What to Expect During a Well-Woman Exam, According to Ob-Gyns Who Perform Them

There are certain doctor's appointments you have when you're sick, and then there are others that you have to make sure you're as healthy as you can be, even when you feel OK. The well-woman exam is one of them.

This doctor's appointment gives you a chance to check in with your doctor about women-specific health, as well as get checked out for a range of potential health issues. If you've never had a well-woman exam, it's understandable to have questions about what's involved in it, as well as how often you actually need one. Here's the deal with the well-woman exam — including what happens and how often to get one, according to ob-gyns who perform them.

Experts Featured in This Article:

Meleen Chuang, MD, is a clinical associate professor in the Department of Obstetrics and Gynecology at Family Health Centers at NYU Langone.

G. Thomas Ruiz, MD, is the lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.

Sherry Ross, MD, is an ob-gyn and women's health expert at Providence Saint John's Health Center in Santa Monica, CA.

What Is a Well-Woman Exam?

Also known as a well-woman visit, this an appointment with an ob-gyn or primary care physician. "The purpose of a well-woman exam is to make sure preventive care like preconception planning, infection evaluation, contraception counseling, and cancer screening for cervical, breast, and colon is done, typically by your ob-gyn," says Meleen Chuang, MD, clinical associate professor in the Department of Obstetrics and Gynecology at Family Health Centers at NYU Langone.

During this appointment, your doctor may evaluate your menstrual cycle and hormone levels, and order workups, if they think it's needed. It's also a time when your doctor will give you a physical evaluation to look for abnormalities like cysts or unusual swelling, says G. Thomas Ruiz, MD, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.

While every practice and provider is different, Dr. Ruiz says the well-woman exam is usually focused on any organ systems that have to do with endocrine function and reproduction. "I do a thyroid exam, breast exam, abdominal exam, and then pelvic exam," he tells PS.

How Is It Different From a Physical?

While a well-woman exam is essentially a check-up, it's "specifically tailored for women's health, focusing on reproductive health, sexual health, and screenings like Pap smears and breast exams," Dr. Chuang says.

On the flip side, a general physical exam usually involves a broader look at your overall health, including your cardiovascular health, weight management, and lifestyle factors, she says. A physical is also usually done by a primary care physician, Dr. Ruiz points out. "They may be ordering a larger panel of labs," he says.

While Chuang says that both exams are "crucial," she adds that "the well-woman exam places a greater emphasis on issues specific to women."

What Happens During a Well-Woman Exam?

Every doctor approaches this slightly differently, but the visit usually kicks off with a nurse who checks your weight and gets your blood pressure, says Sherry Ross, MD, ob-gyn and women's health expert at Providence Saint John's Health Center in Santa Monica, CA.

"Not every well-woman exam involves collecting a urine sample, but this can also be included during the visit," Dr. Ross tells PS. A comprehensive medical history and family history will usually be taken early on, per Dr. Ruiz. That will usually be used to inform your personal risk factors for developing a host of medical conditions, according to the American College of Obstetricians and Gynecologists (ACOG). This may be taken by a nurse, but it can also be taken by a doctor.

Worth noting: If you have a male doctor, you'll usually have a women chaperone in the room, too — at least, when you're in a medical gown, Dr. Ruiz says.

"If this is a woman's first visit with the doctor, she may go into her/his office and have a conversation discussing her medical history before going into the examining room," Dr. Ross says. However, she adds, "some doctors may have this conversation in the examining room with the woman prior to the exam."

At that point, you'll usually be given a gown and asked to undress once the doctor or nurse leaves the room. Usually that means removing your bra and underwear, too, per Dr. Ross. "Most gowns have a top, which opens in the front, and a bottom gown that drapes over and covers the waist and vagina," she says. Your doctor's office may also provide an extra drape that you can have over your lap.

After you're changed, the doctor will come in, review your history, and discuss any gynecological or future obstetrical (i.e. pregnancy) concerns you have, Dr. Chuang says. From there, they'll usually do physical exams.

"In addition to checking your thyroid, arm pits, and breasts for lumps or abnormalities, the doctor will assess the vagina for discharge and discomfort, Dr. Chuang says.

The pelvic exam is the last part of the well-woman exam, Dr. Ross tells PS. "The woman will be asked to put her feet in the stirrups at the end of the examining table and 'scootch' down so her butt comes to the edge of the table." Usually, the ob-gyn will sit on a chair between a woman's legs and push back the gown to look at the vulva and vagina.

"A speculum — which is a device that helps to widen the vagina — is then inserted into the vagina to inspect the inside and visualize the cervix," Dr. Ross says. If you need a Pap smear — which is usually taken every three to five years — your doctor will do that, too, Dr. Chuang tells PS.

"Usually after the speculum exam, the doctor will place one to two fingers in the vagina and the other hand by the pubic bone to do a 'bimanual exam' to feel the uterus and ovaries, and see if there are any areas of tenderness or discomfort," Dr. Chuang says. "This will give the ob-gyn an idea if pelvic ultrasound or any imaging will be needed."

After that, your doctor will have you sit back up and cover the lower half of your body again. If your doctor notices anything that's off during the exam, they'll usually talk to you about next steps which may include an ultrasound or other imaging. "Then, we make a followup appointment for them to discuss the results, which is usually over telehealth," Ruiz says.

After that, the doctor will leave, you'll get dressed, and you'll check out with the front desk.

How Often Should You Get a Well-Woman Exam?

A well-woman visit should happen each year, whether or not you need a Pap smear, according to ACOG. But, of course, if you have any issues before your next well-woman visit, it's important to reach out to your doctor for an evaluation, Dr. Ruiz says.

Korin Miller is a writer specializing in general wellness, health, and lifestyle trends. Her work has appeared in Women's Health, Self, Health, Forbes, and more.