Norman Regional Health System

Thursday, April 21, 2022

Well Woman Exam image

By Amber Duncan, APRN, WHNP-BC

Hello everyone! Today we are going to talk Well Woman Exams! Yay! Everyone’s favorite topic, right? I know everyone hates the dreaded “well woman exam,” or WWE, but it is so necessary!

Annual WWE are the ultimate preventative screening for women. This appointment is when we do your pap smear, breast exam, routine lab work that is needed, birth control, medication management, and the list could go on and on. Even though it’s not the most delightful visit you’ve ever been to, it is only ONCE per year. You can do anything once!

What is included in a well women exam?

Let’s dig into what all goes on at these WWE, shall we? The two most common things that happen at a WWE are a pap smear, if you are of age, and a breast exam. Some of you may not really know what a pap smear is, and that is ok. We will dive into that in just a minute. Other things that go on at a WWE really depend on that person’s age. I’ll break this down into age groups for a simpler understanding.

  • WWE ages 12-20
    • Dressed exam if not sexually active
    • Discuss birth control if needed
    • Discuss cycles and any issues that may be going on
    • If sexually active, STD screening – this would be an undressed exam
    • Discuss HPV vaccines
  • WWE ages 21-65
    • Pap smear
    • Breast exam
    • STD screening if needed
    • Discuss birth control
    • Discuss cycles and any issues that may be going on
    • Routine lab work if indicated
    • Order mammogram if age appropriate
    • Order colon screening if age appropriate

What is a pap smear?

Now, let’s talk more in depth about what a pap smear actually is. Most people just know they hate doing it, and a scratchy brush is involved. While that is mostly true, there is so much good that comes from doing annual pap smears. Early cervical cell changes are caught, HPV is noted, and precancerous cells can be detected and treated. You will notice above; a pap smear was not mentioned in the age range of 12-20. This is because pap smears are not done until a female turns 21. They used to do pap smears before 21 in girls who were sexually active, but with newer studies and guidelines that have come out, it has been determined that it is not necessary to do pap smears before age 21. Typically, pap smears stop at age 65, unless there is a reason to continue them. Guidelines in the more recent years have stated that if you have always had normal pap smears, you can now go three years in between screenings. While this is true, insurance companies are still covering yearly pap smears, so you can discuss your preferences with your doctor about how often you would like to be screened.

Q: What if you are 21, but you have never been sexually active? Do you still need to get a pap smear?

A: Per guidelines, it is still recommended to get a pap smear at 21 even if you are not sexually active. However, most doctors will discuss this with you, and give you the option to have the screening done or postpone another year. This is a decision that should be made together. A provider will never force you to do anything you are not comfortable doing.

Q: So, you have the pap smear done, now what?

A: If your pap smear is abnormal, your provider will go over those results with you, and let you know next steps. Sometimes there is further testing involved, but sometimes there is nothing to do other than repeat the pap smear next year.

When doing the breast exam portion of the WWE, your provider will probably ask you about family history of breast cancer, whether you are doing self-breast exams at home, and whether or not you have noticed any lumps or bumps. As mentioned earlier, if you are of age 40 or above, we will get you set up for a mammogram. These are recommended yearly starting at age 40 through approximately 74 years old. Once a person is 75, it is determined between the patient and provider. Mammograms can pick up far more than any breast exam can so it is very important to get your mammograms yearly. In saying that, that does not take away from the importance of self-breast exams. It just means that doing both is the best preventative measure you can take.

WWE are not made to make you feel uncomfortable. They are routine screenings put in place to make sure you are in the best health possible. If you are behind on your WWE, please go see your doctor! We also like to see you every year to continue following your life and see how you have evolved and grown. It is an ongoing relationship between doctors and patients, and we get joy out of seeing you doing well and staying healthy!