From adolescent to post-menopausal visits, Dr. Padmini Santosh explains what your gynecologist is looking for and how they can help address any problems that may arise.
An annual well-woman exam is not just a physical check-up, but a chance for your OB/GYN to discuss how different factors like personal health history, family history, and lifestyle behaviors come together to shape your health outlook. Over time, your body, your risk factors, and your needs change in a way that is unique to you. Let’s look at what your annual exam can cover at each stage of life and why it’s important to go every year – even when you’re feeling great!
Adolescent Annual Exams
The American College of Obstetrics and Gynecology recommends adolescents see a gynecologist for the first time between age 13 and 15. We try to make teens as comfortable as possible, and often start with just a discussion. We’ll talk about your family history, menstrual history, and sexual history and contraceptive history. We’ll also discuss whether you’re up to date on immunizations including the HPV vaccine, the flu shot, the T-Dap, and now the COVID-19 vaccine.
When it comes to the physical exam, each element is only done with consent of the patient. We will measure height, weight, and BMI as necessary, and continue with an exam of several systems including the cardiovascular and respiratory systems. Teens may or may not need a pelvic exam at that first visit.
The discussion of your physical exam and history gives your doctor a snapshot of your overall health, which they can use as a jumping off point in discussing prevention strategies. What could be prevented? Abnormal menstrual cycles, infections, cancers, etc. We may recommend lifestyle modifications like diet and exercise or discuss any health screening tests and whether they should be started earlier than recommended.
Reproductive Age Annual Exams
In this next phase of life, we’ll continue to have the discussions above, but they may become broader as your personal and family histories evolve. Any surgeries or medical issues can have an impact on gynecological health. At some point, there may be a focus on family planning and preconception if you’re ready to try to conceive.
Screening recommendations will pick up during this phase. It is recommended to have your first pap smear by age 21, and clinical breast exams should become routine by age 25. (Self-breast exams are no longer recommended by ACOG in favor of breast self-awareness – being in tune with your body so you know when something feels off.) Annual mammograms are recommended starting at age 40 (or earlier, depending on family history). These recommendations are driven by research, not insurance or politics. And they change often – just another reason to keep those routine appointments and stay up to date.
Menopausal and Post-Menopausal Annual Exams
Many new symptoms come during and after menopause, such as hot flashes, incontinence, other pelvic floor disorders, decreasing bone density, and more. When I talk to patients about how to deal with these changes their bodies are going through, I remind them that acceptance of reality is half the battle. You won’t feel the same as you did when you were in your 20s or 30s, and that is normal. At this point in life, there is no one-size-fits-all solution, so we discuss the risks and return of different treatment options to meet your individual health and lifestyle needs.
The good news is, by age 65, if pap tests have been normal over the last 10 years, there’s no need to continue them annually because the likelihood of cervical cancer is very low. We continue to do physical exams, so if anything looks abnormal, a pap will be performed.
Your Annual Tune-up
I always tell my patients – even when there’s nothing wrong with your car, you get it serviced every year, right? It’s even more important to have that annual tune-up when it comes to your body. We’re here to make sure everything is running smoothly and talk about what, if any, changes can be made to keep you in the best health possible.