We know it’s important to keep our health in check, and to have regular checkups. For women, there are specific considerations that are often addressed at a well woman exam.
“A well woman exam refers to a general health checkup specifically focused on screening for disease or other health concerns in asymptomatic women. It includes, just to name a few, cancer screening, immunizations, mental health screening, and reproductive counseling,” states Dr. Kim Guida, Medical Director of Pullman Family Medicine, part of the Pullman Regional Hospital Clinic Network.
Unlike a “standard” physical, which is typically a head-to-toe physical exam looking for the presence or absence of disease, a well woman exam focuses on disease prevention. These exams often include a comprehensive discussion about individual risks based on a woman’s personal and family history, as well as lifestyle choices like diet, exercise, and smoking. Age-appropriate screening tests are also considered.
Comprehensive Screening Ensures Early Detection & Prevention
Guidelines for well woman exams follow the United States Preventive Services Taskforce, which sets forth recommendations for age-specific screening tests. However, these guidelines are not necessarily the same for every woman. Each individual woman’s current health status, along with family history, may indicate the need for screening at an earlier age than the guidelines dictate.
Screening for heart disease involves checking for high blood pressure, obesity, high cholesterol, family history of heart disease, and smoking. Oftentimes the well woman exam is the first time a woman will be diagnosed with hypertension or high cholesterol.
Cancer screening is another assessment, including cervical cancer screening via Pap smear and breast cancer screening with mammograms. Colon cancer screening is considered for women over age 50. Skin cancer screening is also part of the physical exam.
In Dr. Guida’s experience, she finds many women think about the well woman exam as being primarily reproductive, which is a part of the entire exam process. “We’ll address contraception. We’ll assist pregnancy planning, as well as symptoms related to menopause such as hot flashes and risks for osteoporosis or low bone density,” she notes.
Infection and immunization is another category that is covered during a woman well exam. Younger women are screened for certain infections like sexually transmitted infections, HIV, and hepatitis C. The exam can also be used to provide age-appropriate immunizations such as tetanus, pneumonia, shingles, and the flu.
One area of focus that’s often forgotten—but is so important—is screening for mental health issues like depression, anxiety, substance use, and domestic violence or partner abuse.
Should I get my Well Woman Exam from my primary Care Provider or OB/GYN?
Dr. Guida recommends women start undergoing well women exams in their late teens or early 20s and continue every two to three years, as long as the woman is healthy and has no chronic conditions. As women enter their 40s or 50s, yearly visits are encouraged—simply because the likelihood of disease increases with age.
While exams can be performed by an OB/GYN physician, some conditions may be better served by a primary care physician. “If there are issues detected that are not primarily gynecologic—for example high cholesterol or high blood pressure, diabetes—women are then referred to primary care to manage those conditions. I feel like primary care doctors are really best suited for these types of exams, because we have a broad range of training to treat these different illnesses,” advises Dr. Guida.
Most insurance companies include annual wellness exams as a benefit that is not subject to a woman’s deductible. Should that be the case, the well exam is a free opportunity for women to make sure they're up-to-date on recommended preventative health services.
“It’s also an opportunity to build an ongoing relationship with your primary care doctor,” shares Dr. Guida. “As physicians, those relationships are very important. When we are given the opportunity to get to know patients when they are well, we can do a much better job taking care of them when they're sick, too.”
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