I was hoping you could provide some clarity regarding reproductive health. Princeton is far from my hometown, so I don’t know how often I’ll be able to visit my gynecologist anymore… and I know I’m getting to the age where I should be getting things like pap smears and other screenings regularly. Can I get these at Princeton? And can you explain what should be on my radar?
–Paranoid about Prevention
Dear Paranoid about Prevention,
First of all, you’re not paranoid – it’s great that you’re starting your college career being proactive about your sexual and reproductive health! Let’s begin by going over some of the most common forms of preventative screenings for women and when you should start them.
- Pap smear: A Pap smear or a Pap test is a procedure, recommended for anyone with a cervix, involving the collection of cells from the cervix with a swab to test for cervical cancer. Pap comes from Dr. Georgios Papanikolaou who came up with the simple procedure. Guidelines suggest that Pap smears should be done every three years beginning at age 21, regardless of whether or not the individual is sexually active. At age 30, this decreases to every 5 years.
- Pelvic exam: A pelvic exam typically consists of 3 parts: an external exam, a speculum exam, and a bimanual exam. The external exam looks at the outside of the vagina including the clitoris, labia, vaginal opening, and anus. The speculum exam is an exam using an instrument typically made of metal or plastic called a speculum which is used to open and examine the vaginal canal as well as the cervix. A pap smear may also take place during a speculum exam. And, a bimanual exam is exam done with one or two gloved fingers. Most healthcare providers agree that the first pelvic exam should take place at age 21 or upon the appearance of symptoms (e.g., pelvic pain, abnormal discharge), but there are certainly other reasons for the exam to take place.
- Well-woman exam: A well-woman exam is an annual exam usually consisting of a breast exam, pelvic exam, and a pap smear.
- HPV: HPV stands for the human papillomavirus. HPV is the most common sexually transmitted infection. There are more than 100 types of HPV, and most are harmless. However, some types of HPV can lead to cervical or other cancers. While guidelines don’t recommend HPV tests before age 30, the Advisory Committee on Immunization Practices (ACIP) recommends getting the HPV vaccine, which protects against 4 strains known to be associated with cervical cancers and genital warts, around age 11 or 12. After age 30, individuals with a cervix are advised to get tested every 5 years, often done alongside their 5-yearly Pap smear.
- STI screenings: Beyond HPV, it’s recommended that everyone between age 13 and 64 be tested at least once for Human Immunodeficiency Virus (HIV) and that all sexually active people young than 25 years old be tested for chlamydia and gonorrhea annually. For individuals at increased risk, syphilis testing is also recommended.
- Mammograms: A mammogram is an x-ray of the breast used to screen for breast cancer. Mammograms are not recommended until age 40, after which they should take place every 1-2 years.
Preventative care guidelines like these enable you to maintain a healthy lifestyle. The Sexual Health and Wellness (SHAW) service on the first floor of UHS provides the well-woman exams and screening for HIV, HPV, chlamydia and gonorrhea, and more. All of these are free of charge to students on the Student Healthcare Plan (SHP), except the chlamydia and gonorrhea test, which costs $14. SHAW also offers accurate advice, information, and evaluations for any sexual health concerns of students of all gender identities and sexual orientations. Appointments at SHAW can be made online or by calling 609-258-3141.
Good luck and stay safe
Recommendations provided by the United States Preventative Services Task Force and the Center for Young Women’s Health (CYWH) at Boston Children’s Hospital. Information regarding HPV provided by Planned Parenthood.