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
Counselling:
- 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
- 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
Laboratory tests (blood 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, 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
Imaging may be ordered, including:
- 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 (Cologuard at-home colon cancer screening test)
- Pelvic ultrasound to evaluate uterine lining (uterine cancer) and ovaries (ovarian cancer)