In August 2012, the American College of Obstetricians and Gynecologists (ACOG) issued a formal opinion: The annual health assessment (annual examination) is a fundamental part of medical care and is valuable in promoting prevention practices, recognizing risk factors for disease, identifying medical problems and establishing the clinician-patient relationship. In other words, don’t skip your annual well-woman exam.
“Currently, ACOG recommends that the first visit to the ob/gyn take place between the ages of 13 and 15 years,” says Dr. Laura Pignotti, a physician with West County OB/GYN Specialists. “This visit is mainly to establish preventive services and guidance and focuses on patient education. It typically does not include a pelvic exam for patients younger than 21, unless the patient exhibits symptoms suggestive of female genital tract, pelvic, urologic or rectal problems.”
Beginning at age 21, pelvic exams should become part of the annual visit, according to ACOG guidelines. Pap tests should be performed every three years for women in their 20s and paired with an HPV test every five years for women 30 and older.
During the well-woman exam, patients have an opportunity to bring up any concerns or questions, and physicians want them to do so. “She should be asking about the screening tests she needs: when she needs a Pap test and how often, when to have a mammogram, colonoscopy, bone-density testing and any blood work that may be needed,” says Dr. Leslie McCloskey, a SLUCare gynecologist. “One more thing: Bring up any gynecologic issue that is bothering you. It will likely require another appointment to address it; but that way, you don’t leave the office with plans to return in a year and then have to deal with this issue unaddressed.”
Dr. J. Lindsay Reed, a physician with SSM Medical Group Ob/Gyn—Serenity, recommends that women also discuss any plans or anticipated changes that will affect their health care. “If you are planning a pregnancy, you should convey this information to your physician so that she can offer preconception counseling to optimize your health before you conceive,” she says. “If you are experiencing hot flashes, discuss the various treatments for menopausal symptoms so that you are aware of your options.”
Physicians also advise patients to bring a list of current medications and supplements and be prepared to answer detailed questions about family medical history, which may affect risk factors for various diseases and subsequent screening recommendations.
Pignotti sums up: “Women should go into their annual exams with a clear understanding of their own medical and family history, as well as any concerns they have in order to fully optimize the time spent with their physician. This way, we, as physicians, may assist our patients most thoroughly and to the greatest extent to provide them with the best care possible.”