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Doctors' Notes

Pap Smears: Is It Time Yet?

Our resident physicians expose five myths about gynecological visits for teens.
Credit: Thinkstock

Welcome to Doctors’ Notes, our newest contribution from Urban Health correspondents and husband and wife physicians Dr. Rob and Dr. Karla Robinson.  The dynamic duo will be fielding questions about health, as it relates to African Americans.  Please feel free to send them questions via talkback@jetmag.comWe promise to keep it anonymous. 

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Question:  I am a single father of two young girls.  When do I need to start taking them to get Pap smears and breast exams?

Dr. Rob says:

As a father, I commend you for being proactive in the health of your young girls.  Gynecology visits, pap smears, pelvic exams, and breast exams are a necessary part of women’s health, but we find that many are getting into the game too late.  In fact, the American Congress of Obstetricians and Gynecologists (ACOG) recommends that an adolescent’s first visit with a gynecologist should actually be between the ages of 13-15 to introduce a young lady to the routine of annual visits to assess female health.  This is a healthy habit that will last a lifetime. 

This first visit does not necessarily include any invasive exams, such as a pelvic exam or Pap smear.  The timing of these exams is based on age. In general, the guidelines state that the first Pap smear should be performed at age 21. 

Dr. Karla says:

There is a lot of anxiety for both parents and children regarding the “first gynecology visit,” in part because of the fear of a pelvic exam. However, the adolescent gynecology visit is a great time for young ladies and parents to address any questions or concerns regarding the menstrual cycle, sexual health, and what to expect with the Pap smear.

The Pap smear is a test designed to screen for cervical cancer.  We now know that cervical cancer is caused by a sexually transmitted virus known as HPV (human papilloma virus).  That is why a Pap smear may not always be indicated at those first early visits, particularly if there has not been any sexual activity. 

The first visit may also be a time to discuss HPV vaccination.  The HPV vaccines are designed to be initiated before sexual activity occurs, and therefore, before exposure to HPV.  That makes adolescence the ideal time to prepare for a lifetime of sexual health.  

For many parents, the subject of gynecological exams is a touchy one and there are a lot of myths surrounding it.  So we’ve compiled a list of the top five myths related to female adolescent health to keep you in the know:

1. My teen is not sexually active, but is going to get birth control pills to regulate her period.  She has been afraid to go because she will have a Pap smear at her doctor’s visit.  This is a concern that most teens and parents have and often time delays the doctor’s visit unnecessarily.  There is NO need for a pap smear in a teen. 

2. I tell my teen to always use condoms if sexually active.  This will prevent ALL sexually transmitted diseases and infections including HPV.  This is not true.  There are many infections transmitted through skin-to-skin contact.  These include HPV, the virus that causes genital warts and cervical cancer, as well as HSV-the virus that causes genital herpes.  Condoms do not fully protect against exposure to these viruses as there are still genital areas that remain uncovered.  Your teen should know that the only way to truly prevent ALL sexually transmitted diseases and infections is through abstinence.

3. My daughter was offered the HPV vaccine, but she doesn’t need it because she is only 11 years old.  This is a common misconception.  Lots of parents are having a hard time vaccinating their young children against a virus that is only sexually transmitted.  This is completely understandable.  However, the goal is to vaccinate well before sexual activity occurs to offer the best chance for protection. 

4. It is not necessary to visit a gynecologist until you have been sexually active.  It is actually best to start visiting a gynecologist between the ages of 13-15.  The point is not for pelvic exams and Pap smears, but just to introduce a young lady to the routine of annual visits to assess female health.  This is a healthy habit that will last a lifetime. 

5. The HPV vaccine will prevent cervical cancer so Pap smears will no longer be necessary.  This is untrue.  While the vaccines are highly effective, they don’t protect against all strains of cancer causing HPV, only the most common.  It is still important to have annual exams if sexually active. 

It’s a health thing…we’ve got to understand!

About the Doctors:

Dr. Karla and Dr. Rob are the founders of Urban Housecall Magazine and host the Urban Housecall Radio Show.  For more from the doctors, visit their website at www.urbanhousecallmagazine.com, like them on Facebook UrbanHousecallMagazine, and follow them on Twitter @urbanhousecall!