Island Health’s team of obstetricians and gynecologists is dedicated to providing myriad health services to support women throughout their lifetimes. We recently had the opportunity to interview Dr. Elizabeth Waring, a passionate advocate for women’s health. Her insights into obstetrics and gynecology and the services she and her team provide underscore their unwavering commitment to helping women in our community maximize their health and wellness at every age.

What is your specialty, and why did you choose it?

My specialty is obstetrics and gynecology. The level of connection with your patient is unparalleled, and that’s why I love what I do, particularly gynecology. It’s a very private form of medicine, and it takes a considerable bond of trust between a patient and a provider to deliver adequate and comprehensive care.

What does obstetric care include?

Obstetrics is the standard schedule of routine prenatal care. We care for women through preconception counseling, pregnancy and delivery of the child, and then support the family and the mom in the postpartum phase.

What is gynecology?

Gynecology can include preventative wellness exams and highly complex surgeries. Most women establish care around their teens or twenties to start managing contraception or answering questions on menstruation or pregnancy. We can see patients anywhere from puberty until the end of their life.

What is a Pap smear, and why is it important?

A Pap smear is a routine cervical cancer screening, and the guidelines have changed quite a bit in the last 15 years. The recommendation is that we start routine cervical cancer screening at age 21. When we do a Pap smear, we collect a small sample of cells from the cervix, which are sent to the lab to be looked at under a microscope.

At age 30, we transition to co-testing, where we look at the cells from the cervix and also test for the presence of HPV, which is the human papillomavirus. HPV is the virus that causes the majority of cervical cancers. If your cells are normal and the HPV test is negative, then you wouldn’t require another routine cervical cancer screening for another five years. Cervical cancer is easily preventable in the majority of cases. By keeping up with your Pap smears, we can identify abnormal cells before there’s any chance for them to become cancer. That being said, I always recommend my patients come and see us yearly because there’s a lot more we do at your annual well-woman exam other than screening for cervical cancer.

What can women do to decrease their risk for cervical cancer?

One of the things that is not discussed enough is the modifiable risk factors for HPV infection as well as abnormal cervical cells. There’s no way to avoid being exposed to HPV at this point. We can only modify our body’s response to that virus. One of the most significant modifiable risk factors for any woman who has had an abnormal Pap smear is to stop smoking. Smoking causes a constant low-grade level of inflammation within the body that makes it very difficult for the cervix to heal.

What is menopause?

The medical definition of menopause is the complete absence of any menstrual bleeding for 12 months. However, the symptoms that precede and then persist after that year-long absence of menses is perimenopause. It’s a complex time, and I jokingly refer to it as puberty in reverse. It lasts just about as long, and the impact on our body is just as profound. It can be very disorienting, confusing and frustrating. Gynecologists are here to help women navigate through the menopause journey.

Are there any specific risk factors or symptoms that require more frequent gynecological visits?

There are some primary “alarm symptoms” that, if you experience consistently, we would want to check. One of those is post-coital bleeding—new bleeding, painless or painful bleeding following intimacy with your partner that hasn’t happened consistently before. The other big thing is any bleeding after menopause. Even if it’s just spotting, this is not normal, and we want to know about it so we can do a thorough exam in the office.

How can a patient connect with you?

You can always contact us after an appointment. We have an excellent support staff, and you can message us through the portal.

Learn more about Dr. Waring and our OB/GYN team at https://islandhealth.org/department/island-ob-gyn.