5 Reasons to See a Gynecologist After 50

1. Cancer Screenings

The risk of gynecological cancers — cervical, uterine, ovarian, vaginal, and vulvar — increases with age. An annual visit to the gynecologist helps provide early detection for these cancers.

To check for cervical cancer, your gynecologist will do an HPV test, a Pap smear, or an HPV/Pap co-test every 3-5 years (one swab is used for the combined test) and can generally be discontinued after age 65.

Although you don’t need a Pap smear every year, a regular pelvic exam checks for both cancerous and non-cancerous conditions that may arise. It also checks for noncancerous conditions such as ovarian cysts and fibroids as well as a variety of conditions that may develop with age. The exam may include the vulva, vagina, pelvic/reproductive organs, and urinary tract. While guidelines vary on how often you should get a pelvic exam, Dr. Rosser advises women to see their OB-GYN every year so that they can be checked for early signs of disease. “Ultimately, you and your OB-GYN should talk about what makes sense for you, depending on your individual situation and medical history,” she says.

The risk of breast cancer also increases with age. At your visit, your OB-GYN will perform a breast exam, checking for any changes including abnormal lumps, and refer you for a mammogram, the gold-standard for detecting breast cancer. For women of average risk, screening guidelines recommend getting a mammogram every year with no upper age limit. The American Cancer Society recommends continuing screening as long as a woman is healthy and expected to live at least 10 more years.

2. Perimenopause and Menopause Treatment

Perimenopause, the transitional phase leading up to menopause (which begins once you’ve had 12 consecutive months without a period) can cause uncomfortable symptoms like hot flashes, mood swings, insomnia, night sweats, irregular periods, vaginal dryness, and weight gain. The average age of menopause is 51. An OB-GYN visit is an ideal time to discuss and learn about these changes and treatment strategies, says Dr. Rosser.

Depending on your symptoms, there are several nonhormonal and hormonal treatment options. Because menopause causes a decline in estrogen, hormone therapy — in the form of pills, creams, gels, foam, ring, or transdermal patches — can relieve symptoms. While this remains the most effective form of treatment for perimenopause symptoms, there are also excellent non-hormonal options for those who cannot or prefer not to take estrogen, such as low-dose antidepressants and medications that can help control hot flashes, as well as lifestyle strategies like yoga and meditation, cardiovascular exercise, and cognitive behavioral therapy to help support mental health during this time. Your OB-GYN can help you decide what treatments may be right for you.

3. Sexual Health and Intimacy Counseling

Declining estrogen levels, due to menopause, are a major factor behind low libido, increased risk of urinary tract infections, as well as vaginal dryness and vaginal thinning (also known as genitourinary syndrome of menopause), which can cause irritation and pain during sex.

Sexual health can be overlooked during health checkups, but it’s an area that is important to overall well-being, says Dr. Rosser. “I counsel many women around menopause and beyond who come to me with concerns about low libido and pain during sex,” she says. “Thankfully, there are treatment options to resolve these problems.”

Treatment options include hormonal therapies like vaginal estrogen and nonhormonal therapies such as over-the-counter vaginal moisturizers and lubricants. For women over 50, “vulvar and vaginal moisturizers are just as important as facial and body moisturizers,” Dr. Rosser says.

She also advises her patients to use water-based lubricants during intercourse. In sexually active patients, a gynecological exam includes screening for sexually transmitted infections (STIs). “I try to normalize talking about sex among this age group by openly discussing it and giving out information,” Dr. Rosser says.

4. Pelvic Floor Therapy

Many women over 50 may have urinary problems, like urgency and incontinence, and other pelvic floor disorders, such as pelvic prolapse, which is when the pelvic floor muscles are weak and the pelvic organs slip down from their normal position. These issues can be due to many things, including decreased estrogen levels during menopause, pregnancy, childbirth, excess weight, smoking, and genetic factors, Dr. Rosser explains.

“A gynecologist can really help to educate a woman about her unique issues and help determine what kind of exercises, strategies, and treatment methods can help,” says Dr. Rosser. “In addition to vaginal estrogen therapy, pelvic floor therapy is a terrific tool for many women. Being able to have these open conversations and know exactly what’s going on can be extremely beneficial.”

5. Preventive Care

A visit to your OB-GYN also covers basic preventive screenings to check blood pressure, cholesterol, bone density, and more. Tests like these can help women stay healthy and active as they age. And the visit is a great time to discuss lifestyle factors such as eating well and exercising that can prevent many chronic diseases, like heart disease and type 2 diabetes.

“The gynecologist’s exam room allows women to open up and talk about a variety of issues,” says Dr. Rosser. “Regular visits allow for education, screening, prevention, and early intervention. We can improve the lives of women for many years to come by having yearly visits with them.”