August 2014

Pap Smear

Periodic “Pap Smear” Examination


Why The Periodic Examination?

The Periodic Pap Smear Examination is a preventive health examination. Its value is that of finding and identifying potential problems before they become real health problems. This cannot only save your life but it can save money, pain, suffering, anxiety and promote peace of mind.

What Is The Periodic Examination?

The examination should consist of a systematic evaluation.

Generally this means:

  1. Your specific medical history: How you feel, what symptoms you might be having, a review of your body systems, a review of your menstrual period history, including regularity, pain, frequency, amount of bleeding, etc. You are evaluated for Premenstrual.
  2. Syndrome, Menopause Syndrome, Nutritional Status as well as Stress Related Disorders.
  3. Your vital statistics are determined: Blood pressure, weight, height, temperature and pulse.
  4. Physical Examination: General appearance, skin examination (looking for skin cancers) and your thyroid is checked. Next your heart and lungs should be listened to, your abdomen should be evaluated especially, your liver, kidney and other internal organs.
  5. Extremities should be evaluated for edema, arthritis, muscle tone and for varicose veins.
  6. Breast Examination: The should be examined for lumps, tenderness and abnormal secretions. You should be taught how to examine your own breasts to look for precancerous changes.
  7. Pelvic Examination: Besides evaluating your vagina, cervix, uterus, fallopian tubes and ovaries for cancer and other disease, changes in hormonal tone should be evaluated. A good exam will also look for falling of the bladder or other easily correctable problems to help you to prevent needing surgery in the future.
  8. Rectal Examination: Should be performed in all women (& men) over 35 a rectal exam should be performed at least yearly.
  9. Laboratory Testing: Specific and routine tests may be indicated.

What Should Your Doctor Be Looking For?

  • System Review looks for subtle signs of disease: thyroid, diabetes, high blood pressure, heart disease etc.
  • Here in sunny Southern California skin cancer is a major problem. If you don't look, you might not find it until it is too late.
  • Elevated blood pressure may be silent and not found until it causes irreversible damage-stroke, heart disease, etc.
  • Breast cancer is a major health problem. Teaching of the self-breast exam helps many women find cancers early well before they need radical surgery. This is extremely important as 85% of breast cancers found by the woman herself are completely curable.
  • The cure rate drops to 40% if the woman waits until the doctor finds it.
  • Genital cancer, venereal disease, vaginal infection, fibroid tumors of the uterus, ovarian tumors and cysts.
  • Infertility - Problems which might lead to difficulty in getting pregnant.
  • Rectal cancer can often be found with a simple rectal exam.
  • The stool can be checked for OCCULT BLOOD to check for bowel cancer.

  • What About Laboratory Tests?

    Laboratory tests are of two types:

    1) Routine and 2) Specific:

    Routine tests such as urine analysis to look for bladder infections, kidney disease and infections and blood count to look for anemia and leukemia are essential screening tools. The pap smear evaluates the cells of the cervix and vagina and looks for cancer of the cervix and vagina even the tubes and ovaries. Vaginal infections, herpes and venereal warts can often also be identified.

    Specific tests may be needed to screen for diabetes, thyroid disease and other problems that might be indicated by the medical history, system review, the physical examination or family history.

    What Other Values Are There To Having Regular Examinations?

    Possibly one of the most important values of the periodic examination is the face to face ability to ask questions of YOUR doctor about YOUR health and how to maintain it. During the office visit questions about birth control, sexuality, about how to get help for family problems, marital problems, premenstrual syndrome, menopause, diet, nutrition, stress, tension, medications and even about other members of your family and friends.

    What About VD Screening?

    There are many women who are dating and possibly having sexual relationships with one or more partners. Even if the woman is fastidiously careful about her hygiene, she may not always be sure about her partner and whether he may have other partners, female or male. The periodic examination gives the woman the opportunity to request testing to protect her from venereal disease. Testing for Chlamydia, Gonorrhea and Syphilis, as well as for Herpes and AIDS are easily performed and relatively inexpensive. The examination also should be used to screen for Condyloma. This is also an opportunity to be educated about the risks of venereal diseases.

    How Often Should The Examination Be Done?

  • Women under 25, once per year is usually sufficient.
  • Women over 25, I recommend exams every six months. The risk of breast cancer starts to rise after 25.
  • Women using birth control pills, every six months to watch for risks of the pill.
  • Women with an IUD (intrauterine devices) should have examinations every six months.
  • Women with specific problems such as endometriosis, fibroid tumors, breast lumps, abnormal pap smears, vaginal warts, herpes, should be evaluated individually.
  • Women with family risk history. DES exposure, breast cancer, other cancers or specific diseases should be taken individually.

  • Should You Have A Periodic Examination

    In truth this is a question that only YOU can answer for yourself. Statistics show that most people are healthy. This is true. I have presented my logic and belief systems of the value of the periodic examination. There are also many short comings; anxiety about being examined, fear of the examination and of the potential findings, discomfort of the examination, the cost, the time out of your schedule just to name a few. Only you can decide what you want to do and what you are ready for. This is part of the process being ready and able to deal with your own health and well-being.

    The most important thing to remember about having a periodic "Pap Smear and Breast Examination," is that: