The Annual Manual

Kalispell-ObGyn-Annual exam for women

by Dr. Jenna Huff | Kalispell OB/GYN

It wasn’t too long ago when women were getting Pap smears yearly and so the answer to “when was your last Pap?” was easy. But as Pap smear recommendations changed, first to every other year and then on to every 3-5 years, the answer seems to be a bit more puzzling. Add in the confusion between Paps, speculum exams, and pelvic exams and this question seems to stump even more people. So “when was your last Pap” goes from being a gimme question at your exam to a much deeper discussion on what’s been going on with your health. So, what is the difference between a Pap, a pelvic, and a speculum exam?

If you’ve ever had that question, read on!

Pap smears were invented by Dr. Papanikolaou way back in the 1920s when he noticed that prior to developing cervical cancer, which was very common at that time, cells on the cervix started to look abnormal. Back then, we didn’t know why that was, so people would get “Pap smears” (because Papanikolaou smears was a little too long and hard to say) yearly to see if anything was abnormal on the cervix. Back then; if they were abnormal, people were treated more aggressively with a hysterectomy to help prevent cervical cancer.

Fast forward almost 100 years and we know a whole lot more about Pap smears and HPV, or Human Papillomavirus, and the progression of cervical cancer. In learning more, we have found that the abnormal cells on the cervix are caused by HPV, which is a sexually transmitted virus. Like the cold virus, it is recognized by the body’s immune system as something to fight off, and for most people, the body can fight it off. For some people though, they can’t get rid of the virus and it continues to make cells, which becomes more and more abnormal on the cervix and can even become cervical cancer. Luckily, we can catch this before it happens and we have more conservative treatments than in the past.

So, with this new information, we found that doing Paps yearly was over aggressive and that we ended up over treating many people. This is the basis of the new guidelines. The latest guidelines for Pap smears are: Start at age 21, with a Pap smear every 3 years. From age 30-65, a patient is to have a Pap and HPV test every 5 years. Spacing out the screening has resulted in fewer unneeded procedures while still catching abnormal cells that could lead to cancer before it ever gets there! Medical success!!

While there may be some confusion on how often to be seen, we still recommend a yearly exam with your provider. Paps, speculum exams, and pelvic exams are something that may or may not be done at every exam but it is something to discuss with your provider each year.

A speculum exam is an exam that is done, usually during an office appointment but possibly performed in the ER, using a small metal or plastic device that looks like a duck beak. We use this to perform a Pap smear or examine the vagina for any abnormalities and to visualize the cervix. While no one looks forward to these exams, they are quick and an important part of making sure your gynecologic health is taken care of. A Pap is performed in the office (almost NEVER in the ER!) and is done with a speculum exam and a little brush to get a sample of the cells. The sample is then sent off to our friendly pathologist, the doctor who looks at those cells under the microscope, and he/she tells us whether the cells are abnormal or not.

A pelvic exam is an exam performed by your medical health professional to give more information about your uterus and ovaries. Also known as a bimanual exam, we are able to feel the size, shape, and mobility of your uterus and ovaries. This is typically performed yearly at your annual exam to help detect masses of the uterus and ovaries. While not as successful as Pap smears in preventing cervical cancer, it is one way we monitor for ovarian and uterine cancer. I promise none of us care if your legs are hairy, but you get bonus points for fun painted toes!!

While there may be some confusion on how often to be seen, we still recommend a yearly exam with your provider. Paps, speculum exams, and pelvic exams are something that may or may not be done at every exam but it is something to discuss with your provider each year. So even though you were told you don’t need a Pap for 5 years, don’t miss your annual appointment to check up on your health. Prevention is one of the best ways to help live a long, healthy life!

See you soon!

Dr. Jenna Huff joined the staff of Kalispell Regional Medical Center and started practicing at Kalispell OB/GYN in October 2017. She attended medical school at the University of North Dakota School of Medicine and did her residency at Akron General Medical Center in Akron, Ohio. For 4 years following that, she practiced obstetrics and gynecology in Loveland, Colorado.

Dr. Huff is board certified in Obstetrics and Gynecology. She specializes in normal and high-risk obstetrics, contraception management, abnormal bleeding and minimally invasive surgery, including robotics. She enjoys caring for women throughout their life, from puberty through childbearing years and then through menopause, and strives to develop a supportive relationship with her patients. She believes in educating women and helping them make the best possible decisions to improve their quality of life.

Dr. Huff is a Montana native and she, her husband and three young children are excited to be back in Montana to be near family. They enjoy everything that the Flathead Valley has to offer.