimanual exam—is unlikely to benefit healthy women, according to a study led by researchers at the University of Georgia.

Recommended for you

Vendors say pot eases morning sickness. Will baby pay a price?

May 22, 2018
(HealthDay)—Nearly 70 percent of Colorado marijuana dispensaries recommended pot products to manage early pregnancy-related morning sickness, new research reveals.

Pregnancy drug DES might have triggered ADHD in the grandchildren of women who used it

May 21, 2018
A study conducted by researchers at Columbia University's Mailman School of Public Health and Harvard T.H. Chan School of Public Health reported elevated odds for attention deficit hyperactivity disorder (ADHD) in the grandchildren ...

Male depression may lower pregnancy chances among infertile couples, study suggests

May 17, 2018
Among couples being treated for infertility, depression in the male partner was linked to lower pregnancy chances, while depression in the female partner was not found to influence the rate of live birth, according to a study ...

Fertility study finds acupuncture ineffective for IVF birth rates

May 15, 2018
A study of over 800 Australian and New Zealand women undergoing acupuncture treatment during their IVF (in vitro fertilization) cycle has confirmed no significant difference in live birth rates. The findings published today ...

More than one day of first-trimester bleeding ups odds for smaller baby

May 10, 2018
(HealthDay)—Some first-trimester bleeding occurs in up to 1 in every 4 pregnancies. Now, new research suggests that if bleeding extends beyond a day there could be implications for baby's birth weight.

For women with history of pregnancy loss, walking may aid chance of becoming pregnant

May 8, 2018
Results of a recent study to better understand modifiable factors such as physical activity that may affect a woman's ability to conceive a child suggest that walking may help women to improve their chances of becoming pregnant.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.