An annual preventative health care examination is a periodic check targeted for your age group. It generally consists of an assessment of specific health risk factors you might have based on your age, race, personal medical history, lifestyle and family history. We try to review any specific symptoms you happen to be having at the time as well, and make recommendations for further work-up of these if necessary. In all age groups we review basic lifestyle issues such as maintaining a healthy weight, healthy diet, exercise and smoking abstinence/cessation.

18 to 39 year old age group

General exam, with focus on the thyroid, breast, skin, abdominal and pelvic aspects of the exam. Yearly PAPs are generally done as well when sexually active or age 21. A PAP is the specific part of the pelvic exam in which cervical cells are scraped gently from the cervix to be tested for precancerous changes. STD testing is recommended with any new partner. Counseling focuses on STD prevention, smoking cessation, well rounded diet, screening for eating disorders, focus on adequate calcium intake and healthy body mass index. Exercise, particularly weight bearing exercise is also important and reviewed. Contraceptive counseling as needed. Pre-pregnancy counseling where appropriate. Glucose and cholesterol screening if not having regular periods, if there is a family history of diabetes or heart disease, if body mass index is over 26. A baseline mammogram in your late 30s is no longer recommended because there are too many false negatives and unnecessary biopsies.

40 to 59 year old age group

In this age group, a general exam is still done, with focus once again on thyroid, breast, abdominal, skin and pelvic exam. PAPs are often still done every year as well, but can be done every three years if you've never had an abnormal PAP, or not at all if you've had a hysterectomy and never had an abnormal PAP in the past. Mammograms are recommended every 1-2 years. Screening for menopausal symptoms takes place, and we often discuss various further investigations and treatments for these. Glucose, thyroid and cholesterol screening in women with risk factors. Bone density in women who have stopped having periods for more than a year. Common problems include hot flashes, vaginal dryness, mood changes, decreased libido, heavy periods, urinary leaking. In the 50 to 59 year old age group, screening for colorectal screening generally begins. This consists of a yearly rectal exam, and optimally, a colonoscopy every 10 years. Not every insurance company covers screening colonoscopy. Alternative regimens may include a sigmoidoscopy (scope of the distal 1/3 of the colon) every 3-5 years, and/or yearly testing of stool for occult blood.

60+ years

At this point, the gynecological preventative exam focuses mostly on the breast and pelvic exam. I feel that after age 60, examination of other organ systems and screening for systemic medical problems is best done by an internist or family physician. Yearly mammograms are recommended until age 70. PAP smears are recommended yearly in those with risk factors and every 3 years in those without, until age 70. Colorectal screening as described above continues to be important as does bone density screening. Pelvic prolapse, thinning of the vagina and urinary problems are increasingly frequent gynecologic problems.