What can I expect during a gynecologist visit at certain ages?

The American College of Obstetricians and Gynecologists recommends annual exams for women over age 65. With an annual exam, a pelvic exam should still be done. Your doctor will check for vaginal or vulvar changes. There can also be risks of malignancy at that age. Depending on your history, your doctor may want to do a Pap smear as well.

Dr. Angela T. Valle, MD
OBGYN (Obstetrician & Gynecologist)

During gynecologist visits when you’re in your 20s and 30s, you can expect your doctor to review your overall sexual and reproductive health. The doctor will address your menstrual cycle and any menstrual irregularities you could be experiencing. At this age, menstrual irregularities could tip doctors off to ovulatory dysfunction or things that might cause problems with fertility in the future. This is a good time to discuss family planning and set goals for when you may or may not want to become pregnant. This can help determine what kind of birth control plan is best for you.

Contraception counseling and sexually transmitted disease (STD) counseling will also be given if you are sexually active. Your doctor will also start talking about screening for hereditary breast and ovarian cancer. There are two genes, BRCA1 and BRCA2, which are hereditary and greatly increase a person’s risk for breast and ovarian cancer. If you have a strong family history of breast and ovarian cancer, your doctor can screen you and any affected family members to help determine what kind of treatment is most appropriate.

Routine for this age group are a breast and pelvic exams, and sometimes a Pap smear. Some common conditions that are treated are pregnancy, infertility, STDs, abnormal Pap smears, menstrual irregularities, fibroids, ovarian cysts or tumors, endometriosis and pelvic pain.

When you are over age 65 and visit your gynecologist, you can again expect the doctor to do an overview of your sexual health. This is important. A lot of times, sexual health is not discussed with women in this age group. It continues to be an important part of someone's life, and if there are any issues, the doctor should try to address and fix them.

Any ongoing menopausal symptoms will also be discussed. Particularly for the elderly, a screening will be done for neglect and abuse because the elderly are at increased risk for abuse.

A breast exam and a pelvic exam will also be conducted. If your Pap smear history has been normal, then a Pap smear is unlikely. Until age 75, screening mammography will continue. This is not a definitive guideline, however. This is something that your doctor will discuss with you, and based on your history and your wishes, mammography screening will be tailored for you.

Referral for bone density studies is recommended at age 65 to determine if you are at increased risk for bone fractures. If necessary, your doctor may suggest medication to help prevent that. If you have risk factors, such as a family history of severe fractures or if you are a smoker or heavy drinker, you might be referred earlier for a bone density study. Your doctor also may consider this if you have already suffered a fracture before age 65.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.