What to expect at an annual well-woman visit

Yearly visits with a gynecologist or certified nurse midwife are an opportunity to review medical history and evaluate current health through various screenings, including a breast exam, mammogram or pelvic exam. They’re also an important way women can establish a long-term, trusting relationship with their doctor.

An annual physical does not consist solely of a pelvic exam or breast exam. They’re also an opportunity for women to have open conversations with their physicians and learn helpful information about their bodies and anatomy.  

The exam and open conversation can lead to the early detection of issues ranging from benign conditions, fibroids, pelvic health issues and sexually transmitted infections, to ovarian, cervical, vaginal, skin and breast cancers and more.

Sexual health is often a topic of discussion for women of all ages. Getting to the root of sexual health concerns can be complicated, as various factors like medication, mental health and age can affect it. Approach your annual visit prepared to have a conversation about any sexual health concerns, contraceptive and preconception counseling, and safe sex practices.

“Mary Faith Terkildsen, MD, has developed a sexual health practice that can comprehensively address patient questions and hone in on possible solutions,” said Carl Buccellato, MD, an obstetrician and gynecologist at Endeavor Health. “The solution may not be straightforward or simple, and she spends the time necessary to find it.”

Genetics are also an important topic to raise at your annual visit, as your genes and family history play a role in your level of risk for diseases like cancer. Endeavor Health’s Personalized Medicine program helps physicians build a care and treatment plan based on an individual’s unique genetic characteristics and health history. The information gathered is also fully integrated with a patient’s medical record, Dr. Buccellato said.

Naturally, pregnant patients have a lot of questions for their physicians. Some receive care from an obstetrician-gynecologist (OB-GYN) and others prefer the support of a midwife on their birth journey.

Endeavor Health certified nurse midwives (CNM) are available in various locations throughout Chicagoland and can provide extended prenatal visits, general gynecology, labor support and lactation consulting. Endeavor’s certified nurse midwives in Lake County also offer group prenatal classes, known as Centering, for patients in the same stage of pregnancy, Dr. Buccellato said.

An annual well-woman visit should include:

1. Discussion about your state of health. Just like a yearly visit with a primary care physician, during a well-woman visit, you can discuss any recent health changes, concerns from the last year and any medical history updates.
2. Medication review. Bring a list of your current medications, including any birth control.
3. Breast examination. A breast exam should happen at each yearly appointment starting at age 21. If you notice any changes in your breasts during a self-exam, inform your physician.
4. Pelvic exam. A pelvic exam is typically performed at each annual visit and will not always include a Pap smear. A pelvic exam consists of both an external and internal visual exam as well as an evaluation of the uterus and ovaries through a manual exam, which should take no more than 2-3 minutes. You may feel some pressure and mild discomfort during this exam, but it should not be painful.
5. Pap smear. You should consult with your physician on a recommended schedule for this test. The timing of a Pap smear will depend on your age, health and medical history. Physicians recommend a first Pap smear by age 21. It is then commonly performed every 3 years until age 30, and every 3-5 years thereafter.

It’s important to schedule more frequent appointments and screenings if you’ve previously had abnormal test results from a Pap smear, a family history of uterine or breast cancer, and/or any recent changes in health such as infection, pain or bleeding.