Well Woman Exams

Annual well woman exams are recommended for all women.

For many women, gynecologic and reproductive health care represent their only regular connection to the medical system. Because the gynecologic evaluation can provoke anxiety in patients, the provider's proficiency will go a long way in establishing positive relationships and providing patients with complete and sensitive care.

Well woman exams typically include a gynecologic history, physical and pelvic exam, and a Pap smear. Contraception counseling is also available.

 

Gynecologic History

Individual women vary tremendously in their knowledge of and comfort with their own bodies. While some may be open to disclosing their sexual, reproductive and genital concerns, others will find such discussions embarrassing or socially inappropriate. Thus, it is essential that providers maintain a sensitive and nonjudgmental approach during this encounter. The basic information required by the gynecologist includes:

  • Menstrual history

  • Sexual history

  • Obstetrical history

  • Contraception, past and current

  • Pap smear history

  • History of gynecologic procedures (e.g., endometrial biopsy, laparoscopy, curettage)

  • History of pelvic, vaginal or vulvar infections

  • Review of symptoms focusing on the genitourinary areas

  • History of other gynecologic problems, such as infertility, endometriosis or polycystic ovarian syndrome, and their treatment
     

Problem-Focused History

The most common gynecologic concerns relate to vaginal discharge, abnormal bleeding, pain, urinary problems, breast disorders, sexual dysfunction and infertility. When a patient identifies one of these issues, detailed questioning can guide further evaluation and diagnosis.


Gynecologic Exam

The gynecologic exam traditionally includes a physical examination of the internal and external genitalia, pelvic organs, abdomen and breasts. However, a more comprehensive exam may be indicated to provide complete primary care and to evaluate gynecologic problems that involve other organ systems.

There is no defined age at which the first gynecologic examination is performed, as this depends upon the probability of identifying a gynecologic problem.

The exam can help to detect cervical cancer, breast cancer, sexually transmitted infections, signs of physical or sexual abuse, pregnancy and many other conditions.

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