Ask Dr Kelly: PCOS and cervical screening

Posted on 29 October, 2019

If you could ask a doctor anything anonymously, what would you ask? 

In the fourth instalment of our Ask Dr Kelly series—Dr Kelly Teagle, GP and Women’s Health Specialist—answers your anonymous questions.

Dear Dr Kelly, I think I have PCOS. How do I go about getting a formal diagnosis?

PCOS (Polycystic Ovarian Syndrome) is essentially a clinical diagnosis based on your doctor’s questioning and examination.

They may need to do some tests to determine whether you meet all the criteria, however.

This article gives a pretty good overview, but basically to be diagnosed with PCOS two of the following three criteria are required:

• No periods, or infrequent periods (due to no ovulation during the cycle)
• High androgens (male sex hormones), determined either by:
  • Clinically (excessive body hair or male pattern hair loss) or
  • Biochemically (from a blood test), and/or
  • Polycystic ovaries on ultrasound

Before making the diagnosis your doctor will also need to exclude any other possible causes for your symptoms, such as congenital conditions or other hormonal problems.

Dear Dr Kelly, do I need cervical screening if I have never had sex before?

This is a nice easy one to answer—no, you don’t. The new cervical screening program commences at age 25, but only women who have ever had sex need to be tested.

Importantly though, sex does not just mean penetration of the vagina by a penis. Human Papillomavirus can also be spread by skin-to-skin contact of the genital area or by using sex toys with a partner.

If you are engaging in these activities you should be tested from age 25.

Dear Dr Kelly, after years of surgery and adhesions galore including my colon attached to my liver, it is unreasonable to have surgery every 5-10 years to remove the adhesions to be able to live a better life?

This is a very tricky question, especially without knowing the details of your previous surgeries or your current condition and symptoms.

Generally speaking, surgeries are not undertaken unless the symptoms or problems you have are bad enough to justify the surgical risks.

Every additional surgery you have carries risks of further unintended consequences. For example, there is a small chance that an abdominal organ or structure might be accidentally damaged, or that you will have anaesthetic or breathing problems whilst unconscious.

Some complications may potentially even be fatal, although thankfully these are very rare. Each new surgery also has the potential to create new adhesions and make the problem even worse.

You mention wanting to “live a better life”. If you are living with terrible problems which might be improved by surgery, such as severe pain or recurrent bowel obstructions, then you definitely should seek the opinion of a surgeon.

I think it’s unlikely that scheduling regular time-based surgeries will be helpful though; surgical decisions should be made based on your condition at the time and the potential risks and benefits of surgery.

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