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Menopause and the need for routine pelvic exams?
I had surgically induced menopause at 50. After that, my primary stopped doing pelvic exams and PAP smears. Jump ahead 10+ years, and I self-referred myself to a gynecologist for concerns I was having. I was diagnosed and treated for undiagnosed lichen sclerosus and provided suggestions for vaginal atrophy. I am now 70, and still see her once a year, including today.
She mentioned that women in menopause should still have a routine pelvic exam. And it is a great time to ask hormone questions. She takes care of the prescriptions I need for Lichen Sclerosus and estrogen cream. In addition, it is a great time to ask for advice on over-the-counter products that can help you with other sexual issues you may be having. And she also suggested seeing a gynecologist for a pelvic exam and other discussions. She mentions that when talking with primary providers, they mention that by the time they talk about all your other medical issues in an appointment, they rarely have time left to do a pelvic exam and discuss "female" issues. Let's face it, the older we get, more medical issues we have that take up time during an appointment. And your primnary may not have the latest knowledge or treatment options as a gynecologist. There are exceptions where your primary is up to date and conducts a thorough exam that includes everything.
What has your experience been with perimenopause or post-menopause and doing routine pelvic exams?
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At 71 yrs of age I still need to do yearly pelvic exam because my last Pap smear came back negative showing precancerous cells. Had surgery to test and remove area in question, but still need to do pelvic exams.
My (former) primary care did them, but I always felt like she didn’t like doing them. During the sit down with the assistant before the doctor came in, I would get the question: Do you have a gynecologist? No. I didn’t know I needed one! My Primary Care was so behind on women’s health. When I mentioned vaginal dryness she told me to use coconut oil! During an exam, she told me I had urethral prolapse, “But I don’t think you need surgery yet…” What?? When I asked if it was there before, she said, “I don’t know.” When I wanted to go on hormone therapy for night sweats and bone protection (at risk for osteoporosis) she pushed back because I have dense breasts. Which is NOT a contradiction for hormone therapy. I lost a lot of bone while being confused by her fearmongering of hormone therapy. I found a gynecologist and she takes care of my hormone therapy and yearly pelvic exams. I agree that ALL women should have annual pelvic exams. Menopause expert Dr. Lauren Stricher discusses this:
https://open.substack.com/pub/drstreicher/p/the-case-for-seeing-a-gynecologist-as-you-age
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