Sat | Oct 20, 2018

Dear Doc | Are Pap tests still relevant over 65?

Published:Sunday | August 26, 2018 | 12:00 AM

Q Dear Doc, I am a 65-year-old woman and my periods stopped a long time ago. I would like to know, do I still have to see a gyno and do my Pap test since I don't see my periods anymore?

A That is a very good question.

For women who are over the age of 65, you may stop having Pap tests if you meet ALL of the following:

- You do not smoke, and have never been a smoker.

- You are not sexually active, and haven't been since the last Pap smear.

- You have been getting Pap tests done regularly until you turned 65.

- Your last three Pap tests in a row have been normal.

- You have had no abnormal Pap tests in the past 10 years.

If any of the above changes, or if you are having certain symptoms, such as vaginal bleeding, or an abnormal discharge, you might need a Pap test.

Regarding seeing your gynaecologist; yes, it is still advised that you see one for what we call well woman visits. Apart from doing Pap smears, they will need to check on your menopause symptoms, and screen for illnesses that may affect women of an older age. Also, you may need to be screened for other cancers, such as ovarian and breast cancer. So, though you may no longer require a Pap test, you do have other reasons to visit your gynaecologist.

 

Did my abortion cause my miscarriages?

 

Q Dear Doc, I need your help. I am afraid that something I did when I was younger has caused me to be unable to have children. I feel very guilty and ashamed and have not told anybody about this. When I was young, I did an abortion. Since then, I have lost two pregnancies. Could the abortion cause me to not be able to have a baby?

A I am very sorry to hear about your pregnancy losses. Unfortunately, I cannot say with certainty whether your pregnancy termination has resulted in your miscarriages.

There are numerous causes for having a miscarriage, and the cause of a miscarriage is dependent on how far in the pregnancy it occurs.

Miscarriage in early pregnancy is very common. Up to 20 per cent of women have a miscarriage before they are 20 weeks (five months) pregnant, and 80 per cent of these occur in the first 12 weeks of pregnancy. A common cause for these early miscarriages is chromosomal abnormalities. In other cases, it may be due to low hormone levels.

Later on in the pregnancy, it may be due to structural problems in the reproductive tract, such as uterine fibroids, or what is called cervical incompetence.

In cervical incompetence, the cervix which should remain closed throughout the pregnancy, opens and causes the pregnancy to be expelled. This defect of the cervix can be genetic, or caused by damage to the cervix, which can happen at pregnancy termination, depending on what method is used.

Another cause for pregnancy losses includes medical conditions such as autoimmune diseases like lupus or other medical conditions such as diabetes.

To truly know what is causing your pregnancy losses, you will need to speak with your gynaecologist and give them the details of your medical history so that you can be fully investigated, and to prevent another loss.

deardoc@gleanejm.com