6 Things Every Woman Needs to Know About Cervical Health

Every woman, regardless of age, should be aware of cervical cancer and how to maintain gynecologic health. We spoke with Christine Kim, MD, a board-certified and fellowship-trained gynecologic oncologist with LVPG Gynecologic Oncology, part of Lehigh Valley Topper Cancer Institute. She provides care at Lehigh Valley Hospital (LVH)–Pocono and LVH–Muhlenberg, part of Jefferson Health. Here, Dr. Kim answers important questions, including when to begin obstetrician gynecologist (OB-GYN) exams.  

The American College of Obstetrics & Gynecology recommends that girls start seeing an OB-GYN between the ages of 13 and 15. Not all young girls will have a pelvic exam as part of their visit, but it’s important to establish care with an OB-GYN for many important reasons. Most girls get their first period between ages 10 and 16, and some may experience heavy, painful periods that an OB-GYN can help with. Some girls become sexually active between ages 15 and 19, so a relationship with an OB-GYN is helpful in understanding contraceptive options and prevention of sexually transmitted diseases.

Women should start having Pap screenings of their cervix starting at age 21 even if they have not become sexually active. We do not recommend routine Pap screening in women younger than 21. In women 21 to 29 years old, a Pap test is recommended every three years. Starting at age 30, women have the option of having a Pap test with human papillomavirus (HPV) co-testing every five years or high-risk HPV testing alone every five years. Subsequent tests depend on the results. Cervical cancer screening can stop at age 65 if a woman has had at least two normal previous screening tests in the 10 years previous and if their immune system is strong.

Sometimes there are issues that may not be detected until a gynecologic checkup. With respect to cervical cancer screening, it is not the Pap tests themselves, but the frequency of tests that has improved the ability to pick up precancerous changes. Additionally, we have HPV testing to guide which Pap tests are potentially more concerning than others. 

Lehigh Valley Health Network (LVHN) and HNL Lab Medicine now offer an HPV test that lets women collect the specimen themselves. It’s an alternative that practically eliminates the unwanted pelvic exam. The testing product, a long cotton swab, is inserted into the vagina and rotated a couple of times to take a sample. The sample is then sent to a lab for HPV testing with an approved test. 

Self-testing must be done in the OB-GYN setting, so this appointment is a good time for women to discuss other issues such as contraception, menstrual irregularities, pelvic pain, menopausal symptoms, osteoporosis and others. 

A woman should contact her doctor or clinician if she is experiencing any abnormal bleeding, such as in between menstrual periods, during intercourse or after menopause. Very heavy bleeding or prolonged bleeding, pelvic pain, vulvar itching, abnormal vaginal discharge, feeling a vaginal bulge, urinary leaking, history of diethylstilbestrol (DES) exposure or any other pelvic issues are reasons to seek gynecologic care immediately. I would encourage all women to check in for routine visits with their OB-GYN even if they have finished having babies. Ideally, women should discuss how frequently they need gynecologic exams with their doctor. 

Gynecologic oncologists are specialists in providing care for women with a known GYN cancer or for women with concerning findings on various tests. We can help distinguish what is potentially cancerous, what is not and offer complex pelvic surgery if that is indicated. We work with our patients’ OB-GYNs to determine the best treatment plan for conditions like complex ovarian masses, abnormal Pap tests or persistent abnormal bleeding.

A woman should see a gynecologic oncologist for further counseling if she has a strong family history of cancers, specifically ovarian, breast, endometrial or colon cancers. A gynecologic oncologist can assess her risks and discuss whether she is a candidate for genetic testing, risk-reducing surgery or if she should be followed more closely. A woman’s doctor may recommend a gynecologic oncologist based on her condition, particularly if she has been diagnosed with cancer or a premalignant condition. The patient also may request an appointment.

Our GYN clinicians are knowledgeable, skilled and invested in women’s overall health. We all want to increase the health of the women in our local and regional communities. There have been many advances in both medical and surgical treatments for various GYN conditions. If we see patients early when a problem arises, oftentimes, they are easily treated. We’re also a great group of people.