For Women Only – Don’t Miss Your Annual Well-Woman Visit in 2024
Mitchel Chere, MD
During COVID and even now, many women have let their annual OB-Gyn appointments lapse, also known as a well-woman visit. Missing wellness appointments puts women at an increased risk for negative health outcomes. A well-woman visit focuses primarily on services relevant to women’s health throughout their reproductive lives, from routine gynecological exams and contraception method options to medical education and an understanding and management of menopause. Often serious medical issues may not have symptoms; completing a well-woman visit each year is a proactive approach to prevention and early detection of medical problems. Developing an ongoing relationship with your provider also helps build trust and confidence, especially if a medical issue does arise and other treatment or tests are needed. It will also help establish a preventive approach to overall health care.
A well-woman visit focuses primarily on preventive care and usually includes: a review of health habits, family and personal medical history, a physical exam, review of any needed vaccinations or screens such as mammograms or Pap test, addressing any symptoms including menstrual problems, sexual or birth control issues, fertility, menopause, as well as any education or counseling. It’s also a time to ask questions and discuss topics such as breast health, contraception, pregnancy plans, menopausal issues, osteoporosis, or other changes women may experience during the reproductive years and beyond.
Screening is a major preventative component of a well-woman visit, and guidelines have changed over the years as science and research continues to evolve. Some research indicates young women may not need to get screened as early and as frequently for cervical cancer as previously thought. However, the need for screening sexually active women for infections is important, especially as these may be silent but have devastating effects on their health and fertility.
The exact screening guidelines for a well-woman visit vary among different health organizations in the US and worldwide. Physicians and other providers will use different guidelines based on their training, professional knowledge, experience, and expertise along with a woman’s individual health conditions. In my professional opinion, it’s actually best to get screened a little early as opposed to a little late. That being said, these are the general guidelines for women’s health screening recommendations:
Breast Health Screenings
Clinical Breast Exams
- Early in gynecological care and annually, along with instruction and reminders for a monthly self-breast examination
Mammograms
- Once a year, starting at age 45, and many organizations recommend starting at age 40
- Mammograms may need to start earlier if there is a family history of breast cancer
Cervical Cancer Screening – Pap test and HPV
A Pap test is part of the pelvic exam where cells are taken from the cervix to test for cervical cancer risk. HPV (human papillomavirus), which may be tested for during the Pap test, is a sexually transmitted, tragically common, viral infection. HPV is associated with 98% of all known cervical cancers. The infection may resolve by itself with the help of your immune system, but then may reoccur. This virus is known to cause not only cervical cancer but also genital warts, oral cancer, and anal cancer. There are many different HPV families, and about 14 of those families are considered high-risk, meaning they may lead to cervical cancer.
- Cervical cancer screening is recommended now to routinely begin at age 21, or soon after becoming sexually active, and organizations differ on a particular age. In my opinion, an annual Pap test should in many cases be done at the time of the first well-woman visit as the best prevention for cancer. The final decision is between you and your provider. It is important to remember your first GYN exam should be soon after sexual activity begins, because of the risk of infection, even if the recommendations are to not have a Pap smear.
- Depending on past history, Pap tests can be done less frequently after the age of 65. Discuss how often to have Pap tests with your provider.
- If you’ve been treated for pre-cancer of the cervix, or have a high-risk form of HPV, a Pap test should be continued annually.
- If a woman has had the uterus and cervix removed (total hysterectomy), and has not been diagnosed with cervical or uterine cancer, a Pap test is not recommended but an annual well-woman visit is still needed
If a pelvic exam or Pap test shows a specific abnormality, a colposcopy may be indicated. This is a simple and relatively painless in-office procedure where the physician can further examine the cervix. This procedure is used to diagnose precancerous changes of the cervix and a small biopsy (sample of cervical tissue) may be taken. Cell changes may occur years before cervical cancer develops, and treating cell changes at an early stage may prevent cervical cancer from developing.
HPV Vaccine
- Recommended for girls at age 11-12 and above, the vaccine, developed in 2006, has now been studied thoroughly and has contributed to a decrease in cervical cancer and genital warts. It should be considered with your health care provider.
Osteoporosis Screening
- All women over age 50 or at the time of menopause should be considered for osteoporosis screening and bone density testing. This decision should be discussed with your provider. Risk increases with smoking, steroid use, and long-term use of Depo Provera.
Sexually Transmitted Infection (STI) Screening
- Women with new or multiple sex partners or a sex partner with a history of STI – test for gonorrhea and chlamydia annually, even if the Pap smear is not yet recommended
- Talk to your provider about other testing if sexually active and/or with multiple partners
Prevention is key in promoting and protecting women’s health at any age. Regardless of recommendations for a Pap test every three years, it’s still very important to schedule an annual well-woman visit. It is typically covered by insurance and is a best practice for preventative medical care. Make sure to schedule your well-woman visit in 2024 and each year after!
At HopeHealth, we provide a full range of services for women’s health needs and also partner with evidence-based programs, non-profit organizations, and businesses to provide the best in women’s health services, regardless of insurance status. Call (843) 667-9414 or visit hope-health.org for more information.
