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The Well Woman’s Exam

In my world as an Obstetrician Gynecologist, I find myself in a variety of situations.  I often smile when someone says, “Oh you are an OB/GYN…it must be great delivering babies!”  A medical colleague will often comment, “I don’t know how you do what you do…pelvic exams and pap smears all day!..No thank you!” I would beg to differ with any stereotype you may imagine; I feel we have the best of ALL worlds.  Yes, we are trained to deliver babies, but also to meet most medical and surgical needs for a woman at just about any life stage.  I may see Patients for their annual physical, then go over to deliver someone’s precious baby, and finish my day completing a hysterectomy or urinary incontinence surgery that very same day.  What a specialty, you never know what we are up to!  It is an amazing calling and I am so blessed to be a part of this wonderful specialty.  I do wish to share with you however, some very important points to ponder and consider in your health care needs.  As an OB/GYN, we refer to your physicals as the “well woman’s exam.”  It is not just about you getting your Pap smear, birth control or mammogram; it is about so much more.  A well woman’s exam is as rich and variable as our field can be; it evaluates whether or not you are indeed well.  How is your form?  How do you function?  Sounds like an anatomy lesson, right?  I see the well woman’s exam as an opportunity to look at the prism of a woman’s life, where every facet is equally important.

Depending on your age, lifestyle or family history, a well woman’s exam evolves based on your life stages and needs.  The journey is ever changing, and the path we follow is unique to each of us.  In the most general sense, let’s imagine some paths you may find familiar.   Can you remember your first gynecology visit?  You of course, likely discussed your menstrual cycle, but before you realized it, you were thrown into a conversation about sexual activity, birth control, peer pressure and even sexually transmitted infections.  Upon turning the age of 21, we develop a love-hate relationship with the speculum and the Pap smear.  We are relieved to know we have a normal pap, however getting to that result is a daunting task for many.  During your reproductive years, pregnancy and fertility issues weave in and out of your visits.  As time passes you may then confront potential pelvic concerns like pelvic pain or urinary incontinence.  Although we are taught to develop a lifelong discipline of self-breast awareness, it is at 40, we assume the position to undergo mammogram screening to catch breast cancer as we cannot see or feel it in the early stages.  As if our adolescence and for some motherhood haven’t been exciting enough, we then look to the perimenopausal years where one may experience hot flashes, night sweats, mood changes, vaginal dryness or all of the above!  From this, our journey through menopause brings about concerns for falls, osteoporosis and heart disease.  You see for a woman, the journey can be wandering and for some a winding path.  The reality is, even though I have given you broad generalizations, life is complex and unique to each person.  You may go down one or all of life’s pathways.  I must consider every path for any age as I get to know someone.  There is so much more to discuss as well.  We have not mentioned screening someone who may be on the path to issues with depression or who is in a domestic violence situation that could include intimate partner violence or elder abuse.   You see as an OB/GYN, we may walk out of one room discussing one’s pregnancy needs to another who desires to never get pregnant!  Sexuality is also something I talk about at any given age as it is an important part of our health.  Sexuality does not imply sexual intercourse.  It may be a discussion on so many levels, ranging from peer pressure, intercourse, pain with intercourse, desire issues we refer to as libido to masturbation, gender attraction or identity issues.  And the discussion doesn’t stop here; there is so much to our world as women. 

You see, I open the discussion to show you our world and if you have a path you have never felt comfortable discussing with your Health Care Provider, do it now.  In the world of women’s health, we all hope to serve and assist you to achieve all your well woman’s needs no matter the need or the nature of the discussion.