Don’t skip your well-woman visits

By DR. JOSHUA STUTZMAN

You may not need a Pap test or pelvic exam every year, but there are plenty of reasons to check in with your doctor for an annual well-woman visit. Regularly seeing your personal care provider or gynecologist regarding your female reproductive health assures that you set the right schedule for screenings and exams, are prepared for and coping well with your changing body as you age, and you are emotionally and physically healthy.

In addition to determining the appropriate schedule for your Pap test and pelvic exam, the doctor performs a breast exam and looks at your major body systems, including the heart and lungs. During the physical exam, your doctor will examine your thyroid, breasts, and abdomen for any lumps, bumps, or abnormalities. The doctor will screen for depression and domestic abuse and ask about specific concerns.

To gain the most from your exam, bring a record of your menstrual cycle over the past 6 to 12 months. Note any changes in length, frequency or regularity. Bring a list of any medications you take, allergies, and changes in your family history, particularly with breast and ovarian cancer. The annual exam is a good place to lay out problems you want to tackle, from severe PMS to urinary incontinence, or vaginal dryness. These topics may not be addressed completely in one visit, but you and your doctor can form an action plan, and you may even leave with the next steps scheduled.

Here are the main ages and stages of womanhood, along with common areas of focus for your well-woman visits:

r Ages 13-15/First visit: Young women should have their first visit with a gynecologist between the ages of 13 and 15. This exam doesn’t include a Pap test or internal pelvic exam, but it lays the groundwork for conversations about sexually transmitted diseases (STDs), birth control, and menstrual health. At this first exam, you may want to talk about heavy menstrual bleeding or cramps, and other issues related to your monthly cycle.

r Early 20s-40’s/Reproductive years: You should have your first internal pelvic exam and Pap test at age 21. These screening tests should typically be repeated every two to five years. At each yearly exam, the doctor may screen for STDs, give advice on contraception or birth control, and address problems with your menstrual cycle, including PMS, heavy bleeding, and cramps. At some point, you may do some prenatal planning to assure you have proper immunizations, a healthy weight, and a good diet and exercise routine before becoming pregnant. If you are trying to become pregnant without success, you can discuss options and possibly be referred to a fertility specialist. During your 30s, and by age 40, you will discuss when to have your first mammogram, and an appropriate schedule for this screening test for breast cancer.

r Ages 45-60/Perimenopause: During these visits, typically when a woman is 45 to 60, discussions include menopausal symptoms, birth control or contraception, STDs and irregular menstrual cycles. The OB/GYN will discuss the pros and cons of hormone therapy and other treatments that can relieve some menopausal symptoms.

r Age 60+/Menopause: Common concerns at these exams include breast cancer screening, sexual health, and any post-menopausal bleeding, which should be reported immediately. Urinary symptoms should also be reported because these can often be addressed through a referral to a urologist or with physical therapy.

It’s tempting to skip or put off well-woman exams, but with regular visits, you develop a good relationship with your doctor and give him or her the best opportunity to take excellent care of you.

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Dr. Joshua Stutzman is an OB/GYN specialist at UPMC Susquehanna.

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