The “WELL WOMAN EXAM” or GYN annual is a routine yearly annual screening visit.
PURPOSE: to allow screening, counseling, and guidance to lessen the impact of risk factors discovered.
DISCUSSION:  We will offer our impression regarding your gynecologic health and the results of your physical examination.
ANSWER QUESTIONS: regarding your gynecologic health and schedule necessary follow-up appointments,
ORDER TESTS:  Of your blood, Imaging (Ultrasound, mammograms, etc), or any referrals to other physicians (family doctor, general surgeon, endocrinologist, mental health specialist, etc.).

GENERAL PRINCIPALS: This visit is scheduled once a year at which time we review your past medical history and update medical, surgical, social and family history information.  We perform a physical examination including breast, abdominal and pelvic examinations. A pap smear is done and any obvious evidence of infection is addressed. Menses and birth control needs are evaluated. Hormonal needs are briefly addressed. We will Identify and manage minor problems.  We will arrange follow-ups of major problems together with providing referrals to other specialists when indicated.  Referrals for Mammograms are provided at this visit.

REVIEW: We will get a sense of your general health, diet, nutrition, exercise, and physical activity. We will inquire about seat belt use and texting while driving.  We will encourage smoking/tobacco cessation as well as alcohol moderation or avoidance.  You will be encouraged to do breast self-exams and to take a vitamin/folic acid supplement during your reproductive years.  Sun exposure will be addressed.  We will encourage you to have an advanced directive. and we will inquire about domestic violence.

REVIEW OF HEART RISK FACTORS: Life Style / Stress / Exercise / Family History / Hypertension / Obesity / Lipid Testing / Diabetes Screening and Prophylactic Aspirin will be addressed.

Calculate your Body Mass Index

REVIEW OF IMMUNIZATIONS: 
Influenza (flu vaccine) annually after 19 years of age
Human Papillomavirus (Gardasil)  3 doses between ages 19-45 years of age.
Tetanus-Diphtheria-Pertussis (Tdap) 1-time dose, and repeat with every pregnancy, also boost every 10 years.
Varicella Vaccine 2 doses recommended.
Measles-Mumps-Rubella 1-2 doses between 19 and 55 years of age.

See full vaccine recommendations:
www.cdc.gov/vaccines/schedules/

SUPPLEMENTS:  We encourage a woman’s daily multivitamin, Vitamin D 2,000IU/day , Calcium 1000 mg/day.

TESTING:
PAP SMEAR: Every 1-3 years.
MAMMOGRAMS: Every 1-2 years after 40. Calculate your breast cancer risk at http://www.cancer.gov/bcrisktool/
FASTING PLASMA GLUCOSE TESTING: every 3 years after age 45 – will reduce the risk of heart and blood vessel disease.
FASTING LIPID TESTING: every 5 years after 45 to reduce risks of heart attacks and strokes.
THYROID FUNCTION TESTING: TSH screening (with symptoms, physical findings or every 5 years beginning at age 50 years).
COLON CANCER SCREENING: Colonoscopy at age 45 and every  5-10 years. Report any symptoms (rectal bleeding or change in stool caliber).
STOOL OCCULT-BLOOD KIT: every year after 50.
TEST YOUR BONES: Bone density testing is recommended for all women aged 65 or older and in any younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman (9.3% OR GREATER RISK OF FRACTURE WITHIN 10 YEARS). Calculate your own risk at www.shef.ac.uk/FRAX