Do you know where your mother is? On advising about sexual health

First off, the recommendations for pap smear exams have changed. After 65, if you’ve had at least 3 normal exams in ten years, you can stop getting an annual exam. What you should do after that is not clear to me, but an MD behind a major report says she tells her patients that they should have one every five years. (The MD is Dr. Sarah Feldman, a gynecologic oncologist at Brigham and Women’s Hospital in Boston and author of a recent editorial summarizing the expert consensus in The New England Journal of Medicine.)

One thing one notices in public health discussions is that daughters can easily become quite active in health decisions for older women. So it is important to realize that your mother may not be quite like what you think she is, as this anecdote from the same doctor illustrates:

Dr. Feldman was surprised to see an abnormal Pap result in an 80-year-old patient who had been a devoted caregiver for her husband of 55 years, who had dementia. “It seemed like an odd finding,” Dr. Feldman said, until she learned her patient was having an affair with a young man she had met at Starbucks.