Preparation for the Well Woman Exam

The well woman visit can be a source of stress for many women, especially when it is the first exam.  However, preparation for the exam and an understanding of the procedure may help to lessen the anxiety. 

Please do not insert anything into the vagina in the 48 hours prior to your exam.  This includes abstaining from intercourse, tampon use, creams, douching, etc.  These substances can affect the results of any tests that are performed.  If you are actively bleeding or are on your menstrual period at the time of your well woman exam, we will ask that you reschedule your appointment.

When you arrive for your appointment, you will be asked to fill out some paperwork for the provider, if you have not already completed them at home via the Portal.  This will give us information about your health and sexual history and alert us to any areas of concern.  You may be asked to give the nurse a urine specimen to test for STD’s.

The provider will meet with you before you are asked to undress.  This is the time to let her know about any particular concerns or questions that you have.  The provider will then discuss with you if a breast, pelvic, or Pap test is recommended or needed. 

The Breast Exam

If the patient is under the age of 30, it is up to her whether or not she would like to have a breast exam. 

It is important that women be familiar with their breasts and report any changes to their health care provider.  While monthly self-breast exams are not usually needed, it is important to periodically examine your breasts and become aware of what your breast tissue normally looks and feels like.  

When performing a self-breast exam, women should be particularly attuned to the presence of:

  • A new lump that the woman has never felt before
  • A change in a breast lump, such as size or texture
  • Red, swollen, or flaky skin on any area of the breast
  • A nipple that is painful or changes appearance
  • Any fluid that is leaking from the nipples (if not breastfeeding)
  • Any dimples in the skin of the breast
  • A lump in the armpit

The Pelvic Exam

A pelvic exam is not always necessary as part of the well woman exam.  Most women in their teens and twenties only need a pelvic exam if they are due for a pap test, or if they have a problem or concern.  These problems or concerns may include:

  • Abnormal vaginal discharge that itches, burns, or has an odor
  • Heavy vaginal bleeding, missed periods, or irregular periods
  • Bleeding between periods, also known as spotting or break through bleeding
  • Painful intercourse
  • Menstrual cramps that cause you to miss school or work

If you have any particular concerns about the pelvic exam, or if you have had negative experiences in the past, please discuss this with the provider prior to the exam. 

Prior to the exam, the provider will ask you to undress from the waist down.  You will be given a drape and a gown to wear.  Next, you will be asked to lie down and place your heels in footrests.  The provider will do a visual exam of the outside of the vagina.  Some of the things that are noted are abnormal discharge, bumps, sores or rashes. If you have noticed any bumps or rashes yourself, please alert the provider.

If at any point during the exam, you become uncomfortable or do not wish to continue, please say so and the provider will stop the exam. 

The Speculum Exam

A speculum will be used during the second part of the pelvic exam. A speculum is a plastic instrument that is used to gently separate the vaginal walls and allows the provider to see the cervix (the muscle at the end of the uterus).  Most women describe feeling pressure, but usually no pain.  After the cervix is located, the provider will take a few cells for a Pap test. To do this, she will use a small flexible plastic brush.  The specimen will then be sent to the laboratory and examined for the presence of pre-cancerous or cancerous cells.  Results of the Pap test are usually available within a week and will be uploaded to your Portal, unless you specify otherwise.  An abnormal pap, depending on the results, will either require repeating the Pap test in one year, or referral to a gynecologist for treatment. 

The Bimanual Exam

After the speculum is removed from the vagina, a bimanual (two-hands) examination of the uterus and ovaries will be performed.  The provider will insert one or two gloved fingers into the vagina and will locate the cervix with the tip of her finger. With her other hand, she will press firmly on the abdomen, just above the pubic bone. During this procedure, the provider is evaluating the size, shape, and consistency of the cervix, uterus, and ovaries. This can often feel like pressure to the woman. Any pain should be discussed with the provider.

After the exam, the provider will leave the room and ask you to get dressed. When she returns to the exam room, you will be given time to ask any additional questions about the exam findings. If any abnormalities were noted during your exam, the provider will use this time to discuss them with you.