Happy New Year!
Do you ever have those routine health check-ups that you’ve been pushing off for so long because they seem too daunting, especially for someone with a bleeding disorder? Since it’s the start of a new year, now is a great time to start scheduling all those annual health visits and preventive health exams. I know I have quite a few that I passed off as a to-do for next year – well the new year is here and it’s time to stay ahead of those health exams.
As a women, girl, or person with the potential to menstruate, it can feel like there are so many health procedures and preventative health exams that we need to keep up with. What procedures should you be getting routinely and what can you expect during each of these exams? Dr. Kalinda Woods, an OB/GYN at Emory, led a session at BDC last year on how to safely navigate these common and very necessary medical procedures, especially for people with bleeding disorders. I wanted to share some of the key points from that session, so you can confidently book your next check-up.
Typically, your annual gynecology visits should begin at the age of 21, but these can begin earlier if you have specific concerns or if recommended by your general provider or adolescent OB/GYN (obstetricians/gynecologist). Depending on your age, these routine exams can consist of a clinical breast exam, an abdominal exam, and a pelvic examination.
Mammograms are the most common breast cancer screening tool, and this screening typically begins at age 40, but can begin as early as age 30 if you have family history. This routine procedure is recommended by the ACOG (American College of Obstetricians and Gynecologists) and safe for all, bleeding disorder or not. But if you are worried you may experience abnormal bleeding, I encourage you to talk with your care team prior to the exam.
The pelvic exam includes STI (sexually transmitted infections) testing and a pap smear. Pap smears are used to screen for cervical cancer and are used to detect HPV (human papillomavirus), which causes cervical cancer. These screenings should begin at the age of 21 and happen every three years until the age of 29, at which point it can decrease in frequency to once every five years until the age of 65. This screening also has minimal risk for bleeding, but please talk with your provider regarding any concerns you may have.
Beyond annual screenings, there are several procedures that the WGPPM community often undergo throughout their lives. For example, procedural birth control methods and uterine fibroid removals are fairly routine and often life-saving procedures for many.
As Dr. Woods describes, procedural birth control comes in many forms: IUD, implant, bilateral salpingectomy, or hysterectomy, to name a few. While IUD insertions come with minimal procedural bleeding risk, implant insertions do come with a risk of abnormal bleeding due to an incision that is made to place the implant. A bilateral salpingectomy is the removal of both fallopian tubes and is considered the standard of care among gynecologists since it reduces risk for both ovarian and tubal cancers. It is also an outpatient procedure with minimal bleeding risk, so it’s a fairly common procedure. Hysterectomies, the full or partial removal of a uterus, are yet another common procedure, but procedural bleeding risk and post-procedural bleeding depends on the mode of hysterectomy. There are several options when it comes to hysterectomies, so be sure to discuss which option is best for you with your provider.
Dr. Woods states that there are also several methods used for uterine fibroid removal, dependent on the size of the fibroid and your health history. Based off this information, you and your gynecologist will decide on the least invasive and most effective procedure for your personal needs. Like with hysterectomies, bleeding risk can range from minimal risk to high risk, depending on the removal method. But be sure to chat with your provider about all the options available to you, so you can make the most informed decision for your health needs.
Overall, WGPPM with bleeding disorders have access to all procedural, diagnostic, and treatment options for their gynecologic concerns, and should not feel the need to forgo any of these crucial procedures due to their bleeding disorder. These routine preventative health screens save lives and can be tailored to your needs. A common theme with all these procedures is to have an informed conversation with your entire care team (hematologist, gynecologist, nurse, social worker, etc.), so that you are able to find the best possible care for you. So don’t be afraid to raise your concerns regarding bleeding risks with your provider and never hesitate to ask your provider to walk you through all your options when it comes to procedural methods and treatment – shared decision making is key here.
I hope this breakdown of common preventative exams and health procedures empowers you to schedule your next annual exam with your gynecologist!
