Ask the Doctor: What to Ask Your Gynecologist as You Age
Torrance Memorial Physician Network gynecology specialists offer a patient-centered care experience for the whole woman and her unique needs ay every stage of life.
Written by Dana Klosner
Many women over age 50 think they no longer need to see their gynecologist—especially if they are postmenopausal. Just the opposite is true. Joseph Roofeh, MD, a Torrance Memorial Physician Network OB-GYN, recommends that women continue with their annual visits throughout their lifetime. It is true, however, that the reasons for these visits change as you age. You will find new screening schedules and issues to discuss.
How often should I have pap smears, mammograms and pelvic exams?
Pap smear: This procedure detects abnormal growth in cervical cells. These abnormal cells are a precursor to cervical cancer, and early detection is vital to the prevention of cancer. If you are between the ages of 50 and 65, continue to have a pap smear every three years. If you are over 65 and have had clear tests your entire life, you don’t need to have them anymore since the risk of cervical cancer decreases with age and it takes a long time to arise. If you have had some abnormal results in the past, after three consecutive normal tests you no longer need them.
Mammogram: Continue to have an annual mammogram until age 75. After that, the risk of breast cancer is so low the screening doesn’t add any benefit.
Pelvic Exam: During a pelvic exam, your doctor checks for indications of ovarian or uterine cancer. Since there are no screenings for these, you must continue to have pelvic exams annually.
Sometimes I pee when I sneeze. Is incontinence just a part of aging?
Incontinence does not happen to everyone, but it is common. More than half of women over age 50 have some issues with it. Treatment begins with lifestyle changes including cutting out caffeine and alcohol, pelvic floor physical therapy including Kegels, and keeping a voiding diary with timed voids to prevent overfilling the bladder. If the problem persists, you may opt for a vaginal pessary. This is a noninvasive, in-office process where the pessary is inserted into the vaginal canal. It may not be ideal for women who are sexually active since it blocks part of the canal and must be removed before intercourse. Another successful treatment is a midurethral sling, which requires surgery.
Are there treatments for low libido and painful sex?
When you are postmenopausal, your ovaries no longer produce hormones. This could decrease your sex drive and cause vaginal dryness. Hormone replacement therapy could increase your libido and helps with moisturization and lubrication, which usually relieves the pain experienced during sex.
Is osteoporosis inevitable?
Postmenopausal women are at an increased risk, but this disease may be slowed or prevented by taking vitamin D and calcium supplements and exercise—both weight-bearing and aerobic.
What symptoms need immediate medical attention?
Pelvic pain: This could be caused by an infection, or it could be something more serious like ovarian cysts, ovarian cancer or a mass arising from the uterus.
Changes in your breasts: You should be aware of your breast shape and where you have denser breast tissue. If you notice any abnormalities, nipple discharge or masses, seek medical care.
Postmenopausal vaginal bleeding: Most of the time this is caused by atrophy—the lining is dry and thin and causes a little bit of bleeding. It could be more serious and a sign of uterine cancer.