Well-woman visit
Health history
Physical exam
Pap test
Mammogram
Other tests
Care of reproductive
and other conditions

A Total Approach to Women’s Health

Your ob-gyn can provide you with a wide range of care, from basic gynecologic exams to comprehensive health care including care for reproductive or other disorders. The type of care is based upon your unique needs.

The Well-woman visit

The well-woman visit is a key part of preventive care. This is an evaluation of your general health, including examination of your breasts and pelvic reproductive organs. The exam is an opportunity for your ob-gyn to catch an emerging health problem in the early stages, to detect risks to your health, and to provide you with useful information on lifestyle changes that can lower your risks.

You may also have certain tests and immunizations, depending upon your age.

You should schedule an annual well-woman exams if you are sexually active or age 18 or older. More frequent exams may be warranted based upon your individual health risk factors. Of course, if you develop a health problem or notice changes in your body—such as genital itching or an unusual vaginal discharge—you should contact your physician as soon as possible.

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Health history. Your doctor will usually begin your exam by obtaining a history of your health. This will include questions about past illnesses, family health history, your menstrual periods, medications, birth control, and whether you are or ever have been pregnant. Your ob-gyn will also ask questions to assess potential environmental and lifestyle risk factors, including questions about your occupation, sources and level of stress, health habits, sexual activity, and personal relationships.

You should be completely honest and open when answering health history questions. Honest answers will better enable your ob-gyn to provide you with the proper care. Anything you tell your doctor will be kept strictly confidential; no one else will know.

In particular, it is very important that you tell your doctor if you smoke, use alcohol or drugs, eat a high-fat diet, or are in an abusive relationship. If you are pregnant, cigarette smoking and substance abuse can also harm your baby. Your doctor can help you break poor habits and substitute healthier practices.

If you are or plan to become sexually active, your doctor can also talk to you about contraception and prevention of sexually transmissible diseases (STDs), including human immunodeficiency virus (HIV).

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Physical exam. The general physical exam usually begins with a check of your weight and blood pressure. Your doctor may also listen to your heartbeat and feel your abdomen and neck. The exam is based on your age and individual risk factors.

A gynecologic exam assesses the health of your reproductive organs. Your ob-gyn will first check your breasts for lumps. You should also perform a breast self-exam regularly. If you are not sure how, your doctor or nurse can teach you.

After examining your breasts, the doctor will examine your pelvic organs. You will be asked to lie on a table with your legs raised and your knees bent and spread apart. The doctor will first examine the outside genitals (vulva). He or she may perform a Pap test (see below).

Next, the doctor will insert one or two gloved fingers into the vagina and reach up to the cervix. While the other hand presses on the abdomen from the outside, the uterus and ovaries can be felt from the inside. This allows your doctor to check the size, position and shape of the reproductive organs. Your doctor may also examine your rectum using a gloved finger. This helps to detect any tumors, lumps, or other problems that may be present.

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Pap test

The Pap test, also called a Pap smear, involves taking a sample of cells from the cervix to look for changes that could signal cervical cancer. The test can provide early detection of possible disease in women who do not have obvious symptoms like bleeding, pelvic pain or discharge.

For accurate results, you should schedule the test when you’re not having your period. Also, do not douche or use a vaginal medication or lubricant for at least 24 hours beforehand.

First, a speculum is inserted into the vagina so the cervix can be seen. Next, a small brush or swab and applicator are used to remove cells from inside the opening of the cervix and from the outer part of the cervix. This should not hurt. The cell samples are sent to a lab, where a trained technician or doctor looks for cells that do not appear normal.

You may experience some spotting for a day or two after the test, especially if you're pregnant.

You should have your first Pap test by age 18, or when you become sexually active. The Pap test and pelvic exam have traditionally been part of the annual checkup. However, the most recent scientific and medical research suggests that while regular Pap tests are very important, it is not necessary for most women to have a Pap test every year. Because most cervical cancers grow very slowly, a Pap test every two to three years will provide the same early detection benefit as an annual test. You may be able to extend your interval between Pap smears to two to three years if you have had normal annual Pap test results for at least three years in a row. Check with your doctor.

More frequent Pap tests are still recommended for women:

with a history of abnormal cell changes that may lead to cancer
during the next five years
who have a new sexual partner or partners
who are HIV positive or otherwise immunosuppressed

Cervical cancer is one of the most common female cancers in the United States, diagnosed in approximately 13,500 women each year. Over 4,000 women die each year from the disease. However, the survival rate is 89 percent with early diagnosis. And if the disease hasn’t spread, the survival rate rises to virtually 100 percent.

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Mammogram

Mammography is an X-ray examination of your breasts that can detect tumors and other breast abnormalities before you can feel them. This early detection produces cure rates of more than 90 percent. And since the amount of radiation involved in mammography is low, repeat examinations do not pose a health risk. However, you should not undergo mammography if you are pregnant because even a low dose of radiation can harm a fetus. Tell your doctor if you are expecting a baby.

The image created by mammography is called a mammogram. An X-ray passes through your breast and makes an image on a film or plate. The X-ray clearly shows the internal structure of your breasts, allowing early identification of both cancerous and noncancerous growths. A highly trained radiologist studies the picture and pinpoints any suspicious areas. He or she then reports the findings to your doctor, who will discuss any areas of concern with you.

Your breasts are compressed during mammography, which can cause discomfort. Accordingly, you may wish to schedule your exam for the week following your menstrual period (when your breasts are the least tender).

No special preparation is necessary. On the other hand, it’s a good idea to not use deodorants, powders or other body cosmetics on the day of your mammogram, since they can create shadows on the X-ray. You will be required to undress from the waist up.

The American Cancer Society and the American College of Obstetricians and Gynecologists recommend a first mammogram between ages 35 and 40. This first image is saved and used for comparison with future images, to spot any changes. You should have a mammogram every two years between ages 40 and 49. After this, you should increase to once a year because the risk of breast cancer increases with age. Higher risk patients, such as those with a strong family or personal history, may require more frequent mammograms. Check with your doctor.

Mammography is not 100 percent effective in early detection of breast disease. Still, it is the best weapon currently available in the fight against breast cancer.

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Other tests

The type and frequency of tests you receive are based upon your age and your individual risk factors. Based upon your unique needs, your ob-gyn may recommend other tests as part of your well-woman exam. Examples include:

Cholesterol test is a blood test performed to check cholesterol levels, a substance that helps transport fat in the blood. Patients with a high cholesterol count are advised about diet and other preventive health measures.
Fecal occult blood test is a test of a stool sample for hidden blood that may indicate colon or rectal cancer.
Sigmoidoscopy is the use of a slender device placed into the rectum and lower colon to look for cancer.
Urinalysis tests urine to look for changes that might signal illness.
Blood count is a test for detecting anemia and infection.

Tell your doctor if you have concerns about possible exposure to STDs—including HIV. He or she may suggest specific tests based on your individual risk factors.

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Care of reproductive and other conditions

Your ob-gyn can detect and treat a variety of medical conditions affecting the reproductive system. An ob-gyn may also treat certain medical conditions that do not involve the breasts or reproductive organs. This is especially important for women who don’t regularly visit a doctor other than their ob-gyn. In some cases, the ob-gyn may diagnose a medical problem and refer the patient to another doctor for treatment. In others, the ob-gyn can treat the problem during the course of routine health care. Deciding how to treat a disorder depends upon how severity, whether the condition is worsening or improving, and the comfort level of the woman and her physician.

You and your ob-gyn can work together to ensure your good health. By taking proper care of yourself, visiting your doctor regularly, and promptly reporting any symptoms that may signal a problem, you will greatly increase your chances of staying healthy. A healthy lifestyle and preventive care are always preferable to treatment and recovery.

* * *

This information is adapted from patient education information developed by the American College of Obstetricians and Gynecologists. This information does not dictate an exclusive course of treatment or procedure to be followed and should not be interpreted as excluding other acceptable methods of practice.





			Well-woman visit Health history Physical exam Pap test Mammogram Other tests Care of reproductive and other conditions A Total Approach to Women’s Health Your ob-gyn can provide you with a wide range of care, from basic gynecologic exams to comprehensive health care including care for reproductive or other disorders. The type of care is based upon your unique needs. The Well-woman visit The well-woman visit is a key part of preventive care. This is an evaluation of your general health, including examination of your breasts and pelvic reproductive organs. The exam is an opportunity for your ob-gyn to catch an emerging health problem in the early stages, to detect risks to your health, and to provide you with useful information on lifestyle changes that can lower your risks. You may also have certain tests and immunizations, depending upon your age. You should schedule an annual well-woman exams if you are sexually active or age 18 or older. More frequent exams may be warranted based upon your individual health risk factors. Of course, if you develop a health problem or notice changes in your body—such as genital itching or an unusual vaginal discharge—you should contact your physician as soon as possible. back \| top Health history. Your doctor will usually begin your exam by obtaining a history of your health. This will include questions about past illnesses, family health history, your menstrual periods, medications, birth control, and whether you are or ever have been pregnant. Your ob-gyn will also ask questions to assess potential environmental and lifestyle risk factors, including questions about your occupation, sources and level of stress, health habits, sexual activity, and personal relationships. You should be completely honest and open when answering health history questions. Honest answers will better enable your ob-gyn to provide you with the proper care. Anything you tell your doctor will be kept strictly confidential; no one else will know. In particular, it is very important that you tell your doctor if you smoke, use alcohol or drugs, eat a high-fat diet, or are in an abusive relationship. If you are pregnant, cigarette smoking and substance abuse can also harm your baby. Your doctor can help you break poor habits and substitute healthier practices. If you are or plan to become sexually active, your doctor can also talk to you about contraception and prevention of sexually transmissible diseases (STDs), including human immunodeficiency virus (HIV). back \| top Physical exam. The general physical exam usually begins with a check of your weight and blood pressure. Your doctor may also listen to your heartbeat and feel your abdomen and neck. The exam is based on your age and individual risk factors. A gynecologic exam assesses the health of your reproductive organs. Your ob-gyn will first check your breasts for lumps. You should also perform a breast self-exam regularly. If you are not sure how, your doctor or nurse can teach you. After examining your breasts, the doctor will examine your pelvic organs. You will be asked to lie on a table with your legs raised and your knees bent and spread apart. The doctor will first examine the outside genitals (vulva). He or she may perform a Pap test (see below). Next, the doctor will insert one or two gloved fingers into the vagina and reach up to the cervix. While the other hand presses on the abdomen from the outside, the uterus and ovaries can be felt from the inside. This allows your doctor to check the size, position and shape of the reproductive organs. Your doctor may also examine your rectum using a gloved finger. This helps to detect any tumors, lumps, or other problems that may be present. back \| top Pap test The Pap test, also called a Pap smear, involves taking a sample of cells from the cervix to look for changes that could signal cervical cancer. The test can provide early detection of possible disease in women who do not have obvious symptoms like bleeding, pelvic pain or discharge. For accurate results, you should schedule the test when you’re not having your period. Also, do not douche or use a vaginal medication or lubricant for at least 24 hours beforehand. First, a speculum is inserted into the vagina so the cervix can be seen. Next, a small brush or swab and applicator are used to remove cells from inside the opening of the cervix and from the outer part of the cervix. This should not hurt. The cell samples are sent to a lab, where a trained technician or doctor looks for cells that do not appear normal. You may experience some spotting for a day or two after the test, especially if you're pregnant. You should have your first Pap test by age 18, or when you become sexually active. The Pap test and pelvic exam have traditionally been part of the annual checkup. However, the most recent scientific and medical research suggests that while regular Pap tests are very important, it is not necessary for most women to have a Pap test every year. Because most cervical cancers grow very slowly, a Pap test every two to three years will provide the same early detection benefit as an annual test. You may be able to extend your interval between Pap smears to two to three years if you have had normal annual Pap test results for at least three years in a row. Check with your doctor. More frequent Pap tests are still recommended for women: with a history of abnormal cell changes that may lead to cancer during the next five years who have a new sexual partner or partners who are HIV positive or otherwise immunosuppressed Cervical cancer is one of the most common female cancers in the United States, diagnosed in approximately 13,500 women each year. Over 4,000 women die each year from the disease. However, the survival rate is 89 percent with early diagnosis. And if the disease hasn’t spread, the survival rate rises to virtually 100 percent. back \| top Mammogram Mammography is an X-ray examination of your breasts that can detect tumors and other breast abnormalities before you can feel them. This early detection produces cure rates of more than 90 percent. And since the amount of radiation involved in mammography is low, repeat examinations do not pose a health risk. However, you should not undergo mammography if you are pregnant because even a low dose of radiation can harm a fetus. Tell your doctor if you are expecting a baby. The image created by mammography is called a mammogram. An X-ray passes through your breast and makes an image on a film or plate. The X-ray clearly shows the internal structure of your breasts, allowing early identification of both cancerous and noncancerous growths. A highly trained radiologist studies the picture and pinpoints any suspicious areas. He or she then reports the findings to your doctor, who will discuss any areas of concern with you. Your breasts are compressed during mammography, which can cause discomfort. Accordingly, you may wish to schedule your exam for the week following your menstrual period (when your breasts are the least tender). No special preparation is necessary. On the other hand, it’s a good idea to not use deodorants, powders or other body cosmetics on the day of your mammogram, since they can create shadows on the X-ray. You will be required to undress from the waist up. The American Cancer Society and the American College of Obstetricians and Gynecologists recommend a first mammogram between ages 35 and 40. This first image is saved and used for comparison with future images, to spot any changes. You should have a mammogram every two years between ages 40 and 49. After this, you should increase to once a year because the risk of breast cancer increases with age. Higher risk patients, such as those with a strong family or personal history, may require more frequent mammograms. Check with your doctor. Mammography is not 100 percent effective in early detection of breast disease. Still, it is the best weapon currently available in the fight against breast cancer. back \| top Other tests The type and frequency of tests you receive are based upon your age and your individual risk factors. Based upon your unique needs, your ob-gyn may recommend other tests as part of your well-woman exam. Examples include: Cholesterol test is a blood test performed to check cholesterol levels, a substance that helps transport fat in the blood. Patients with a high cholesterol count are advised about diet and other preventive health measures. Fecal occult blood test is a test of a stool sample for hidden blood that may indicate colon or rectal cancer. Sigmoidoscopy is the use of a slender device placed into the rectum and lower colon to look for cancer. Urinalysis tests urine to look for changes that might signal illness. Blood count is a test for detecting anemia and infection. Tell your doctor if you have concerns about possible exposure to STDs—including HIV. He or she may suggest specific tests based on your individual risk factors. back \| top Care of reproductive and other conditions Your ob-gyn can detect and treat a variety of medical conditions affecting the reproductive system. An ob-gyn may also treat certain medical conditions that do not involve the breasts or reproductive organs. This is especially important for women who don’t regularly visit a doctor other than their ob-gyn. In some cases, the ob-gyn may diagnose a medical problem and refer the patient to another doctor for treatment. In others, the ob-gyn can treat the problem during the course of routine health care. Deciding how to treat a disorder depends upon how severity, whether the condition is worsening or improving, and the comfort level of the woman and her physician. You and your ob-gyn can work together to ensure your good health. By taking proper care of yourself, visiting your doctor regularly, and promptly reporting any symptoms that may signal a problem, you will greatly increase your chances of staying healthy. A healthy lifestyle and preventive care are always preferable to treatment and recovery. * * * This information is adapted from patient education information developed by the American College of Obstetricians and Gynecologists. This information does not dictate an exclusive course of treatment or procedure to be followed and should not be interpreted as excluding other acceptable methods of practice.

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