An annual exam or well woman exam is a yearly visit for a general health check, including a breast exam and pap smear. Annual exams are also called yearly exam, annual pap, and preventative visit. You may expect the following:

  • General physical exam
  • Pelvic Exam
  • Complete health history
  • Complete review of current medications including herbs and supplements
  • Evaluation for additional health screening tests (i.e. mammograms, DEXA, cancer screenings etc.)
  • Complete blood work (CBC, Lipid Panel, CMP, etc.)
  • Immunization updates (if needed)

An annual exam visit does not include discussion of new problems or a detailed review of chronic conditions.

If you have other health concerns, please schedule another visit to discuss them in detail.(Insurances often do not pay for additional tests/procedures during the time of an annual exam and this expense would be an out-of-pocket expense for you.) Examples would be:

  • New healthcare concerns or problems found at the time of your annual exam (such as pelvic pain)
  • Ongoing health problems that need more attention.

If you happen to have a new health problem at the time of your annual exam, we will need to schedule you for another visit to adequately discuss and treat the problem in detail.

Please check your insurance policy to make sure you are covered for a yearly preventative health visit or a women’s health pap/pelvic/breast exam. Different insurance policies have different rules for preventative care coverage.

Most insurance companies will only pay for one annual exam per year. Your appointment must be one year from your previous annual exam. Medicare guidelines allow a well woman exam to be done once every two years.


Pap Test

Pap test

A Pap test or a Pap smear is a test that checks for changes in the cells of your cervix which is the lower part of the uterus that opens into the vagina. The Pap test can tell us if you have an infection, abnormal (unhealthy) cervical cells or possible cervical cancer.

Pap Tests are needed if you are:

  • 21 years old or older
  • Under 21 years old and have been sexually active for three years or more

You should also have an annual Pap test no matter how old you are if:

  • You have a weakened immunity system due to an organ transplant, chemotherapy or using steroid medications.
  • Your mother was exposed to diethylstilbestrol (DES) while pregnant.
  • You are HIV- positive.

The American College of Obstetrics and Gynecology (2009 ) Guidelines are:

  • Adolescent => Within 3 years of onset of sexual activity
  • 21 – 29 years => Yearly (Start @ 21 years of age if not sexually active)
  • 30 – 64 years => Yearly; After 3 negative Pap Tests, no history of CIN2 or CIN 3; no history of DES exposure; normal immunity then every 3 years

Pap tests can literally save your lives. It can detect the earliest signs of cervical cancer and if caught early, the chance of curing cervical cancer is very high. Pap tests can also detect other vaginal infections and abnormal cervical cells that can turn into cancer.


A mammogram is an x-ray of the breast. They can be used to check for breast cancer in women who have no signs or symptoms of the disease.


This type of mammogram is called a screening mammogram. This is to detect any tumors that cannot be felt by your healthcare provider. Screening mammograms may also find microcalcifications (tiny deposits of calcium) that sometimes may indicate the presence of breast cancer.

A diagnostic mammogram may be needed if there is a detected lump or mass or another sign of breast cancer is found during a routine exam. Signs of breast cancer may include pain, skin thickening, nipple discharge, or a change in breast size or shape. A diagnostic mammogram may be done to evaluate changes found during a screening mammogram or to view breast tissue when it is difficult to obtain a screening in such situations such as having breast implants.


Osteoporosis is a disease where the bones become fragile and more likely to break or fracture. If is not prevented or is left untreated , osteoporosis can progress painlessly until the bone breaks. These breaks or fractures commonly occur in the hip, spine, and wrist.


Although any bone can be affected, areas of special concern are the hip and spine due to treatment requiring major surgery and hospitalization. Spinal fractures also may have severe consequences such as loss of height, severe back pain, and deformity.

Millions of men and women are at risk. While women are four times more likely to develop osteoporosis than men, men also suffer from osteoporosis. Find out if you are at risk. Download now!

Here are some additional resources:



Dual Energy X-ray Absorptiometry is the most commonly used test for measuring bone mineral density. It is one of the most accurate ways to diagnosis osteopenia or osteoporosis. The National Osteoporosis Foundation’s guidelines state that women over 65, younger post menopausal women who have any osteoporosis risk factors ( should have a DEXA Scan done.


Osteopenia is one condition that may be improved by what we do and how we act every day. There is no single cause for osteopenia, but it is very important for you to understand what the causes are ( so you may start working on improving your risk factors. The following are some of the causes for osteopenia:

  • Genetics and age
  • Lifestyle factors:
    • Not enough weight bearing exercises such as walking, dancing, or lifting weights.
    • Stress
    • Dieting or eating disorders which reduce hormone levels
    • Alcohol use
    • Caffeine
    • Sodium
    • Tobacco use
    • Excessive Exercise which reduces hormone levels
    • Too little calcium or other minerals in the diet
    • Vitamin D deficiency
    • Phosphorous imbalance
    • Protein
    • Prior fracture as an adult (in the absence of severe trauma)
  • Some medical conditions are directly related to developing osteopenia such as anorexia, asthma, cancer, celiac disease, and Crohn’s disease.
  • Some medical treatments for chronic inflammatory diseases such as rheumatoid arthritis, lupus or endometriosis.
  • Prescribed medications such as Depo-Provera or Prednisone may interfere with developing bones.