A well woman exam includes a pap smear, pelvic, breast, heart, lung and thyroid exam. Since the induction of the Pap smear, the incidence of cervical cancer has declined by more than 70% in the U.S. over the past 50 years.
The American Cancer Society guidelines advise women to begin annual screening by the age of 21 or within the year of first sexual activity.
Women who have had a hysterectomy should continue to have pap smears every 2-3 years, but an annual physical exam still should to be performed.
The pap smear is not the only reason why women have the well woman exam. Breast exams should be performed by a clinician yearly to note if there are any lumps present. The pelvic exam can often detect masses, prolapse or melanomas on the vulva. Referrals for Mammograms and Bone density scans will be given out at the appointment when appropriate.
SEXUALLY TRANSMITTED INFECTIONS
Another service provided during the well woman’s exam is checking for sexually transmitted infections (STI). If you are currently sexually active, have multiple partners, or a history of multiple partners, it is important to be screened. The most common STIs are Chlamydia, Gonorrhea, Herpes, HPV, Trichomoniasis and HIV. HPV testing is often done in conjunction with the pap smear as it can predict future risks for cervical abnormalities.
It is important to understand that you can be positive for Chlamydia and Gonorrhea and not have any symptoms. STIs not treated with an antibiotic, such as Chlamydia, can cause scarring of the fallopian tubes leading to infertility. It should be understood that birth control pills, diaphragms and cervical caps including condoms, do not protect you from getting a STI.