An annual gynecologic exam is of paramount importance.  Our patients often ask when their daughters should have their first examination.  The American College of Obstetricians and Gynecologists recommends that women have their first visit to the gynecologist at age 15.  At that time we would not do a Papanicolaou (Pap) smear, but would offer STI screening if the young woman had already had intercourse.  Otherwise, that would be a good time to get comfortable with myself as a gynecologist, and I would do a general physical and only an external exam.  For women who have had intercourse, it is very important to have a Pap smear on a regular basis after age 21. This is a screening test to look for chronic irritation, precancerous changes, and cervical cancer.  The recommendations for how often a woman needs a Pap smear have changed and they depend upon a woman's risk factors and history of abnormal Pap smears or cervical dysplasia. The presence of the high risk Human Papilloma virus demands more frequent testing and often a colposcopy. A Pap smear is more sophisticated than prior, and now cervical cells are collected, placed in a solution, and a computer makes the slides that will be read by the cytologist/pathologist.

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These computer-generated Pap smears are easier for the cytologist to read, and therefore a more accurate assessment can be made.  Also, testing for the high risk types of the Human Papilloma virus can be done with a Pap smear for a more accurate risk assessment. When a Pap smear is abnormal or when high risk HPV is detected, sometimes further assessment has to be made with a colposcopy, and sometimes a surgery needs to be performed to remove abnormal tissue from the cervix.  This type of procedure, known as a LEEP can be performed in the office.

Below are Common Gynecologic Procedures:


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