Whether you are going in for your first gynecological appointment or your 30th, there are many things women won’t even think about or are afraid to ask about. So many women think that going to their annual exam means they have been tested for everything and are of good health with no further actions being required.

A well woman exam, which includes a pelvic exam with a pap smear, is recommended yearly, by age 21 unless the person is sexually active. Someone experiencing gynecological problems, should seek help from a physician. Your well woman exam is your chance to ask any questions from fertility to cancer signs to inherited disorders. Here are some topics to think about before your next well woman exam.

1. A clinical breast exam does not replace a mammogram and breast self exam. A clinical exam is only once a year, but breast self exam is once a month, helping you detect abnormalities much sooner. A mammogram is a more thorough examination that can detect abnormalities that perhaps cannot be

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   felt. Depending on your medical history and family history, at age 40, a woman should begin having a mammogram every year. If you are under age 40, you should speak with your doctor about your risks and determine when mammograms are necessary for you. If you have a first degree relative such as parent or sibling that has been diagnosed with breast cancer, you need a baseline mammogram done 10 years prior to the age of their diagnosis. For instance, if your mother was diagnosed with breast cancer at age 45, then you would need to be screened at age 35. In addition, if you have questions about breast self exam, be sure to ask!
   
2. A well woman exam does not include testing for other health related issues. Hypertension, high cholesterol and diabetes are just a few of the health issues that a well woman exam does not cover unless specifically requested. Tests for these issues are not routine but are available from many gynecologists. These tests become more important as you age, but if you have a medical history, family history, are overweight or have other risk factors, it is important to have your doctor test for these conditions.
   
3. It is up to you to ask about different contraceptives. It is up to you to address any questions or concerns regarding the contraceptives you use. If you have used one type for a long time, there may be something new or that better fits your lifestyle. Having your annual exam does not guarantee that anyone will offer you better or different alternatives. Only you can ask the question: “Do I need to change my contraception?”
   
4. Sexually transmitted disease tests are not part of a regular well woman exam. Many women think they have had STD testing because they had their annual exam. However, it is up to you to specifically request STD testing, because almost every STD requires a separate diagnostic. Pap smears and pelvic exams do not detect STDs, unless there is a visual symptom, but many of them may not be visible or may be asymptomatic. If you have had multiple partners, a new partner or suspect you may have an STD, you should ask about this additional testing.
   

Maintaining good communication with your doctor is key to having your health concerns address and leading the healthy lifestyle you want to achieve. Don’t assume your physician knows what to ask you about. Make sure at your next exam you ask questions and bring up any health concerns you may have.

For more information on well woman exams and other women’s issues, visit the Center for Women & Children’s Health.