Well Woman Exam

The well woman exam is a preventative health care visit that generally occurs annually. This visit to your gynecologist, OB/Gyn or healthcare provider generally includes:

A comprehensive history:

• Current symptoms (such as: fatigue, hot flashes, sleep disturbances, weight fluctuations, painful periods, tender breasts, PMS symptoms and mood changes)

• Family history, past medical history and gynecologic history – age when period first started, regularity of periods, duration and amount of bleeding

• Discussion of reproductive plans and contraception – desire to get pregnant and timing, or to avoid pregnancy

• Sexually transmitted infections (STIs)

• Mental health, including mood and anxiety disorders

• Sleep

Counseling:

• Discussion about all options for contraception including the associated risks, benefits and alternatives

• STI prevention

• Healthy lifestyle including diet; exercise; sleep; stress management; weight management; alcohol, drug, tobacco and vaping use

• Immunizations – HPV vaccine, Hepatitis A/B, Influenza, Covid, Zoster (Shingles)

• Risk avoidance – sunscreen

• Folic acid supplementation – if planning pregnancy

Screening tests:

• PAP smear to screen for cervical cancer – beginning at age 21, repeated every 3 years

• PAP + HPV test – beginning at age 29, repeated every 5 years

• Chlamydia and Gonorrhea tests (if sexually active)

A physical exam:

• Blood pressure, weight, height and body mass index (BMI)

• Palpation of neck and collarbone area to check for thyroid enlargement, nodules or enlarged lymph nodes

• Heart, lungs, neurological, dermatological and extremities exam

• Clinical breast exam – clinician will examine your breasts feeling for lumps, bumps, nodules, nipple discharge and enlarged lymph nodes in axilla

• Abdominal exam to check for enlargement of various organs such as liver, spleen and uterus

• Pelvic exam to evaluate external genitalia, speculum exam to view vagina and cervix, bimanual exam to feel for uterine enlargement, adnexal masses or tenderness

• Rectal exam depending on age and current symptoms. (Note: a colorectal cancer screening is also recommended for women starting at age 45. See Cancer Screening Tests section below for colorectal cancer screening tests that may be ordered for you.)

Laboratory tests to screen for high cholesterol, diabetes, hypothyroidism, anemia may be ordered. These may include:

• Complete blood count (CBC) to check for anemia (hemoglobin and hematocrit), platelet count and white blood cell count

• Comprehensive chemistry panel to check liver and kidney function, blood sugar, HbA1c (if applicable), electrolytes, calcium and magnesium

• Lipid profile to check total cholesterol, LDL, HDL and triglycerides

• Hormone levels, including FSH and estradiol

• Thyroid test to check TSH

• Vitamin D level

• Urinalysis

• Hepatitis C screening for ages 18+ years

Imaging may be ordered, including:

• Annual screening mammogram beginning at age 40 for women at average risk

• Pelvic ultrasound to check the ovaries, uterine lining and uterine size

• Bone density test (DEXA scan) to check for osteopenia or osteoporosis

Cancer screening tests may be ordered, including:

• Colon cancer screening:

  • Colonoscopy, every 10 years beginning at age 45

  • Stool test for occult blood through a Fecal Immunochemical Test (FIT)/Fecal Occult Blood Test (FOBT) or Cologuard at-home DNA and stool colon cancer screening test

• Pelvic ultrasound to evaluate uterine lining (uterine cancer) and ovaries (ovarian cancer)