Meet Dr. Powless

When and How Often Should You Have PAP Smears?

Posted April 8, 2010

The frequency in which women get Pap smears is not the same for everyone. While one woman may need an annual Pap smear, another woman may only need a Pap smear every three years. How often a woman needs a Pap smear depends on several factors, like age, general health, and findings from previous Pap smears.

When to Have Your First Pap Smear

The American Cancer Society recommends that women have their first Pap smear about three years after they become sexually active or by age 21, whichever comes first. Subsequent Pap smears should occur every two years thereafter with a liquid based Pap test or annually with a conventional test.  The American College of Obstetricians and Gynecologists recommend women have an annual Pap until age 30.

If you are well over twenty one and you have never had a Pap smear, it is not too late to have start having regular screenings. Having a regular Pap smear may considerably reduce your risk of developing cervical cancer.

Thirty and Over

Unless recommended by a physician, continue screenings annually or every two to three years. Women who have had previous abnormal Pap smears, infected with HPV, or at high risk for cervical cancer may need to be screened more frequently.

At age 30, women have the option of having an HPV test along with their Pap smear. The HPV test identifies women who are infected with high risk strains of HPV that could lead to cervical cancer, if left unmonitored or untreated.

Age Sixty-Five and Over

At age 65 to 70, women who have had no abnormal Pap smears within the last 10 years may discontinue having regular Pap smears. This is a decision that has to be made with a physician or other clinician. For women who have a previous history of cervical cancer, abnormal Pap smears, or are at high risk for developing cervical cancer, should continue having regular screenings.




Oh, my aching back!

Posted March 11, 2009

 It's no surprise that back pain is a common complaint during pregnancy. You're gaining weight. You're walking in a new way. And your hormones are relaxing the muscles and ligaments throughout your body.  But there is some good news. Often, you can treat - or prevent - back pain during pregnancy with simple self-care strategies. 
1.  Stand up straight. As your baby grows, your center of gravity shifts forward. As you compensate to avoid falling forward, you may strain the muscles in your lower back - which can cause back pain. By tucking your buttocks under, pulling your shoulders back and downward, and standing straight, you can relieve this strain. 
2.  Lift properly. When lifting a small object, squat down and lift with your legs. Don't use your back, and know your limits. Ask for help if you need it.
3.  Sit and stand carefully. Choose a chair that supports your back or place a small pillow behind you. Sit with your feet slightly elevated, and change position often.  Avoid standing for long periods of time. 
4.  Sleep on your side. Sleep on your side, not your back. Keep one or both knees bent. It may also help to place a pillow between your knees and another under your abdomen.
5.  Wear the right shoes and pants. Wear low-heeled shoes with good arch support. Wear maternity pants with a low, supportive waistband. 
6.  Try heat, cold or a back rub. Apply heat to your back. Soak in a warm bathtub or try a heating pad. Some women find relief by alternating ice packs with heat. A back rub also may help. 
7.  Stay fit. Regular exercise can keep your back strong and may actually relieve back pain. With your doctor's permission, try swimming, walking or riding a stationary bike. 
8.  Try pelvic tilt exercises. Kneel on your hands and knees with your head in line with your back. Pull in your abdomen, arching your spine upward. Hold the position for several seconds, then relax your abdomen and back. Repeat five times, working gradually up to ten. Ask your doctor about other stretching exercises that might help.

Acetaminophen (Tylenol, others) is safe to use during pregnancy, but other pain relievers - including aspirin and ibuprofen (Advil, Motrin, others) - are not.

Check with your doctor before taking any medication to treat your back pain.


Planning Your Pregnancy

Posted March 1, 2010

Planning before you get pregnant is very important, and we hope you'll start planning for pregnancy as soon as you begin to have thoughts about having a baby.  The healthier you are before you get pregnant, the more likely you are to have a healthy baby.

A baby's organs begin to form in the first few weeks of pregnancy, before you may know that you are pregnant. Because this is a critical phase of baby's development, the more planning you do, the greater the pay off can be in terms of your baby's health. Unfortunately, there are no foolproof methods for having a healthy baby, but there are things you can do that may improve your chances of a good outcome.

Planning your pregnancy may help you to:

  • have a healthier pregnancy
  • avoid or minimize pregnancy complications
  • give birth to a healthier baby
  • recover more quickly after giving birth
  • have a more pleasant postpartum (post birthing) experience
  • minimize your child's risk of future adult health problems

By planning your pregnancy, you will know that during this important early stage you were taking the best possible care of yourself and your baby.

Top Tips

Make a Preconception Doctor's Visit

While this isn't absolutely necessary, there are some women who should visit their OB/GYN before getting pregnant. If you have a history of pregnancy complications, a family history of genetic disease, irregular periods or other warning signs of possible fertility issues, or if you are severely overweight or underweight, a visit to your doctor is a good idea.

Start Taking Folic Acid

Folic acid is an important supplement to prevent defects, such as spina bifida. If you have no family history of neural tube defects, a prenatal vitamin or multivitamin with a folic acid supplement should be sufficient.

Quit Smoking and Drinking Alcohol

Smoking in early pregnancy raises the chance of miscarriage. That means you shouldn't wait until you actually find out you're pregnant to quit, as you may already be several weeks along by then and have put you and your baby at risk. Smoking during the entire pregnancy results in an increased risk of preterm labor. The reason why: The toxins in cigarettes go right across the placenta into the baby's blood stream and can cause the placenta to calcify. The risks of drinking alcohol while pregnant are well-documented.

Check your Medications

Not abusing drugs, legal or illegal, goes without saying. But beyond that, if you're on medication for a chronic condition it's important to check with your physician prior to becoming pregnant to be sure that the drug you're taking is safe for the baby. Don't just stop taking your medication, as that can put you at risk.


A regular, non-strenuous exercise program that you can start before you get pregnant and maintain during and after pregnancy will cut down on pregnancy aches and pains and facilitate labor and delivery.

Check Your Immunizations

There have been a lot of changes in immunization guidelines in the past dozen years or so. Be sure you're up-to-date on the Hepatitis B vaccine and that you are immune to chicken pox.


While, in general, your weight should not be a factor in trying to conceive, there are certain considerations for those who are extremely underweight or overweight. Your doctor can help you understand these.

To schedule an appointment with Dr. Powless, please call 765-864-8765.