The Importance of Annual GYN Exams

Annual gynecologic exams are among the most important ways for women to receive preventive health screening and education. While cervical cancer screening recommendations have changed in the last few years, and many women only need to be tested every three to five years, you should still visit your gynecology provider annually to ensure your overall gynecologic health. GYN providers are trained to care for women from adolescence through older age and address their changing health care needs.

What is an annual GYN exam?

An annual GYN exam is performed by a medical provider with specialized training in gynecology. You may see a gynecology physician, primary care physician, nurse practitioner, certified nurse midwife, or physician assistant. 

During the exam, you and your provider may discuss:

• Birth control
• Sexually transmitted infection (STI) screening and prevention
• Vaginal infections
• Menstrual problems
• Pelvic pain
• Sexual function
• Preconception counseling
• Fertility
• Menopausal symptoms
• Bone health
• Urinary leakage
• Breast changes

Many conditions that affect women’s health, such as the human papilloma virus (HPV), cervical cancer, and breast cancer, can present no signs or symptoms. Regular screening with GYN exams and tests can detect these conditions at earlier stages when they can be treated most effectively.

Your provider may also discuss ways to ensure your overall health including diet, exercise, smoking cessation, mental health, and vaccinations.

What should I expect at an annual GYN exam?

Your provider will ask for your medical history including your family history. They will measure your vital signs like blood pressure, heart rate, height, and weight. You will also be asked about your periods, pregnancy history, sexual activity, contraception needs, history of GYN problems, history of GYN surgeries, and any current symptoms you are having.

Your provider will perform a breast and pelvic exam. The pelvic exam consists of an external examination of the vulva, an internal examination of the vagina and cervix with a speculum, and an examination of the uterus and ovaries. During the speculum exam, you may receive a Pap smear, which involves cells being brushed from the cervix and sent to a laboratory for examination.

Your provider will also discuss ways to improve your health including lifestyle changes, screening tests, or vaccinations based on your age or other risk factors.

When should I start annual GYN exams?

The American College of Obstetricians and Gynecologists (ACOG) recommends that you first visit a GYN provider between the ages of 13 and 15. This visit will likely not involve a pelvic exam, but will focus on education, including:

• Normal development of sex organs
• Good health habits like balanced nutrition, maintaining a healthy weight, and avoiding cigarette smoking
• Preventing sexually transmitted infections (STIs)
• Services related to birth control, STI testing, and HPV vaccination

The ACOG recommends that pelvic exams, including Pap smears, begin at age 21, whether or not a woman has become sexually active.

What concerns should I bring up at an annual GYN exam?

You should ask your GYN provider any health-related questions or discuss any concerns you may have. If you experience any of the following, you should bring it to the attention of your provider:

• Pelvic pain or bloating
• Missed periods
• Abnormal bleeding, heavy periods, bleeding in between periods, or bleeding after sex
• Painful intercourse
• Unusual vaginal discharge
• Vulvar changes
• Problems moving bowels or passing urine
• Menopausal symptoms
• Any breast concerns, such as pain, lumps, puckering, or nipple discharge

What regular GYN screenings should I receive?

The types and frequency of recommended screenings vary depending on a woman’s age, personal risk factors, and family history.

Recommended screenings you may receive include:

• Chlamydia and gonorrhea: If left untreated, these STIs can lead to serious complications like pelvic inflammatory disease, infertility, and chronic pain. Annual testing is recommended for sexually active women under the age of 25. Women age 25 and older may benefit from testing if they have multiple partners, a new partner, exposure concerns, or have recently been diagnosed with another STI.
• HIV testing: This test should be done at least once during your lifetime. However, your provider should check for risk factors annually that could warrant repeat testing. Screening for other STIs like syphilis, trichomonas, herpes simplex virus, and hepatitis should be based on risk factors.
• Hepatitis C testing: This one-time test is recommended for women who were born anytime from 1945 through 1965 and who are unaware of their infection status.
• Pap smear: This cervical cancer screening should be performed every 3 years in women ages 21 to 29. In women who are 30 and older, co-testing of Pap smear and human papilloma virus (HPV) is recommended every 5 years.
• Clinical breast exam: A breast exam by a health care provider is recommended every 1 to 3 years, beginning at age 20.
• Mammography: This diagnostic imaging test is used to identify abnormalities in the breast that may indicate breast cancer. The exam is less sensitive in younger women and is more likely to result in false positives or over-diagnosis in younger women. It is recommended that women ages 40 to 49 years discuss the benefits and risks with their provider before deciding whether to start mammogram screening. By age 50, all women should receive mammograms every 1 to 2 years.
• Bone density testing: This exam is recommended for all women age 65 years and older or in postmenopausal women who are younger than 65, but at risk for bone fractures.
• Diabetes testing and lipid (cholesterol) profile assessment: A blood test can determine if your blood sugar and cholesterol are within normal limits or if they need to be addressed. This should be recommended periodically by your provider.

Talk with Your Provider

Don’t be afraid or embarrassed to ask a question or discuss a concern with your provider. Chances are your provider has been asked the same question many times before.

If your provider requests additional testing, such as blood work or an ultrasound, it is important to complete these tests. At the Women’s Medicine Collaborative, we have on-site laboratories at all our locations to draw bloodwork and process urine tests. This enables our patients to complete their testing while in our office, and allows us to obtain results the same day if necessary.

Effective health care is a partnership between you and your medical provider. Having an annual gynecologic exam before you have an issue is essential for maintaining your gynecologic - and overall - health and well-being.

Learn more about Obstetrics and Gynecology Services at Brown University Health.