The current recommendation is that gynecology exams and Pap tests begin at age 21. However, we do see many women in their teens to discuss contraception, sexually transmitted disease, and to address various gynecologic conditions.
Pap testing begins at age 21. Between the ages of 21 and 30, Pap tests are performed at least every three years. Beginning at age 30, Paps that include HPV testing may be performed every three to five years. Based on individual history, these intervals may change. Please discuss your personal recommended interval with your provider. Pap tests may not be performed after the age of 65 or after hysterectomy.
Although you may not need a Pap test annually, it is very important to schedule a yearly gynecologic exam. A breast and pelvic exam will be performed, prescriptions refilled, screening tests ordered, and any concerns will be addressed.
HPV is very common among women in their early twenties who have been sexually active. HPV is only a significant concern if a Pap test becomes abnormal or if HPV persists consistently after age 30. Starting at age 30, Pap and HPV co-testing is less likely to miss an abnormality than Pap testing alone. Pap and HPV co-testing may also lengthen the recommended screening interval for cervical cancer.
The HPV vaccine is administered to both females and males age 9-26 in three doses over a six month period. Insurance companies will only pay for the doses completed before the patient’s 27th birthday. The Centers for Disease Control and the American College of Obstetricians and Gynecologists recommend routine HPV vaccination to girls at age 11 or 12. The vaccine is most effective when given before any exposure to HPV (i.e. before any sexual activity) and produces higher antibody when given at this age as opposed to older ages. Girls and women age 13-26 can still receive the vaccine if they have not previously. The HPV vaccine is not recommended for pregnant women.

HPV can cause genital warts, precancerous lesions of the cervix and vagina, and cervical cancer. The vaccine helps to protect against diseases caused by HPV Types 6, 11, 16, and 18. These four types of HPV cause approximately 70% of cervical cancers and 90% of genital warts. However, because there are more than 100 types of HPV, the vaccine will not protect against all of them. The vaccine will also not protect against types of HPV to which you have already been exposed. However, since exposure to all four types of HPV is rare, the vaccination should still provide benefit. HPV vaccination does not make you exempt from routine Pap testing and following your providers guidelines for Pap testing is imperative.

The American Cancer Society and the American College of Obstetricians and Gynecologists recommend annual mammograms beginning at age 40. If you are at high risk of developing breast cancer due to personal or family history, mammograms before age 40 may be indicated, as well as other enhanced screenings such as breast MRI. Routine mammogram screening ends at age 75. Please discuss with your provider when you should begin mammogram screening.
For well exams that may include a Pap, we recommend scheduling when you will not be on your period but we do understand that these things are sometimes out of our control. If you are not bleeding heavily and are comfortable keeping your appointment, you may do so.
Call our office during normal business hours for an appointment. We typically have same day appointments available. Infections can have varying symptoms so it’s very important to be evaluated by your healthcare provider to ensure the correct diagnosis and treatment.
Call our office to schedule an appointment. Early treatment helps to minimize the long-term effects of STI’s. Avoid all sexual contact until you are screened and treated. Many STI’s have mild or no symptoms, so intermittent screening is often recommended.
Not necessarily. Many sexually transmitted infections may have mild or no symptoms and can be transmitted without knowing. The only way to know is to get tested.
If you miss one pill, take it as soon as you remember. If you so not remember until the next day, take two pills at the same time. If you miss two pills, take two pills for the next two days and use a back-up contraception method such as condoms for the remainder of the pill pack. Please be aware that taking two pills at a time can sometimes cause nausea. Also, missing pills or taking pills late can cause light vaginal bleeding and can decrease the efficacy of your birth control. Try to take the pill at the same time every day. If you have trouble remembering, set an alarm on your cell phone. If that doesn’t work, you may wish to talk to your provider about alternative methods of contraception available.
Hormonal contraception such as birth control pills, Nuvaring, Mirena IUD, and Implanon/Nexplanon may cause spotting or light bleeding for the first few months. This is a normal and common side effect that should improve over time. This does not mean your contraception is not working. Also, it is not uncommon for women using these methods to miss their period completely. As long as you are using the method correctly there should be no concern.
Intrauterine contraception is highly effective, long-acting, and a safe option for most women. Ideal candidates are women who desire long-term contraception, are not planning pregnancy for at least a year, and are in mutually monogamous long term sexual relationships, and desire a non-estrogen method of birth control. Mirena, Paragard, and Skyla IUD’s are available in our office. The insertion is a quick procedure that is often done during your period. If you are breastfeeding and are currently not experiencing a monthly period, you may schedule an IUD insertion at any time.
If you are sexually active and could be pregnant, take a home pregnancy test or call our office for an appointment. If you are using hormonal contraception this could be a common side effect. If you are not on any medication and have not had a period for three months, call our office for an appointment.
Emergency contraception, also referred to as the Morning After Pill, helps prevent pregnancy after unprotected sex or birth control failure. It should be taken as soon as possible because the earlier you take it, the better it works. It can be taken for up to five days after the event of unprotected intercourse, but is most effective in the first 72 hours. It is available over the counter for women 17 years or older. If you are under the age of 17 a prescription is required from your healthcare provider.
*If you are already pregnant, emergency contraception will not affect or abort an existing pregnancy.
There are several treatment options for the management of menopausal symptoms including lifestyle changes, the use of bioidentical hormones, and conventional hormone replacement therapy (HRT). Please call our office and schedule an appointment to discuss which options are right for you.