The Well-Woman Exam and Why It’s Important!

It’s not uncommon to hear women complain about their annual well-woman exam and wonder why it’s so important. Check out the post below from Certified Nurse Midwife, Carrie Bonsack! Carrie explains the importance of this annual exam and why you should be going each year!

Why is this important?

The annual exam is an opportunity for your certified nurse midwife, woman’s health nurse practitioner, or ob/gyn physician to physically assess, screen and evaluate your health and provide counseling on preventive care based upon your age and risk factors.  Although you don’t need a pap every year, you should have an annual exam. It is also a wonderful opportunity to develop a long-term relationship with your provider, as you may choose to see this provider throughout your life span for birth control, pregnancies, and postmenopausal care.

Who needs an annual exam?

All females beginning at age 13 should start having an annual physical exam.  The exam, screening, immunizations, and counseling will vary based upon age and risk factors.       

What happens during an annual “well woman” exam?

The annual exam is composed of an update of your health history, a physical exam, laboratory or other testing, and evaluation and counseling.

The health history may include questions about your health status based upon your medical, surgical, menstrual, and reproductive history. Questions about family medical history may also be asked. Questions related to your nutritional habits, physical activity, your sexual practice and orientation, number of sexual partners, use alcohol, tobacco, or other drugs, and abuse or neglect may be discussed. (ACOG, 2012)

The physical exam may include measuring your height, weight, body mass index (BMI), and blood pressure, assessing your thyroid gland on your neck, palpating your lymph nodes, listening to your heart and lungs, and examining your abdomen. A clinical breast exam may be performed on women every one to three years beginning at age 20, and every year beginning at age 40. (ACOG, 2012)

What about the pelvic exam, what is it and do I have to have one?

The pelvic exam includes an inspection of the outside of female genitalia, an inside exam using a speculum, and an inside/outside exam called the “bimanual exam” to feel the cervix, uterus, and ovaries.  (ACOG, 2012)

There is limited data on when and how often to have a pelvic exam done. The American College of Obstetrics and Gynecologists (ACOG) recommends that a pelvic exam be done for women every year beginning at the age of 21.  However, women who do not have any signs or symptoms of vaginal discharge, problems with their periods, or pelvic pain may not need a pelvic exam. The decision whether to do a pelvic exam or not can be made together between the patient and their provider based on your symptoms and risk factors.  Tests to screen for sexually transmitted infections can now be done with your urine or vaginal swabs without a speculum exam.  Women do not need a pelvic exam before starting on birth control. (ACOG, 2012)

Laboratory and other tests vary based upon your age and risk status. The labs or tests may include screening for cervical cancer based upon your age, and screening for sexually transmitted infections. Other tests based upon your age and if you have other high risk medical factors may include: mammograms, bone mineral density testing, colorectal cancer screening, diabetes screening, lipid/cholesterol testing, thyroid testing, hepatitis C virus testing, and tuberculosis skin testing (PPD).  (ACOG, 2012)

Evaluation and Counseling may include family planning (birth control or preconception planning), prevention of sexually transmitted disease, weight management for obesity or prevention of obesity (nutrition and exercise counseling) and evaluation for eating disorders, use of calcium, vitamin D and folic acid as nutritional supplements, mental health evaluation (stress, depression symptoms, behavioral health counseling), skin cancer awareness (exposure and ultraviolet rays), breast exam awareness, hygiene, and smoking cessation counseling. Your provider may also refer you to another provider such as a dermatologist or dietician when indicated. (ACOG, 2012)

Although we don’t need a pap every year we do need annual “well woman” exams. Please make an appoint with your HealthNet provider for your annual exam, so that we may help your understand your body, your risk factors, and help you achieve overall better health. Cheers and happy New Year to all!

For more information about HealthNet’s OB/GYN services, please visit www.indyhealthnet.org. 

References:
Cervical cancer screening among women aged 18-30 years – United States, 2000-2010. (2013). MMWR. Morbidity And Mortality Weekly Report, 61(51-52), 1038-1042.
Moyer, V. (2012). Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Annals Of Internal Medicine, 156(12), 880. doi:10.7326/0003-4819-156-12-201206190-00424
Well-woman visit. Committee Opinion No. 534. American College of Obstetricians and Gynecologists. Obstet Gynecol 2012;120:421–4.

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