Debunking gynecology visit myths

Shawn Davis-Wilensky, MD is a board-certified obstetrician-gynecologist. She practices at Inova Saville Screening and Prevention Center.

There are many myths that exist about women’s health. In order to make informed decisions about your care, it is important to be educated with the facts. Here are some myths debunked.

Myth #1: The pill can increase cancer risk.

Taking birth control pills can slightly increase breast cancer risk but decrease uterine and ovarian cancer risk. The risk varies with age and duration of use.  Because of that protection your overall cancer risk might be lower. Since the risk of cancer varies significantly among women depending on their risk factors, determining what the right balance of risk and benefit for you is a personal one and one that can be discussed with your gynecologist.

Myth #2: Gynecological cancers only affect older people.

Unfortunately, gynecologic cancers can affect women of all ages. In fact, based on data from the American Cancer Society, cervical cancer is most frequently diagnosed between the ages of 35 and 44. Ovarian and endometrial (uterine) cancers tend to develop later, with the average age of diagnosis in the 60s. That being said, individuals who have a family history of gynecologic cancers could develop them at an earlier age than the general population.

Myth #3: I’m not at risk for gynecological cancers if I have no family history.

Familial cancer syndromes, caused by abnormalities in the genes, are the cause of approximately 10-15% of ovarian and uterine cancers.  The vast majority of gynecologic cancer cases are not related to family history. We know that obesity, diet and lifestyle habits such as smoking and alcohol use can contribute significantly to cancer risk, making it important to focus on these factors when considering ways of reducing your cancer risk.

Myth #4: A Pap smear, also known as a Pap test, will detect all gynecological cancers.

No, this test is meant to detect cervical cancer, or precancerous cells on the cervix. Occasionally it may incidentally pick up signs of endometrial (uterine) cancer. It is not an effective screening test for the detection of cancer of the fallopian tubes or ovaries.

Myth #5: You cannot get gynecological cancers after a hysterectomy.

The term “hysterectomy” is often used to describe several different types of surgeries; a “supracervical hysterectomy” refers to removing the uterus and tubes only; a “total hysterectomy” may refer to removal of the uterus, tubes and cervix; and if the ovaries are removed as well, it may be referred to as a “hysterectomy with oophorectomy”. Depending on what organs remain, you may still be at risk of developing cancer in those organs. If you just remove your uterus without removal of the lower portion of the uterus (the cervix), you can still get cervical cancer. If your ovaries remain, you can still get ovarian cancer. In addition, you can develop cancer in your vagina and vulva.

Myth #6: Cervical cancer cannot be treated.

Cervical canceris one of the cancers that is treatable because with good screening, most women are diagnosed early and have very good outcomes.

Myth #7: Cervical cancer cannot be prevented.

More than 90% of cervical cancer comes from the Human Papillomavirus (HPV). The HPV vaccine contains the versions of HPV that cause the majority of cancers. Vaccinating early, between ages nine and 26 years old (target 11-12 years old) can help decrease your chances of developing cervical cancer. As of 2019, individuals up to age 46 can be vaccinated against HPV, which also helps reduce the risk of developing HPV-associated head and neck cancer.

Getting regular cervical screening also helps by identifying precancerous changes which may spontaneously resolve or can be treated to prevent the progression to overt cancer.

Recommendations for gynecologic care

Women should make plans to visit a gynecologist every year for a pelvic examination, even though they will not get a Pap smear each year. Your gynecologic provider can also complete breast and vaginal exams and discuss family planning (birth control or plans to conceive) along with other issues such as heavy or irregular bleeding, painful periods, pain during sex, decreased libido and menopausal symptoms. Some of the exams you can expect your provider to do include taking a look at the skin outside your vagina or vulva to look for changes that need to be evaluated. Gynecologists will also examine any abnormal vaginal discharge and evaluate it for common things like yeast and bacterial vaginosis (extra growth of bacteria). Screenings for sexually transmitted diseases can also be administered along with essential vaccines such as HPV, flu, TDaP (to prevent tetanus, diphtheria and pertussis) and Shingrix to protect against shingles when appropriate.

Emerging trends in gynecology

As the field of gynecology continues to evolve, there are new developments occurring in a number of different areas:

• There is now more of a focus on managing issues related to the “pelvic floor” including  urogynecologists who can perform specialized examinations, pelvic floor therapists and advanced testing to address urinary leakage, pelvic pain, painful sex, prolapse (when pelvic organs move out of position into the vagina) which were often previously dismissed
• Women who are choosing to undergo surgery will find that there is an increasing ability to perform these procedures in ways that decrease hospital time, recovery time, time away from work and larger surgical scars
• The field is looking at ways to improve the quality of life for menopausal women through medical and non-medical management
• Gynecologists are being better trained to provide care for people who previously had breasts, a uterus, ovaries or vagina/vulva who do not currently identify as women
• Our goal is to provide collaborative, inclusive and effective care for women across their life

Your health matters, and we’re here to support you every step of the way. Schedule an appointment today.