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After menopause, do I still need complete gynecological exams?

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Menopause may be a time of transition, but one thing that does not change is the need to see a gynecologist on a regular basis. In fact, since some cancers become more common as a woman ages, these office visits can take on an even greater importance after midlife. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that all women 21 and up have an annual pelvic exam, in which a doctor checks the health of your reproductive organs. Some women, such as those who have had hysterectomies, may not need an annual exam. ACOG also recommends a cytology and HPV screening every 5 years or cytology alone every 3 years. Screening may be discontinued at age 65 if the previous three cytology tests are normal, or if the patient has had two negative cytology and HPV tests within the last 10 years, as long as the most recent tests were done within the last 5 years.

Every women should continue to have an annual gynecological exam for good preventive health. Especially as women age, the risk of cancer can increase. It is important to monitor reproductive organ health. Women at higher risk of ovarian or cervical cancer should talk with their doctor about monitoring their health carefully. Not all women will need an annual Pap test–those without a cervix, and those over 65 who have had 3 negative tests or no abnormal results in 10 years will not generally need one. But an annual exam is important to check for other medical conditions.

There are not any medical tests that need to be done routinely in a woman who reaches menopause. There are several screening tests that are recommended based on age or a patient's personal risk, but menopause is not a factor that makes any specific medical test indicated.

Women today can expect to live as much as one-third of their lives beyond menopause. The years following menopause can be healthy years, depending on how you take care of yourself.

Many women pay close attention to their gynecological health during their younger years and start to ignore it after menopause. Your wellness plan after menopause should include, at minimum, annual visits to a healthcare professional. These visits should include:

  • An annual breast examination by a healthcare professional
  • A mammogram every one to two years
  • An annual gynecologic exam
  • A Pap test every three years or a Pap test combined with an HPV (human papillomavirus) test every five years. Women who are age 65 or older and who have had adequate prior screening with normal results and who do not have a new sexual partner and who are not at high risk for cervical cancer may stop getting Pap tests.
  • A fecal occult blood test (FOTB), fecal immunochemical test (FIT) or stool DNA test (sDNA), all of which check for colon cancer, are recommended annually beginning at age 50.
  • Colon cancer screening with colonoscopy every 10 years beginning at age 50, unless you or someone in your family has had benign colon polyps or colorectal cancer or an inflammatory bowel disease, such as ulcerative colitis, irritable bowel syndrome or Crohn's disease, in which case you should start screening earlier. African Americans are at higher risk than other groups for getting colon cancer and dying from the disease. The American College of Gastroenterology recommends that African Americans begin screening for colon cancer at age 45.
  • Blood pressure check at least every two years (more often if it's chronically high), and blood cholesterol screening every five years (more often if it's chronically high or you have other risk factors for heart disease or stroke).
  • Bone density screenings, such as a dual-energy X-ray absorptiometry (DEXA or DXA) if you are over age 65, or at a younger age if you are at risk for developing osteoporosis.
  • Annual screenings for diabetes, if recommended by your healthcare professional.
  • Thyroid function testing every five years, if recommended by your healthcare professional.
  • Age-appropriate flu shots and other immunizations.

Discuss any unusual or uncomfortable symptoms with your healthcare professional. Keep track of medications that you take and ask your healthcare professional or pharmacist about potential drug interactions, if you are told to take a new medication. Be sure to discuss with your healthcare professional any alternative medical treatments or herbal products you use or may wish to use. Also, you are never too old to begin or continue exercising. A simple walking routine for 30 minutes four to five days a week can provide health benefits. There are other exercise options. Talk to your healthcare professional about which ones fit your lifestyle and medical needs.

Patricia Geraghty, NP
Women's Health

Many women call their annual gynecological exam a pap test (not "smear"). This test does not need to be done annually. However, while guidelines vary, experts in women's health including the American College of Obstetricians and Gynecologists, support annual exams to check multiple aspects of health above and beyond the pap test. In particular in the postmenopause age group, increased risk of breast cancer and increased vaginal tissue problems need to be monitored.

If you are having sex (and we hope you are) and are female, yes. Annual exams, including complete gynecological exams, are good preventive measures. And the screening exams that you receive through your gynecologist can be life saving.

As you age, the risk for certain health problems such as cardiovascular disease, high blood pressure, and breast cancer increases, especially after menopause.

For many women, the gynecologist is the only doctor they see regularly, so your gynecologist may be the only person to pick up on your elevated blood pressure, blood sugar, or cholesterol. So keep up your visits, no matter what.

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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.