3 Things to Know About Cervical Health

In celebration of January’s Cervical Health Awareness Month, we are sharing 3 things to know about the cervix and cervical health.

1. What is the cervix?

The cervix is the lowest part of the uterus, which attaches the uterus to the vagina. It consists of the ectocervix, which is the external part of the cervix that protrudes into the vaginal canal, and the endocervix, which is the tunnel from the inside of the uterus to the ectocervix’s central opening to provide passage between vagina and uterus. 

The cervix’s function is to secrete mucus that facilitates the entrance of sperm into the uterus. Some hormonal contraception works by thickening the cervical mucus to bar sperm from the endocervix.

2. HPV is closely linked to cervical cancer

Human Papillomavirus (HPV) is a group of viruses passed through skin-to-skin contact is the most common sexually transmitted infection. Certain types of HPV are known to be the primary risk factor for cervical cancer. The good news is most cases of HPV do not develop into cervical cancer. However, it is important to know the risks of HPV, and to protect yourself via regular STI screening, the HPV vaccine, and communication about safety protocols with your sexual partner(s). 

Each year, around 14,000 cases of cervical cancer are diagnosed, making it the fourth most common type of cancer for people with uteruses worldwide. This is why cervical care is an integral part of overall health maintenance. Two of the best ways you can take care of your cervix are by getting regular Pap smears and regular STI screenings. 

3. Regular pap smears can help detect cervical cancer early

A Pap smear tests for cancerous and precancerous cells in the cervix. People age 21-65 years old generally speaking should have routine Pap smears every three years. It is recommended to get tested for HPV during a pap smear as follows by Planned Parenthood: 

• “If you’re 21–24 years old: you can choose to get a Pap test every 3 years, or you can wait until you’re 25 years old to start getting tested.

• If you’re 25–65 years old: get an HPV test every 5 years, or a Pap test and HPV test together (co-testing) every 5 years. In some places where HPV testing is less available, you may get only a Pap test every 3 years.

• If you’re older than 65: you may not need HPV/Pap tests anymore.”

During a pap smear, the patient lies down on an exam table and the health practitioner will insert a speculum into the vaginal canal and open it to see the cervix. They will then insert a stick or soft brush to collect cells from the surface of and inside the cervix and vagina. They are typically not painful, but may cause mild discomfort. 

These routine health measures are important for taking care of your cervical health. You can learn more about Cervical Cancer Awareness Month here.

Sexual Wellness Resources For Pelvic Physical Therapists

Pelvic healthcare is a subfield of medicine that deals with the pelvis, which encapsulates the bladder and reproductive organs. Pelvic health is particularly important because the pelvic floor supports urination, bowel movements, and pregnancy/labor for those who can become pregnant and give birth. These muscles can be strained by things like childbirth or chronic coughing and when they are weakened, it can lead to difficulty with bladder control, put a strain on other muscles, and more complications. There are a variety of healthcare professionals who deal with pelvic floor health such as physical therapists, doulas, midwives, gynecologists, urologists, and more. A shortcoming of the healthcare field, however, is that less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. 

Pelvic health is intertwined with sexual health and failing to take that context into consideration when treating pelvic floor issues can be problematic. Take for instance a scenario in which a professional is seeing a patient complaining of pain in their lower abdomen and unusual discharge. If the healthcare professional neglects to ask the patient’s sexual history which includes having had an STD, it would be difficult to identify Pelvic Inflammatory Disease as a potential cause of the discomfort. This is just one example of many illustrating why having full context is vital for informing pelvic healthcare. For those looking to supplement their knowledge, pelvic healthcare professionals or otherwise, we have compiled resources to guide you. 

One option is to Contact ESW for a Sexual Wellness In Pelvic Health Professional Training. During this training providers can expect to enhance their knowledge of assessing sexual functioning concerns and relational dynamics, and learn how to employ a trauma informed, sex-positive approach with patients. Case consultation is included.

Additional Resources Include:  

• “Why a Sexual History?” by Kansas Department of Health and Environment

• “Sexual Health and Your Patients: A Provider’s Guide” by the National Coalition for Sexual Health   

• “Why Do We Take a Sexual History” by the AMA Journal of Ethics 

• “A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders” by Gregg Kanter et al. 

• “Talk about Sex: Sexual History-Taking Preferences Among Urogynecology Patients and General Gynecology Controls” by Pamela Susan Fairchild et al.

3 Tips for Disclosing Your HIV/AIDS Status to a Partner

December 1st 1988 was the first ever World AIDS Day. Today marks the 33 year anniversary of this observance, and yet the stigma surrounding HIV/AIDS remains present as ever. This stigma fuels a shame-based culture in which it becomes difficult for people with HIV/AIDS to disclose their status without fear of retribution. That being said, it is ethically important to inform sexual and/or romantic partners of pertinent medical information that has the potential to affect them. This applies to HIV/AIDS among other sexually transmitted infections and any contagious conditions. Without everyone being on the same page about everyone’s health status, it’s difficult to ensure proper safety precautions are being taken and that everyone’s boundaries are being respected. In addition to moral implications of disclosure, 35 states have laws that criminalize neglecting to disclose HIV/AIDS status with sexual partners and/or anyone sharing needles. It is undoubtedly important to disclose, but the prospect of doing so can be intimidating for fear of rejection, violence, and judgment from the listening party. Here are some ways to make that conversation as easy as possible when disclosing your status to your partner(s).

Source: https://news.delaware.gov/2018/11/30/delaware-events-mark-world-aids-day-dec-1-2018/

1. Be specific and straightforward

• Make sure to disclose the status of the infection including what it is, the definition of the condition, and what, if anything, you need from the other person in terms of support

• If it would be helpful, you can disclose with the help of your doctor or therapist 

2. Plan ahead for all possible reactions

• Make sure you have support systems and coping mechanisms in place to navigate the possibility of an adverse reaction

• Speak to a therapist and/or have the disclosure discussion with a counselor or therapist

• Respect the needs of the recipient for their processing of the news

• While you should respect the needs of the other person, make sure you know what you need in terms of emotional regulation and allow yourself the grace to feel negative emotions if they come up 

3. Come prepared with educational and safety resources about the relevant health status

• When discussing a condition with a risk of transmission, one of the first concerns that comes to mind is the health and safety of everyone involved. A good way to navigate the fear is to make sure everyone involved in the conversation has the resources and support they need.

  • Resources for someone living with HIV/AIDS

    • Ryan White HIV/AIDS Program

      “The Ryan White HIV/AIDS Program works with cities, states, and local community-based organizations. The Program provides primary medical care and essential support services to more than half a million people each year. Through the Program, people living with HIV who have no insurance or are underinsured can get the HIV medical care and other support services they need.” 

    • CDC “Sharing Your Test Result” 

    • Send an anonymous STD test notification to sexual partners 
      This is a good option to inform casual or past partners, but in a serious relationship, it’s probably better to discuss it in person to navigate the implications for the relationship

  • Resources for someone who has a loved one living with HIV/AIDS  

    • CDC HIV prevention tips  

    • Living with an HIV Positive Partner (Flo Health)

    • AIDS | Definition, Diagnosis, Treatment, & Facts

Living with any chronic illness like HIV/AIDS is difficult in many ways, disclosure being just one of them. Hopefully these resources prove helpful in easing the process. Regarding HIV/AIDS specifically, though there’s no cure, a diagnosis is not the end of the world. It can be managed with medication such as antiretroviral therapies and safer sex practices. Disclosing your status to the people in your life not only keeps them informed of any potential implications for their health, but they can also be a shoulder to lean on.