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    Well Women Exam

      Late Teens
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      In Your Late Teens

      This is likely your first Well Woman exam. Now is the time to establish open communication with your health provider. Be willing to have an honest discussion about your sexual and reproductive health – no topic should be off-limits. While your Well Woman exam will be designed with your unique health in mind, you can expect it to include the following elements:

      • Evaluation and Appropriate Testing. Your provider will evaluate your risk for certain diseases and take a general evaluation of your health.¹
      • STI Testing. This is an important part of protecting your reproductive health and fertility as it may include testing based on your age, the presence of symptoms or if you have an increased level of risk. Your provider can explain common STIs and how screening protects your health.²
      • Immunizations. Vaccinations based on age and risk factors will be addressed during the visit.³
      • Visual Exam of Breast & Pelvic Area. Your provider will perform a visual examination of your breasts and pelvic area when appropriate.⁴ ⁵
        References
        1. Mutch, D., “Why Annual Pap Smears Are History – But Routine Ob-Gyn Visits Are Not,” https://www.acog.org/womens-health/experts-and-stories/the-latest/why-annual-pap-smears-are-history-but-routine-ob-gyn-visits-are-not
        2. Workowski KA, et al. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70.
        3. ACOG Committee Opinion Number 755. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/Well Woman-visit
        4. Pelvic Exams Frequently Asked Questions. https://www.acog.org/womens-health/faqs/pelvic-exams
        5. Mammography and Other Screening Tests for Breast Problems. Frequently Asked Questions. How is a clinical breast exam done? https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
        Twenties
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        In Your Twenties

        Your Well Woman visits during ages 20-29 years may include family planning, contraception discussion, the beginning of cervical cancer screening and more. Be sure include contraception and family planning discussions during your Well Woman exam.¹ Your exam may include the following screenings and tests:

        • Pap Test. This test examines a sample of cells from your cervix for pre-cancerous and cancerous cells. If you are 21-29 years old, Pap testing alone is recommended.²
        • Pelvic Exam. Your healthcare provider will visually examine the outside of your genital area and feel your abdomen for anything out of the ordinary. An internal exam will enable your provider to better examine your reproductive organs and take any samples needed for testing.³
        • Clinical/Self-Breast Exam. Your provider will touch your breasts, feeling for lumps or other unusual tissue. A self-breast exam can be performed by you at home and involves looking in a mirror and feeling each of your breasts for possible lumps, distortions or swelling. If you find something, don’t panic. Contact your healthcare provider, who will determine what additional tests may be needed.⁴
        • Sexually Transmitted Infections (STI) Testing. Your healthcare provider may recommend testing based on your age, sexual activity, the presence of symptoms or if you have an increased level of risk.⁵
        • High Blood Pressure Check-Up. You should have your blood pressure checked as part of your Well Woman Exam. Nearly half of all adults with high blood pressure are women. Some women who have never had high blood pressure develop it while they’re pregnant so it’s important to know your numbers.⁶
        • Menstrual Health. It’s estimated that one in five women experience heavy periods, also known as abnormal uterine bleeding which is marked by heavy menstrual bleeding that last more than seven days.⁷ It may require double protection and can have a significant impact on a woman’s quality of life. Your healthcare provider can talk to you about a procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding.
          References
          1. Well Woman Visit. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/Well-Woman-visit. Published October 2018. Accessed February 4, 2022.
          2. Mutch, D., Why Annual Pap Smears Are History – But Routine Ob-Gyn Visits Are Not. https://www.acog.org/womens-health/experts-and-stories/the-latest/why-annual-pap-smears-are-history-but-routine-ob-gyn-visits-are-not
          3. Pelvic Exams Frequently Asked Questions. https://www.acog.org/womens-health/faqs/pelvic-exams
          4. Mammography and Other Screening Tests for Breast Problems. Frequently Asked Questions. How is a clinical breast exam done? https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
          5. Workowski KA, et al. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70.
          6. American Heart Association. Go Red for Women. High Blood Pressure. Accessed January 17, 2022. 
https://www.goredforwomen.org/en/know-your-risk/high-blood-pressure-and-women
          7. Centers for Disease Control and Prevention. Heavy menstrual bleeding. https://www.cdc.gov/ncbddd blooddisorders/women/menorrhagia.html. Accessed March 9, 2021.
          Thirties
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          In Your Thirties

          For women ages 30-40, this may be a time in your life when you’re more sexually active, and you may have given birth or plan to become pregnant. Be sure to discuss contraception and family planning during your exam. Your Well-Women Exam may include the following screenings and tests:

          • Pap Test. This test examines a sample of cells from your cervix for pre-cancerous and cancerous cells.¹ 
          • Pap + HPV together. Pap + HPV together combines Pap testing with HPV testing to determine whether you have human papillomavirus (HPV), the virus responsible for cervical cancer.
          • Pelvic Exam. Your healthcare provider will visually examine the outside of your genital area and feel your abdomen for anything out of the ordinary. An internal exam will enable your provider to better examine your reproductive organs and take any samples needed for testing.²
          • Clinical/Self-Breast Exam. Your provider will touch your breasts, feeling for lumps or other unusual tissue. A self-breast exam can be performed by you at home and involves looking in a mirror and feeling each of your breasts for possible lumps, distortions or swelling. If you ind something, don’t panic. Contact your healthcare provider, who will determine what additional tests may be needed.³  
          • Sexually Transmitted Infections (STI) Testing. The Centers for Disease Control has established guidelines for STI testing⁴ that your healthcare provider will follow. She or he may recommend certain screening tests based on your age, while other tests may be right for you depending on the presence of symptoms or if you have an increased level of risk.⁵
          • High Blood Pressure Check-Up. Nearly half of all adults with high blood pressure are women.⁶ Your blood pressure may be normal for most of your life but, pregnancy and other life changes, may cause it to elevate.⁷
          • Menstrual Health. It’s estimated that one in five women experience heavy periods, also known as abnormal uterine bleeding which is marked by heavy menstrual bleeding that last more than seven days.⁸ It may require double protection and can have a significant impact on a woman’s quality of life. Your healthcare provider can talk to you about a procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding.
            References
            1. Cervical Cancer Screening Frequently Asked Questions. https://www.acog.org/womens-health/faqs/cervical-cancer-screening
            2. Pelvic Exams Frequently Asked Questions. https://www.acog.org/womens-health/faqs/pelvic-exams
            3. Mammography and Other Screening Tests for Breast Problems. Frequently Asked Questions. How is a clinical breast exam done? https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
            4. STI Treatment Guidelines. https://www.cdc.gov/std/treatment-guidelines/default.htm
            5. Workowski KA, et al. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70.
            6. American Heart Association. Go Red for Women. High Blood Pressure. Accessed January 17, 2022.
            7. Hypertension. Clinical Updates in Women’s Health (Jan 2016). https://www.acog.org/clinical/journals-and-publications/clinical-updates/2016/01/hypertension
            8. Centers for Disease Control and Prevention. Heavy menstrual bleeding. https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html. Accessed March 9, 2021.
            Forties
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            In Your Forties

            You may notice weight gain during ages 40-50 because of stress from juggling family, work, friendships, and social activities. Stress can lead to weight gain.¹ So, during your next Well Woman exam, be sure to talk with your healthcare provider about your mental health as well as nutrition and exercise. Your Well Woman exam may include the following screenings and tests:

            • Pap Test. This test examines a sample of cells from your cervix for pre-cancerous and cancerous cells.²
            • Pap + HPV together. Pap + HPV together combines Pap testing with HPV testing to determine whether you have human papillomavirus (HPV), the virus responsible for cervical cancer.
            • Pelvic Exam. Your healthcare provider will visually examine the outside of your genital area and feel your abdomen for anything out of the ordinary. An internal exam will enable your provider to better examine your reproductive organs and take any samples needed for testing.³
            • Clinical/Self-Breast Exam. Your provider will touch your breasts, feeling for lumps or other unusual tissue. A self-breast exam can be performed by you at home and involves looking in a mirror and feeling each of your breasts for possible lumps, distortions or swelling. If you find something, don’t panic. Contact your healthcare provider, who will determine what additional tests may be needed.⁴
            • Breast Cancer Screening/Mammogram. A mammogram is an X-ray of your breasts to detect abnormalities that may not be obvious from a clinical exam. If you and your doctor agree, you can have a mammogram every year starting at age 40.⁴ Most everyone can benefit from a 3D mammogram, especially when there’s breast cancer in your family or if you have dense breast tissue.
            • Sexually Transmitted Infection (STI) Testing. The Centers for Disease Control has established guidelines for STI testing⁵ that your healthcare provider will follow. She or he may recommend certain screening tests based on your age, while other tests may be right for you depending on the presence of symptoms or if you have an increased level of risk.⁶
            • Colorectal Cancer Screening. These tests detect cancer in the colon and rectum. During a colonoscopy, the most common type of screening, a small camera is used to examine your colon. There are other colorectal cancer screening options that you may discuss with your provider.⁷
            • High Blood Pressure Check-Up. Nearly half of all adults with high blood pressure are women.⁸ Your blood pressure may be normal for most of your life but, pregnancy and other life changes, may cause it to elevate.⁹
            • Menstrual Health. It’s estimated that one in five women experience heavy periods, also known as abnormal uterine bleeding which is marked by heavy menstrual bleeding that last more than seven days.¹⁰ It may require double protection and can have a significant impact on a woman’s quality of life. Your healthcare provider can talk to you about a procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding.
              References
              1. Creagan, E.T., Stress Management. https://www.mayoclinic.org/healthy-lifestyle/stress-management/expert-answers/stress/faq-20058497
              2. Cervical Cancer Screening Frequently Asked Questions. https://www.acog.org/womens-health/faqs/cervical-cancer-screening
              3. Pelvic Exams Frequently Asked Questions. https://www.acog.org/womens-health/faqs/pelvic-exams
              4. Mammography and Other Screening Tests for Breast Problems. Frequently Asked Questions. How is a clinical breast exam done? https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
              5. STI Treatment Guidelines. https://www.cdc.gov/std/treatment-guidelines/default.htm
              6. Workowski KA, et al. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70.
              7. Problems of the Digestive System Frequently Asked Questions. https://www.acog.org/womens-health/faqs/problems-of-the-digestive-system
              8. American Heart Association. Go Red for Women. High Blood Pressure. Accessed January 17, 2022. 
https://www.goredforwomen.org/en/know-your-risk/high-blood-pressure-and-women
              9. Hypertension. Clinical Updates in Women’s Health (Jan 2016). https://www.acog.org/clinical/journals-and-publications/clinical-updates/2016/01/hypertension
              10. Centers for Disease Control and Prevention. Heavy menstrual bleeding. https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html. Accessed March 9, 2021.
              Fifties
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              In Your Fifties

              For women ages 50-60, this is a time when you may begin menopause. During your next Well Woman exam, be sure to talk with your healthcare provider about any bodily changes you’ve experienced, your questions about menopause and what you may expect. Your Well Women Exam may include the following screenings and tests:

              • Pap Test. This test examines a sample of cells from your cervix for pre-cancerous and cancerous cells.¹
              • Pap + HPV together. Pap + HPV together combines Pap testing with HPV testing to determine whether you have human papillomavirus (HPV), the virus responsible for cervical cancer.
              • Pelvic Exam. Your healthcare provider will visually examine the outside of your genital area and feel your abdomen for anything out of the ordinary. An internal exam will enable your provider to better examine your reproductive organs and take any samples needed for testing.²
              • Clinical/Self-Breast Exam. Your provider will touch your breasts, feeling for lumps or other unusual tissue. A self-breast exam can be performed by you at home and involves looking in a mirror and feeling each of your breasts for possible lumps, distortions or swelling. If you find something, don’t panic. Contact your healthcare provider, who will determine what additional tests may be needed.³
              • Breast Cancer Screening/Mammogram. A mammogram is an X-ray of your breasts to detect abnormalities that may not be obvious from a clinical exam. If you and your doctor agree, you can have a mammogram every year starting at age 40.³ Most everyone can benefit from a 3D mammogram, especially when there’s breast cancer in your family or if you have dense breast tissue.
              • Sexually Transmitted Infection (STI) Testing. The Centers for Disease Control has established guidelines for STI testing⁴ that your healthcare provider will follow. She or he may recommend certain screening tests based on your age, while other tests may be right for you depending on the presence of symptoms or if you have an increased level of risk.⁵
              • Colorectal Cancer Screening. These tests detect cancer in the colon and rectum. During a colonoscopy, the most common type of screening, a small camera is used to examine your colon. There are other colorectal cancer screening options that you may discuss with your provider.⁶
              • High Blood Pressure Check-Up. Nearly half of all adults with high blood pressure are women.⁷ Your blood pressure may be normal for most of your life but, pregnancy and other life changes, may cause it to elevate.⁸ ⁹
              • Menstrual Health. It’s estimated that one in five women experience heavy periods, also known as abnormal uterine bleeding which is marked by heavy menstrual bleeding that last more than seven days.¹⁰ It may require double protection and can have a significant impact on a woman’s quality of life. Your healthcare provider can talk to you about a procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding.
                References
                1. Cervical Cancer Screening Frequently Asked Questions. https://www.acog.org/womens-health/faqs/cervical-cancer-screening
                2. Pelvic Exams Frequently Asked Questions. https://www.acog.org/womens-health/faqs/pelvic-exams
                3. Mammography and Other Screening Tests for Breast Problems. Frequently Asked Questions. How is a clinical breast exam done? https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
                4. STI Treatment Guidelines. https://www.cdc.gov/std/treatment-guidelines/default.htm
                5. Workowski KA, et al. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70.
                6. Problems of the Digestive System Frequently Asked Questions. https://www.acog.org/womens-health/faqs/problems-of-the-digestive-system
                7. American Heart Association. Go Red for Women. High Blood Pressure. Accessed January 17, 2022. 
https://www.goredforwomen.org/en/know-your-risk/high-blood-pressure-and-women
                8. Hypertension. Clinical Updates in Women’s Health (Jan 2016). https://www.acog.org/clinical/journals-and-publications/clinical-updates/2016/01/hypertension
                9. Maas AH, Franke HR. Women's health in menopause with a focus on hypertension. Neth Heart J. 2009;17(2):68-72. doi:10.1007/BF03086220 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644382/
                10. Centers for Disease Control and Prevention. Heavy menstrual bleeding. https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html. Accessed March 9, 2021.
                Sixties and Beyond
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                In Your Sixties and Beyond

                For women 60 or older, this is a time when your body undergoes changes that may include weakening of your bones, which could lead to osteoporosis.¹ During your next Well Woman exam, make sure to talk with your healthcare provider about ways to strengthen your bones and lifestyle changes that can help slow down the progression of osteoporosis. Your Well Woman exam may include the following screenings and tests:

                • Pap Test. This test examines a sample of cells from your cervix for pre-cancerous and cancerous cells.²
                • Pap + HPV together. Pap + HPV together combines Pap testing with HPV testing to determine whether you have human papillomavirus (HPV), the virus responsible for cervical cancer. Women should stop having cervical cancer screening after age 65 if: they do not have a history of moderate or severe abnormal cervical cells or cervical cancer, and they have had either three negative Pap test results in a row, two negative HPV tests in a row, or two negative co-test results in a row within the past 10 years. The most recent test should have been performed within the past 3 or 5 years, depending on the type of test.²
                • Pelvic Exam. Your healthcare provider will visually examine the outside of your genital area and feel your abdomen for anything out of the ordinary. An internal exam will enable your provider to better examine your reproductive organs and take any samples needed for testing.³
                • Clinical/Self-Breast Exam. Your provider will touch your breasts, feeling for lumps or other unusual tissue. A self-breast exam can be performed by you at home and involves looking in a mirror and feeling each of your breasts for possible lumps, distortions or swelling. If you find something, don’t panic. Contact your healthcare provider, who will determine what additional tests may be needed.⁴
                • Breast Cancer Screening/Mammogram. A mammogram is an X-ray of your breasts to detect abnormalities that may not be obvious from a clinical exam. If you and your doctor agree, you can have a mammogram every year starting at age 40.⁴ Most everyone can benefit from a 3D mammogram, especially when there’s breast cancer in your family or if you have dense breast tissue.
                • Sexually Transmitted Infection (STI) Testing. The Centers for Disease Control has established guidelines for STI testing⁵ that your healthcare provider will follow. She or he may recommend certain screening tests based on your age, while other tests may be right for you depending on the presence of symptoms or if you have an increased level of risk.⁶
                • Colorectal Cancer Screening. These tests detect cancer in the colon and rectum. During a colonoscopy, the most common type of screening, a small camera is used to examine your colon. There are other colorectal cancer screening options that you may discuss with your provider.⁷
                • Bone Density Test/Osteoporosis. The bone density test helps determine if you have osteoporosis, which can increase your chances of breaking a bone, such as a hip or shoulder. You will receive this test if you’re age 65 or older, or if you’re younger than 65 but have a risk of suffering a fracture. Your healthcare provider can discuss ways to protect your bone health, including what levels of calcium and Vitamin D are appropriate for your age.¹
                • High Blood Pressure Check-Up. Nearly half of all adults with high blood pressure are women.⁸ Your blood pressure may be normal for most of your life but may increase considerably during or after menopause.⁹ ¹⁰
                • Menstrual Health. It’s estimated that one in five women experience heavy periods, also known as abnormal uterine bleeding which is marked by heavy menstrual bleeding that last more than seven days.¹¹ It may require double protection and can have a significant impact on a woman’s quality of life. Your healthcare provider can talk to you about a procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding.
                  References
                  1. Osteoporosis Frequently Asked Questions. https://www.acog.org/womens-health/faqs/osteoporosis
                  2. Cervical Cancer Screening Frequently Asked Questions. https://www.acog.org/womens-health/faqs/cervical-cancer-screening
                  3. Pelvic Exams Frequently Asked Questions. https://www.acog.org/womens-health/faqs/pelvic-exams
                  4. Mammography and Other Screening Tests for Breast Problems. Frequently Asked Questions. How is a clinical breast exam done? https://www.acog.org/womens-health/faqs/mammography-and-other-screening-tests-for-breast-problems
                  5. STI Treatment Guidelines. https://www.cdc.gov/std/treatment-guidelines/default.htm
                  6. Workowski KA, et al. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70.
                  7. Problems of the Digestive System Frequently Asked Questions. https://www.acog.org/womens-health/faqs/problems-of-the-digestive-system
                  8. American Heart Association. Go Red for Women. High Blood Pressure. Accessed January 17, 2022. https://www.goredforwomen.org/en/know-your-risk/high-blood-pressure-and-women
                  9. Hypertension. Clinical Updates in Women’s Health (Jan 2016). https://www.acog.org/clinical/journals-and-publications/clinical-updates/2016/01/hypertension
                  10. Maas AH, Franke HR. Women's health in menopause with a focus on hypertension. Neth Heart J. 2009;17(2):68-72. doi:10.1007/BF03086220 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644382/
                  11. Centers for Disease Control and Prevention. Heavy menstrual bleeding. https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html. Accessed March 9, 2021.
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