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Tag Archive for: HPV screening

Posts

Cervical Cancer & HPV: Prevention & Treatment

Blog, Women's Health

Cancer is the big “C-word” diagnosis that no one wants to hear, no matter how high its survival rate. One of the more common—and treatable—cancers that affect women is cervical cancer.

Women have an excellent rate of surviving cervical cancer when it is found and treated in its early stages. Even better, cervical cancer can be easily prevented through regular screenings done painlessly during your well-woman checks.

Cervical Cancer: Symptoms, Causes, Treatments

Most Common Symptoms of Cervical Cancer

Cervical cancer is asymptomatic in its earliest, most treatable stages—meaning, you won’t notice any symptoms. This is why regular screenings are so important.

Once cervical cancer becomes more advanced, you may notice changes in vaginal bleeding or discharge, such as bleeding between periods, after sex, or even after menopause. This could range from light spotting to heavy bleeding, or other abnormal discharge.

The most advanced cases of cervical cancer cause pelvic and back pain and changes in urination and bowel movements.

What Causes Cervical Cancer

Cervical cancer is usually the result of a progression of abnormal cells that have gone undetected for 20-25 years. While we don’t know what causes every instance of cervical cancer, we do know the cause of more than 95% of cervical cancer: persistent cases of specific strains of the human papillomavirus (HPV).

HPV is a viral, sexually transmitted infection (STI) that often has no side effects but that can cause warts or skin growths in the genital regions, the mouth, and the throat. It is the most common STI. Not every type of HPV causes cancer, but the ones that do cause cancer can be prevented by the HPV vaccine.

How to Prevent Cervical Cancer

The first step to preventing cervical cancer is to get the HPV vaccine before becoming sexually active. This can prevent you from getting the cancer-causing strains of HPV. Even if you’re already sexually active, getting the vaccine can prevent you from contracting strains you have not been exposed to yet.

The next step is to stay up to date on your Pap tests and HPV tests so that any irregular cells or infections can be detected as soon as possible. The Pap test (or Pap smear) looks for irregular or precancerous cells. The HPV test looks for the presence of HPV in your body.

For both of these tests, your OBGYN will gently swab your cervix and the surrounding area to remove some cells that can be examined in a lab using a microscope.

When to Get Pap Tests & HPV Tests

Age 21 – 20:

  • Get your first Pap test / Cervical cancer screening at age 21.
  • If there are no abnormal cells, then continue with screening every three years.
  • If abnormal cells are found, get screened annually and get tested for HPV.

Age 30+:

Get your HPV test and Pap test at age 30 if your previous screenings showed no abnormal results.

If your results continue to be normal, reduce screening to every 5 years.

Regardless of your age, your screening intervals could become more frequent based on your Pap and HPV results.

Understanding Pap and HPV Test Results

Pap Test Results

If precancerous or abnormal cells are found during the Pap test, what happens next depends on the abnormality of the cells. If they are low-grade abnormal, then you will simply be monitored more regularly to see if they progress and become more abnormal. If the cells are high-grade but not severe, then you will be monitored even more closely. Depending on your plans for childbearing, your OBGYN may recommend you have a LEEP procedure to remove the abnormal cells before they turn cancerous.

If cancerous cells are found, then further tests will be done to see how advanced the cancer is and if it has spread to any other areas of your body.

HPV Test Results

If HPV is found, it doesn’t mean that you have or will have cervical cancer. But it does mean that you will be more regularly monitored to see how long the virus persists in your body. (Remember, most cervical cancer is caused by PERSISTENT cases of certain strains of HPV.)

Because HPV is a virus, there is no treatment for it—for most people, HPV goes away on its own. Long-lasting HPV increases the risk of cervical cancer over time, which is why you will be screened more regularly.

The next step will be to determine which strain (genotype) of HPV you have. There are more than 100 kinds of HPV. Only a few of them cause health problems.

How to Treat Cervical Cancer

There are different options to treat cervical cancer depending on when it is found, where the cancerous cells were found, your age, and your overall health.

Options for treating cervical cancer include:

  • radiation therapy and chemo
  • simple hysterectomy (removal of the cervix and uterus)
  • radical hysterectomy (removal of cervix, uterus, ovaries and fallopian tubes)

HPV: Symptoms, Prevention, Treatments

What Causes HPV

HPV is a sexually transmitted virus. It is passed through genital contact and skin-to-skin contact.

What Does HPV Do?

Some strains of HPV can cause genital warts that are not cancerous. A few types of HPV can cause cancer if they persist in your body for two years or longer.

The types of HPV that cause cancer are HPV16 (highest risk for causing cancer) and HPV18 (second highest risk for causing cancer). It can also cause cancers of the vulva and vagina in females, and cancers of the anus, mouth, and throat in males and females. There is no way to screen for HPV in these regions.

How to Prevent HPV

Most people who have sexual intercourse will be exposed to HPV at some point, but there are steps you can take to prevent getting it.

  1. Practice abstinence or use barrier contraception during sexual contact (genital and oral).
  2. Limit your number of sexual partners.
  3. Choose a sexual partner who has had limited sexual partners.
  4. Get the HPV vaccine before becoming sexually active.

When to Get the HPV Vaccine

The HPV vaccine has been available and approved by the FDA since 2006. It is recommended that people (male and female) get the vaccination between ages 11-26 and is approved for people up to age 45.

  • Children 11-15 will need two doses (two shots) to reach immunity
  • Children and adults over age 15 will need three doses to reach immunity

The vaccine works best when given before a person is infected. It won’t cure an infection. If you are already sexually active, there is still a benefit to getting the vaccine because it could prevent strains you have not yet been exposed to.

How to Treat HPV

There is no treatment for HPV itself, but there are treatments for the problems caused by HPV (for example, genital warts or cervical changes).

Like any virus, your body’s immune system is responsible for getting rid of it. The best way you can “treat” HPV is by making healthy choices that promote a strong immune system.

Promote a strong immune system by:

  • Eating a nutritious diet
  • Exercising regularly
  • Getting adequate sunlight or supplement with vitamin D
  • Getting adequate sleep
  • Not smoking or using nicotine. Smoking leads to more persistent cases of HPV.
  • Not using illegal drugs
  • Not abusing alcohol

What to Do if You Have HPV

Most cases of HPV are asymptomatic and people don’t know they have HPV until they are tested. Some strains of HPV cause genital warts or growths. If you have genital warts or skin growths on your genitals, anus, mouth, or throat, do not have sexual intercourse.

For most people, HPV goes away on its own. However, people with weaker immune systems and people who smoke are more likely to have persistent cases of HPV.

The Most Important Cervical Cancer Prevention: Regular Screening

Cervical cancer and the virus that causes it rarely have symptoms. That is why regular screening is so important. And the procedure to test for it is practically painless.

Screening may be a little awkward at first, but those short moments of awkwardness can save you a lot of pain and discomfort down the road.

Shannon Wixom, A.P.N.P. - Female gynecologistShannon Wixom is a board certified Nurse Practitioner and Lactation Consultant. She earned her Bachelor of Science in Nursing from Edgewood College in 2005. After graduating nursing school, she enjoyed 13 years caring for women as a labor and delivery nurse. She obtained her Master of Science in Nursing from Concordia University and began her career as a Nurse Practitioner in 2018. Her experience in primary care and passion for women’s health led her to Madison Women’s Health. Her areas of special interest include preventive health, pregnancy and reproductive health care.

July 25, 2022/by Shannon Wixom, A.P.N.P
https://madisonwomenshealth.com/wp-content/uploads/2022/07/AdobeStock_327069911-scaled-e1659115198129.jpeg 668 1000 Shannon Wixom, A.P.N.P https://madisonwomenshealth.com/wp-content/uploads/2017/09/mwh_logo-300x177.png Shannon Wixom, A.P.N.P2022-07-25 14:11:342023-11-27 13:04:57Cervical Cancer & HPV: Prevention & Treatment

Gynecologist Exams, Prenatal Care and More: When Should You See Your OBGYN?

Women's Health

Gynecologist, obstetrician (OBGYN), or primary care physician — which doctor should you see and when?

To know which type of physician you should visit, it’s important to understand the difference between them and what they specialize in.

What is a primary care provider?

A primary care provider is focused on the whole patient, specializing in family medicine, internal medicine or pediatrics. They are often at the center of your health journey and will refer you to other specialists as needed.

What is a gynecologist?

A gynecologist is a primary care physician who specializes in women’s health needs, reproductive health, and women’s health after menopause. Gynecologists also perform minimally invasive surgeries including hysterectomies, removal of ovaries or ovarian cysts, tubal ligation, removal of polyps and fibroids from the uterus, treatments for precancerous changes of the cervix such as LEEP, and other surgical procedures.

What is an obstetrician (OBGYN)?

An obstetrician (OBGYN) is a physician who has received specialized training in the care of women who are pregnant. They care for women throughout their pregnancy, delivery, and into their post-partum period. While they are primarily focused on women’s health and reproductive health, they can also help women manage other health issues.

Which One Should I See?

Many women choose an OBGYN to be their primary care provider so that all their care is through the same person. This is a common choice, especially with younger women who have uncomplicated medical needs. However, older women and women with complex medical problems should continue to have both a Primary Care Provider and a separate OBGYN or gynecologist.

Most of the physicians at Madison Women’s Health are OBGYNs. If you are already a patient at Madison Women’s Health and wonder if you should see an OBGYN or your Primary Care Provider, send us a message through MyChart. We’ll be able to tell you who would be the most appropriate physician for your unique situation.

Reasons You Should See Your OBGYN or Gynecologist

There are many reasons to visit your OBGYN or gynecologist. Below are the typical reasons someone would come in for an appointment at Madison Women’s Health.

    • Birth control: Discuss the many different contraceptive options that are available to you, how they work, how often you need to take birth control, and what kind of birth control would be best for your lifestyle and needs. Read more about birth control options.
    • Pre-pregnancy planning: Learn how to have a healthy lifestyle that will support a healthy pregnancy and delivery. Read more about preparing for pregnancy.
    • Pregnancy: Call us as soon as you find out you’re pregnant, which is usually around 8 weeks pregnant (or 3-4 weeks past your missed period). At your first prenatal visit, we’ll do an ultrasound to establish a due date and confirm viability of the pregnancy. You’ll meet with a nurse to learn about what to expect over the next 30 weeks. Read more about our pregnancy services.
    • Changes in your menstrual period: If your period is different than it was before — heavier, lighter, more prolonged, more irregular — then it’s a good idea to see your gynecologist or OBGYN. Changes in your period could be caused by a variety of factors, such as hormonal imbalances, stress, weight loss or weight gain, infections, abnormal cervical changes, presence of an ovarian cyst, and development of fibroids or polyps in the uterus.
    • Unusual vaginal discharge or odors: It’s important to know what is causing pain, irritation, discharge and odor so you can treat it. These things could be caused by a yeast infection, vaginitis, or STI. Read more about our well woman care services.
  • Screening for Sexually Transmitted Infections (STI)
    • Pain while going to the bathroom (urinary tract infection)
    • Age-related screenings for breast cancer, colon cancer, osteoporosis, and bone health.
  • Pap smear and pelvic exam
  • HPV screening beginning at age 25

If you have other health symptoms or concerns, such as questions about skin issues, painful joints and aching muscles, anxiety and depression, postpartum depression, it is perfectly fine to ask your OBGYN about them. As a primary care provider, your OBGYN can give you care and write prescriptions. They will also refer you to other specialists as needed.

How Often You Should Receive an HPV Screening/Pap smear and Pelvic Exam

Several years ago, women received annual pelvic exams and Pap smears to screen for cervical cancer. We’ve since learned that the presence of certain types of HPV (human papillomavirus) is what increases your risk of developing cervical cancer. The changes to the cervical cells that lead to cancer take a number of years to develop. We know that HPV causes the cells to become abnormal.  For that reason, HPV screening is routine alone, or in conjunction with a pap smear for women 25 and older.  If you test negative for HPV, the pelvic exam may not be needed as often as previously recommended.

Pelvic exams are done along with HPV screening and pap smears,  typically about every 3-5 years unless you have had an abnormal pap smear or positive HPV test, or if you have concerning pelvic symptoms. A pelvic exam is one way your gynecologist can screen you for infectious diseases, cancers to the reproductive system, or other conditions like endometriosis and pelvic floor dysfunctions.

During a pelvic exam, your gynecologist will look at your vulva, vagina, and cervix. They do this by gently inserting a speculum, which widens the vagina so they can see the vagina and cervix. They will also check for any changes in your other organs, the uterus, fallopian tubes, ovaries, and bladder. Samples needed for HPV screening or a Pap smear are taken during the pelvic exam while the speculum is inserted. Your gynecologist will use what looks like a long popsicle stick and brush shaped like a mascara brush to swab the cervix, collecting a sample of cells which will be used for testing.

Most women ages 21-65, regardless of sexual history, should receive HPV screening and or a pap smear every 3-5 years to test for the presence of abnormal cells that could lead to cervical cancer. Some women may be more at risk of developing cervical cancer, such as women with HIV, those with a weakened immune system, or those who have had treatments for pre-cancer or cancer. These women would be screened more frequently, on an individual basis.

HPV screening detects whether the HPV virus is present. If HPV is detected in the sample, then the remaining cells from that sample are sent in for cytology (Pap smear) to see if they are pre-cancerous or cancerous. If the test for HPV is negative, you won’t need another screen for 3-5 years.

How to Prepare for Your Exam with a Gynecologist

It’s important that you feel comfortable and listened to at your gynecological exam. The best way to have a good exam is to relax and remember that your doctor is on your side. We want to help you be the very best version of yourself!

You might be surprised to hear this, but as OBGYNs, we’re really not worried about whether you shaved your legs or waxed your bikini line. You don’t need to do anything special ahead of time. We’re here to take care of you just as you are!

We generally don’t recommend douching because it throws off your vaginal pH, which can cause bacterial imbalances which can lead to or predispose to infection.

Questions to Ask at Your Next Gynecologist Exam

Never be afraid to ask your doctor anything! We care about you as a whole person, so we’ll ask you a lot of questions that cover many aspects of your life. If we haven’t covered something in our conversation with you, please feel free to ask us.

Here are the most common questions we’re asked. If it helps, write a list ahead of time of questions you’d like your doctor to answer (or screenshot ours).

  • Do I need birth control? How does it work?
  • Is my period normal?
  • Do I have to be in so much pain every month?
  • Do I have to have my period every month? Is it too heavy? Too light?
  • How often should I consider sexually transmitted infection (STI) screening?
  • What should I expect about perimenopause and menopause?
  • How can I reduce perimenopause and menopause symptoms?
  • How can I reduce mood changes associated with my menstrual cycle?
  • I have a family history of chronic illnesses, like diabetes, heart disease, and thyroid disorders. How can I reduce my risk of living with these disorders?

Preparing Your Daughter for Her First Gynecological Exam

Moms, we strongly encourage you to openly discuss reproductive and sexual health with your daughters. We’re here to help you with that discussion and process! We have pamphlets at our office that you can use to talk to your daughters about what to expect.

A common question we’re asked is, “When should I bring my daughter in for her gynecological exam?” You may be surprised to hear the answer because many of the recommendations may have changed since you were a teenager.

If your daughter doesn’t have a particular concern regarding her period, risk for sexually transmitted infection,  or need for birth control, she may not need a pelvic exam and HPV screening until she is 21.  If she is using birth control for contraception or periods, she should have a visit at the doctor’s office, but she may not need a pelvic  exam until age 21. Urine tests for STIs can be done without the need for a pelvic exam. If she does need a pelvic exam, reassure her that even though it is awkward, it’s not painful. The exams are very brief, and if it gets uncomfortable, we always stop and readjust.

What To Expect at a Well Woman Exam

Even though you do not need a Pap test or HPV test every year, it’s important that you continue scheduling your annual Well Woman Exam. Your Well Woman Exam is an essential part of your ongoing health maintenance, and is usually covered 100% by your insurance.

At your Well Woman Exam, your doctor will screen you for chronic, preventable diseases such as cardiovascular (heart) disease and diabetes by checking your blood pressure, weight, cholesterol, and glucose levels. You’ll be able to talk to your doctor about other symptoms you may have, such as allergies, migraines, low libido, depression / anxiety, and more. You’ll also discuss whether you need refills for specific medications, or whether you should be seen by a specialist. Your doctor will also make sure you feel safe in your home environment.

Because a Well Woman Exam is more for preventative care and routine health maintenance, the assumption is that you do not have a specific medical problem or condition. If you have specific concerns, you may need to make an additional, separate appointment to talk about your symptoms in more detail with your doctor.

Depending on your age and health history, you may also receive a pelvic exam, mammogram, Pap smear, HPV screening, STI testing or other tests.

Beginning at age 40, you should have mammograms every few years. If you have a history of breast cancer in your family, you may be screened more regularly.

For women 50+, a colon cancer screening is recommended. This is done with either a colonoscopy or an at-home Cologuard test.

As women get older, they’ll also be screened for osteoporosis and bone health.

Woman getting ultrasound at OBGYN clinic

What to Expect at Your Pre-Natal Appointments

At Madison Women’s Health, much of what our OBGYNs do involves pregnancy care and delivering babies. If you become pregnant, we’ll be seeing a lot more of each other!

Set up your very first prenatal visit as soon as you find out you’re pregnant. For most women, this happens around week 8, when they’re about 3-4 weeks past their missed period.

First Appointment: 8 Weeks Gestation

At your first visit, we’ll do a transabdominal and transvaginal ultrasound. This will help us establish a due date and check for a heart beat. You’ll meet with a nurse to go through your medical history. You’ll learn all about exercise, diet, and ways to manage morning sickness. We’ll cover any changes you may need to make to your medication as well. After you’ve had some basic lab work done (blood and urine tests), your OBGYN provider will meet with you to answer any questions you may have.

12 Weeks – 32 Weeks Gestation: Appointments every 4 weeks

Some women choose to have genetic screening done at about 12 weeks. As part of the genetic screening, you will have another ultrasound and you’ll be able to see all the growth and changes that have happened in just 4 weeks. At 20 weeks, you’ll be able to find out the sex of your baby if you desire to do so.

You’ll continue to come in at 4 week intervals until you reach 32 weeks (about 7 months). If your pregnancy is higher risk, you may see your OBGYN more frequently.

33 – 36 Weeks Gestation: Appointments every 2 weeks

Once you reach 7 months, or 33 weeks, you’ll see your OBGYN every two weeks. Your weight and blood pressure will be monitored. And you may receive testing for gestational diabetes.

37 Weeks until Birth: Appointments every 1 week

In the final weeks leading up to your baby’s birth, you’ll come in for an appointment every week. Your blood pressure will be monitored, and your OBGYN will check the positioning of your baby.

Our Gynecologists and OBGYN Providers Are Here for You

At Madison Women’s Health, we’re committed to treating you as the WHOLE person you are. We want to help you be the happiest, healthiest version of you that you can be! Don’t hesitate to reach out if you have any questions about how we can help you.

Dr. Karla Dickmeyer M.D. Founding partner of Madison Women's Health OBGYN ClinicDr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.

 

January 25, 2021/by Karla Dickmeyer
https://madisonwomenshealth.com/wp-content/uploads/2021/01/obgyn-gynacologist-exam-madison-womens-health.jpg 667 1000 Karla Dickmeyer https://madisonwomenshealth.com/wp-content/uploads/2017/09/mwh_logo-300x177.png Karla Dickmeyer2021-01-25 20:23:152024-01-04 13:09:42Gynecologist Exams, Prenatal Care and More: When Should You See Your OBGYN?

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