Written by Dr. Decarolis, ND
Naturopathic Doctor at IVitality
A Well Woman’s Exam is an annual visit that includes important screening tools for general health as well as specifics for sexual health. During this exam, your provider will go through your menstrual and sexual history. Collecting this information allows them to have a full view of how they can best assist you. There are a few aspects to the physical exam for a Well Woman’s Exam. Most practitioners will perform the physical exams from least to most invasive. Often, your doctor will begin by listening to your heart and lungs, as well as feeling your thyroid. These are important screening tools that can provide information that may be otherwise lost. After this portion of the exam, your doctor may perform all or some of the following exams: breast, speculum, and bimanual.
During the breast exam, the practitioner will observe your breast tissue and how it moves by asking you to place your arms in different positions. They will also assess the tissue through palpation, using different pressures to determine if there are any abnormalities. Self breast exams are often not recommended by practitioners as patients often think they find an abnormality despite their tissue being normal, but these exams can be useful for familiarizing yourself with your body.
If there are any abnormalities found during the breast exam, most patients 29 y/o or younger will be sent out for a breast ultrasound. This is the first step with diagnostic imaging, as ultrasounds do not utilize any radiation and can often visualize the areas of concern well. For patients 30 y/o or older that have an abnormality found on the physical exam, most practitioners will order a mammogram. Mammograms are utilized as a screening tool for females over the age of 40, and are often recommended annually or biannually. Recommendations for mammograms are patient specific and depend much on personal/family history.
With the speculum exam, the practitioner will first begin by observing the tissue for any abnormal changes. At this point any samples for Sexually Transmitted Infection (STI) screenings are collected. After this, using a speculum, they will visualize the vaginal canal as well as the cervix. This portion of the exam is why a Well Woman’s Exam is often called a “Pap” or “Pap Smear”. A pap smear is the name of the test that is performed where cells are collected from the cervix to see if there are any abnormal changes or any infection with HPV. Paps are typically recommended every 3 years for females between 25-29 y/o and every 5 years for females 30 years or older, if performed with HPV testing. Even though your Well Woman’s Exam is performed yearly, not every aspect of the exam is needed each year.
