Well-Woman Exams: Who Needs Them and What To Expect

For women and people assigned female at birth (AFAB), taking care of your health requires more than an annual physical. You should also visit a women’s health specialist — like an Ob/Gyn, midwife or nurse practitioner — each year to keep healthy. More than just a checkup for your breasts/chest and reproductive organs, well-woman exams can also help you develop rapport with a women’s health specialist.

“Well-women exams are important for a number of reasons. No. 1 is that they help you to establish care with a specialist so that if there is a problem down the road, you have a provider that you know and feel comfortable talking to,” says Ob/Gyn Amanda Elbin, MD.

That comfort level is important, too, especially because many of us may not feel comfortable talking with just anyone about issues “down there.”

“When you have a level of comfort with a provider, it’s easier to talk openly about sensitive issues,” notes Dr. Elbin. “It’s important to be able to talk with a healthcare provider about your sexual health, your reproductive wishes, abnormal discharge or whatever your concerns may be. So, having regular check-ins helps to make sure you’re comfortable with having those discussions when you need to.”

We spoke with Dr. Elbin about who needs well-women exams and what you can expect from these annual visits.

What is a woman’s wellness exam?

Your women’s health specialist is your partner in screening for issues like breast cancer, ovarian cancer and cervical cancer that aren’t a part of a regular physical exam.

The American College of Obstetricians and Gynecologists states that the importance of these preventive care visits go beyond screening for physical abnormalities. Regular visits to a specialist can help you navigate all the other nuances that come with life. That can include things like:

• Contraception options.
• Emotional well-being.
• Fertility questions.
• Hormone questions.
• Menstruation concerns.
• Relationship health.
• Sexual wellness.
• Sexually transmitted diseases and infections (STDs and STIs).

“So much of your health is impacted by things outside of your body’s physical functioning,” Dr. Elbin says. “In addition to screening for physical changes, a lot of what we talk about is your mental health — what’s going on in your life, how are your relationships. We spend a lot of time working with people and figuring out how we can help them be their best well-rounded, whole person.”

Who needs well-woman exams?

Dr. Elbin explains that these appointments are recommended each year for anyone with female anatomy (regardless of their gender identity, and including cisgender women, non-binary people with female anatomy and transgender men). They can also be helpful for anyone who identifies as a woman, regardless of their anatomy.

“For women who don’t have a vagina, a woman’s health specialist can work with their primary care physician, or other healthcare providers, to help with managing hormones, medication or other concerns,” Dr. Elbin states. “A women’s health specialist can also be a trusted resource for all people to access a sensitive and welcoming healthcare environment to ask questions or get advice.” You may also consider seeking out an LGBTQIA+ specialist for your care.

Well-woman exams should be a part of your regular health maintenance beginning in your teenage years and well beyond menopause.

“Even beyond childbearing age, these health practitioners work with you to keep you as healthy as possible,” Dr. Elbin says.

Is a well-woman exam the same as a physical?

Like your annual physical, one component of an annual well-woman exam is taking stock of your current health to understand your risks for certain conditions and to screen for potential health concerns. But a primary care doctor is going to check for different issues than a women’s health specialist.

During a physical, a primary care physician will be more likely to check for things like high cholesterol, high blood pressure or unusual moles on your skin.

During a well-woman exam, your healthcare provider is looking primarily for concerns related to your reproductive health, like changes to your menstrual cycle or advising you on contraception options.

What to expect during a well-woman exam

Your healthcare provider may do things differently depending on your age, your health status and other factors, but typically, a well-woman visit will start with questions about your overall health. They’ll take your vital signs. And you’ll get into one of those oh-so-chic hospital gowns to examine your breasts and pelvic area.

Dr. Elbin says there’s nothing you need to do to prepare for a well-woman exam except to bring any questions you have and be open to talking about how you’re doing.

“Come as you are. There’s nothing fancy that you need to do, no products that you need to use and, no, we don’t care if you shave your legs. Makes zero difference to us,” Dr. Elbin says. (And contrary to some popular beliefs, you can get a gynecological exam when you’re on your period.)

Dr. Elbin walks us through what you can expect during a well-woman exam.

1. Medical history

Your exam will likely start with reviewing your medical history, including your family history, to understand your current health and note any changes since your last visit.

Questions you may be asked include:

• What was the first day of your last period?
• Are you currently taking any medications?
• Do you have any allergies you’re aware of?
• Have you had any surgeries?
• Are you sexually active?
• Have you ever been pregnant?
• Do you wish to have children in the future?
• Do you feel safe at home?
• What questions do you have for me?

2. Wellness screening

Your exam will likely include some time devoted to taking your vital signs, including your:

• Height.
• Weight.
• Temperature.
• Blood pressure.

Your provider will also likely listen to your heart and lungs using a stethoscope and will feel your neck to check your thyroid.

3. Breast exam

During the appointment, your provider will likely perform a breast exam to check for any changes, such as lumps or swelling. In most cases, this exam will take place with you lying on a doctor’s table with your arm above your head. Your doctor will use their fingertips and medium pressure to check your breast tissue for any signs of concern.

4. Pelvic exam

If you’re between the ages of 21 and 65, another part of your exam will likely be a pelvic exam. This is a screening where your healthcare specialist will look for any signs of disease in your vagina, uterus, ovaries, fallopian tubes and cervix.

During the pelvic exam, you’ll lie on your back with your feet in stirrups. Your healthcare provider will use a speculum to look inside your vagina to ensure things look healthy. They may also perform an exam by touch, feeling your uterus and ovaries for any signs of abnormalities.

A pelvic exam may be uncomfortable or cause some mild cramping for some people, but it shouldn’t hurt.

5. Pap smear

Pap smears are recommended every three years for people AFAB between the ages of 21 and 65. Your doctor may recommend them more frequently if you had abnormal Pap smear results in the past.

If it’s time for your Pap smear, your healthcare provider will use a small brush or spatula to gently remove cells from your cervix as part of your pelvic exam. That sample will be sent for testing to check for human papillomavirus (HPV) and signs of cervical cancer.

Other reasons to connect with a women’s health provider

In addition to your regularly scheduled well-woman exam, Dr. Elbin reminds you to not hesitate to reach out to a healthcare provider with other concerns between annual visits. Some common reasons to consult your Ob/Gyn or other provider include:

• Pregnancy.
• Irregular periods or abnormal bleeding.
• Pelvic pain.
• Troubles with urination.
• Menopausal symptoms, like hot flashes or night sweats.

“If anything changes out of the blue or doesn’t feel right, we want to see you and make sure all is well,” Dr. Elbin says.