HealthFit’s approach to well-woman exams
Women’s annual exams, often referred to as well-woman exams, are a comprehensive look into the overall physical health and reproductive health of women. Health experts recommend women get these annual exams beginning in their teenage years. Well-woman exams should be done routinely to check for signs of sexually transmitted infections (STIs), uterine fibroids, ovarian cysts or to diagnose more complex medical conditions.
Well-woman exams vary based on the age of the woman, her sexual history, her medical history, and whether or not she is pregnant. But the exam often includes a breast exam, pelvic exam, Pap smear and STI screening.
Who needs a well-woman exam?
Well-woman exams are an opportunity for our doctors and other healthcare providers to develop a clear understanding of a woman’s body and discuss a variety of important women’s health topics like periods, sex, birth control, menopause and overall health concerns.
Young women should start getting annual well-woman exams in their mid-to-late teens or early 20s, and continue to receive a well-woman exam throughout their lives. Women who have already undergone menopause should still see their provider for a well-woman exam.
What to expect during a well-woman exam
During a well-woman exam, your health provider will ask questions about your period, sexual activity, alcohol and drug use, lifestyle, family medical history, existing medical conditions and previous surgeries.
It’s important for a woman to be honest with her care provider in order to provide a global view of her reproductive health and make diagnosing and treating conditions more efficient. A well-woman exam is also a great opportunity for patients to ask questions about their general health.
In addition to discussing various aspects of female health and well-being, the provider may perform a pelvic exam (see below), which allows the provider to assess the health of the female reproductive organs. The provider may also perform a Pap smear or request lab tests to screen for sexually transmitted diseases (STDs).
During a well-woman exam, the healthcare provider may perform a pelvic exam. Pelvic exams are essential for preventing and diagnosing medical conditions within the reproductive organs. To help eliminate any discomfort or anxiety, our providers will communicate clearly with the patient about the procedure.
A pelvic exam involves the provider examining the external and internal reproductive organs. Along with a discussion about her overall health and sexual activity, this exam gives the provider a comprehensive understanding of a woman’s reproductive health. Through a pelvic exam, the provider may detect enlarged ovaries, which may indicate the presence of ovarian cysts or cancer. In addition, the fallopian tubes are examined for signs of structural issues and screened for infection.
Pap smear (screening for cervical cancer)
Pap smears are an important cervical cancer screening test for women. It is important to receive Pap smears regularly to prevent cervical cancer or diagnose it when it is most treatable.
A Pap smear is used to identify types of abnormal cell growth that can include potentially pre-cancerous or cancerous cell growth within the cervix. A Pap smear can also detect human papillomavirus (HPV), which can cause cervical cancer in some women.
We recommend testing for HPV in women age 30 and older. Abnormal results do not always indicate HPV or cancer, and additional testing is often required to make a diagnosis or confirm a false-positive.
How often do women need to get a Pap smear?
The frequency of testing depends on a woman’s age, her medical history and the results of her last Pap smear. The American Academy of Family Physicians recommends that women start getting tested every three years at the age of 21, regardless of sexual activity, and to continue regular testing through the age of 65, if they have not had a hysterectomy.
Women age 30-64 can opt to get a Pap smear and HPV test together every five years or a Pap smear alone every three years. Women over the age of 65 should discuss their medical history with their provider to determine whether they need to be tested or not.
What to expect during a Pap smear?
A provider will generally perform a Pap smear during a pelvic exam. The healthcare provider will swab or gently scrape the cervix to collect a small sample of cells, which will be sent to a lab to test for abnormalities. The procedure may cause some cramping or discomfort but should not be painful.
The results of a Pap smear test are said to be normal if the cells collected are found to be normal. A positive result means that one or more of several types of abnormal cells were found. This may require additional testing, but a positive result does not necessarily mean the woman has cervical cancer.
Breast examinations can detect a lump or other changes that may indicate a medical condition within the breast tissue. They are one of the most important breast cancer screening techniques. Many providers perform a breast exam in conjunction with a well-woman visit. The provider will feel for lumps and identify any cause for concern.
Depending on her personal health and family history, a woman in her 20s or 30s might receive a breast exam every one to three years, increasing in frequency to once a year after the age of 40. Women are highly encouraged to conduct self-exams on a monthly basis to increase the chances of catching breast cancer early.
What to expect during a breast exam?
Examining one breast at a time, the provider will apply light pressure on the tissue with the tips of the fingers to check for lumps in the armpits, under the nipples, within the breast tissue, and in some cases underneath or surrounding breast implants. The provider will also examine each breast’s shape, size and skin texture to evaluate for other issues.
Sexually transmitted infection (STI) screening
Most sexually transmitted infections, which can develop into the more commonly known sexually transmitted diseases, do not present with clear symptoms, so testing may be recommended during an annual well-woman exam.
Certain infections can be identified during physical examination and confirmed through further testing such as blood testing. Other STIs, such as chlamydia and gonorrhea, can be identified during a Pap smear, with a genital swab or via a urine sample. Additional simple blood tests can provide a more comprehensive screening.
Providers may recommend STI testing even if the woman does not show physical signs of infection. Regular testing can help prevent the spread of infection and disease from one person to another. It can also prevent serious health issues, such as infertility, that may develop as a result of untreated infection.
Take the next steps at HealthFit
At HealthFit Family Medicine, we understand that some of the most important and personal aspects of a woman’s health can sometimes be uncomfortable to discuss. Our goal is to create a comfortable atmosphere for women of all ages – from girls receiving their first exam to women who are through menopause.