The days of the annual pelvic exam are over. Research has shown that routine screening pelvic exams are unnecessary for most women. A pap smear, the test that screens for cervical cancer, is recommended for average risk women 21-30 every three years, and for women over 30 who are also tested for HPV, every five years. Unless you're having symptoms, like sores, dryness, irritation, or discharge, you may need a pelvic exam even less often. 

But that doesn't mean you shouldn't see your primary care provider each year. The new annual is a well-woman visit, and you should schedule yours today. 

What is a well-woman visit? 

This annual visit with your primary care provider covers far more than your gynecological health –it's a whole-health appointment, focusing on preventive care and screening. Your physical health, mental health, lifestyle, and social situation, in addition to your gynecologic or reproductive health, are all part of your overall health. 

"The well-woman visit is an opportunity to address preventive health care needs for women of all ages and stages," says Amy Cantor, M.D., M.P.H. Dr. Cantor specializes in women's primary care at the OHSU Center for Women's Health. "The visit is tailored to you and your specific health needs." 

What to expect 

A well-woman visit starts with a conversation with your provider. Based on your age and risk factors, your provider will help you determine what screenings, tests, or immunizations you need. 

When to screen for cancer, for example, varies widely for different types of cancer. Cervical cancer screening starts at age 21, breast cancer in your 40s or 50s, and colon cancer in your 50s, for women at average risk. For some of these tests, exactly when, how often, and how you should be screened is determined by you and your provider through shared decision-making. Your provider's expertise, research recommendations, your health, and your preferences are all taken into account.

Another common area of discussion is reproductive health. Depending on your age and life goals, this discussion will vary. Not interested in kids any time soon? Your provider will help you choose the right contraception method for you. Planning on a pregnancy? Your provider will discuss prenatal vitamins and preconception care with you. Approaching menopause? Your provider will talk about that life change with you. 

Mental health is an important topic too. Screening for anxiety and depression is important for women of all ages, and your provider will also talk to you about substance abuse and interpersonal violence. 

There is still an exam portion, but it may not include a pelvic exam. "Many women will have a breast exam," says Dr. Cantor. "Your provider will also perform a general physical exam and take your vital signs." 

Women's Preventive Services Initiative (WPSI) 

All of the screening and prevention elements of a well-woman visit are based directly on research. Every recommendation comes from a large and growing body of evidence showing how it can benefit women's health. 

Many screening recommendations come from the U.S Preventive Services Task Force. The Women's Preventive Services Initiative (WPSI), a multidisciplinary group of experts, is charged with developing, reviewing and updating recommendations for women's preventive health care services. Dr. Cantor is an investigator at the OHSU Pacific Northwest Evidence Based Practice Center, and part of the research team responsible for reviewing the evidence to inform recommendations for the WPSI.  

"The WPSI has gone a step beyond making recommendations and has expanded coverage for women under the Affordable Care Act," says Dr. Cantor. "You should know that women's preventive services, from contraception to screenings to breastfeeding support are covered by insurance at no cost to you."