Well Woman Exam

A well woman exam is an annual preventative visit that screens for breast and gynecological diseases.  It is an important step that every woman should take to help protect their health and well-being. 

Current recommendations are to have the first visit to a gynecology between ages 13 and 15.  This initial visit is a counseling session and does not include a pelvic examination.  Thereafter, annual well woman exams should begin either at age 21 or when you first become sexually active, whichever comes first. 

During your well woman exam, your health care provider will discuss your overall health, lifestyle behaviors, and will perform a physical exam with a focus on the breasts and pelvis.  Some of the things you can expect to be asked questions about include your health history, exercise, nutrition, lifestyle habits, sexual practices, and menstrual cycle.  It’s also a good time for your health care provider to review your family history, assess your risk of certain cancers, and evaluate contraceptive needs.   Some tests that may be performed/ordered include pap smears, mammograms, bone density tests, and lab work.  For patients who are sexually active, screening for sexually transmitted infections and discussions about birth control options will also be available.  

A pap smear is a test that screens for changes to the cells of the cervix related to cervical cancer.  It also allows us to test for the presence of human papillomavirus (HPV), which can cause changes to cervical cells resulting in cervical cancer.  Having this test done is an important step in maintaining your long term health; it lets us know if you are at higher risk for cervical cancer and, if abnormal cells are detected, allows us to initiate treatment as soon as possible for the very best outcomes. It also helps us prevent cervical cancer by detecting the changes leading up to cervical cancer, allowing us to provide you with the appropriate surveillance and treatment as soon as possible.  The American Society for Colposcopy and Cervical Pathology recommends that pap smears start at age 21, regardless of sexual activity status.  

The simple answer is, it depends.  There are some instances that may require you to have a pap smear every year, such as previous detection of abnormal cervical cells or the presence of HPV.  For those who ​have not ​ had a previous abnormal pap smear, current guidelines are based upon age and risk of developing cervical cancer.  After the age of 65, pap smears are not required.  Additionally, after hysterectomy pap smears are typically not required if there were no significant cervical abnormalities in the patient’s lifetime.  There are instances that require more frequent cervical cancer screening and the providers at Alliance Obstetrics & Gynecology Group can advise you on what pap smear schedule is right for you based on your current and previous health. 

Absolutely!  Well woman exams aren’t just about pap smears.  Having annual gynecological exams, including breast and pelvic exams, is an important part of making sure you stay healthy.  Any other gynecological concerns you may be having related to your menstrual cycle or sexual health can also be addressed.  You should make it a point to have a well woman exam every year.  

While it may be uncomfortable having a pelvic exam, it should not be painful and the brush that is used for the pap smear is soft and flexible.  Additionally, speculums come in various shapes and sizes to fit each unique woman and your provider can help choose the right one for you.   If it is your first time having a gynecological exam, please be sure to let us know so we can walk you through the entire process, step-by-step, and alleviate any anxieties you may have about the exam.  

For women with an average risk of breast cancer, screening mammograms begin annually at age 40.  However, for women at higher risk of breast cancer, mammograms may be started earlier than age 40 and breast MRIs may also be ordered.  Based upon your personal health and family history, the providers at Alliance Obstetrics & Gynecology Group can assess your risk factors and determine when you should begin mammograms.   

Absolutely!  Birth control is an important part of overall health maintenance and can be discussed at your well woman visit.  Your health care provider can educate you regarding the various methods of birth control and assist you in choosing the best method for you and your lifestyle.  You can expect to be asked a variety of questions about your past and current health to make sure that you do not have any conditions that would exclude you from using certain types of birth control.  

Dual-energy x-ray absorptiometry (DEXA) scans are a form of imaging used to measure the density of your bones.  DEXA scans are done to screen for conditions with decreased bone density, including osteopenia and osteoporosis. 

Current guidelines recommend that DEXA scans begin in all women at age 65.  They are typically performed every two years.  Some women should have a DEXA scan performed at a younger age if they have certain risk factors present.  These risk factors include:

• previous bone fracture after age 50 
• use of glucocorticoid therapy
• family history of hip fracture
• low body weight
• cigarette smoking
• excessive alcohol consumption
• Rheumatoid arthritis 
• certain endocrine disorders
• malabsorption diseases
• chronic kidney disease

If you’re unsure which category you fall into, the providers at Alliance Obstetrics & Gynecology Group will help you determine the appropriate time for you to begin having DEXA scans. 

To optimize your health and well-being, schedule your annual exam with us at Alliance Obstetrics & Gynecology and The Center for Pediatric & Adolescent Gynecology.