Well Woman Care

Your Annual Health Care Visit

Having an annual health care visit is a great opportunity to take charge of your health. Routine health care visits can help find problems early or prevent health problems before they occur. If problems are found early, they may be easier to treat and less likely to pose serious risks to your health. Preventive health care includes the following:

• Discussion of health topics relevant to your age and risk factors

• Exams and screening tests

• Immunizations To see the health topic discussions, exams and screening tests, and immunizations that are recommended for you, click on the appropriate age range below. If you have certain risk factors, you may need additional tests other than those recommended for your age group.

At your annual health care visit, you and your health care provider may discuss the following health issues:

Sexuality

• Changes in your body
• Waiting to have sex
• Sexual behaviors that can put you at risk of pregnancy or sexually transmitted diseases
• Contraception, including emergency contraception
• Preventing sexually transmitted diseases (such as using condoms)
• Internet and phone safety

Fitness and Nutrition

• Physical activity
• Nutrition (including eating disorders and weight concerns)
• Important vitamins and minerals (such as folic acid and calcium)

Risk Factors for Heart Disease

• Family history of heart disease
• Personal risk factors for heart disease, such as high blood pressure, high cholesterol, obesity, and diabetes
• Personal history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension

Your Relationships and Mental Health

• Depression and suicide
• Family relationships
• Sexual orientation and gender identity
• Your personal goals
• Behavioral and learning disorders
• Emotional, physical, and sexual abuse by a family member or partner
• School experience
• Relationships with friends
• Acquaintance rape prevention
• Bullying

Other Topics

• Use of complementary and alternative medicine
• Hygiene (including dental hygiene and fluoride supplementation)
• Injury prevention: exercise and sports safety, weapons and firearms safety, occupational and recreational hazards, protecting your hearing, helmet use
• Safe driving practices: seat belt use, no distracted driving or driving while under the influence of substances
• Skin exposure to ultraviolet rays
• Tobacco, alcohol, and other drug use
• Piercing and tattooing

At your annual health care visit, you and your health care provider may discuss the following health issues:

Sexuality and Reproductive Planning

• Contraception
• Reproductive health plan to help identify potential issues before and between pregnancies
• Preconception and genetic counseling
• Sexual problems or concerns
• Preventing sexually transmitted diseases (such as condom use)

Fitness and Nutrition

• Physical activity
• Nutrition (including eating disorders and weight concerns)
• Important vitamins and minerals (such as folic acid and calcium)

Cardiovascular Risk Factors

• Family history of heart disease
• Personal risk factors for heart disease, such as high blood pressure, high cholesterol, obesity, and diabetes
• Personal history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension

Your Relationships and Mental Health

• Your personal and family relationships
• Intimate partner violence
• Acquaintance rape prevention
• Work satisfaction
• Lifestyle and stress
• Sleep disorders

Other Topics

• Use of complementary and alternative medicine
• Breast self-awareness (may include breast self-examination)
• Medication to prevent breast cancer (if you are aged 35 years or older and at high risk of breast cancer)
• Dental hygiene
• Injury prevention: exercise and sports safety, firearms safety, occupational and recreational hazards, protecting your hearing
• Safe driving practices: seat belt use, no distracted driving or driving while under the influence of substances
• Skin exposure to ultraviolet rays
• Depression and suicide
• Tobacco, alcohol, and other drug use

At your annual health care visit, you and your health care provider may discuss the following health issues:

Sexuality and Reproductive Planning

• Contraception
• Sexual problems or concerns
• Preventing sexually transmitted diseases (such as condom use)
• Preconception and genetic counseling (may be appropriate for some women)

Fitness and Nutrition

• Physical activity
• Nutrition (including eating disorders and weight concerns)
• Important vitamins and minerals (such as folic acid and calcium)

Cardiovascular Risk Factors

• Family history of heart disease
• Personal risk factors for heart disease, such as high blood pressure, high cholesterol, obesity, and diabetes
• Personal history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension

Your Relationships and Mental Health

• Your family relationships
• Intimate partner violence
• Work satisfaction
• Lifestyle and stress
• Sleep disorders
• Advance directives

Other Topics

• Use of complementary and alternative medicine
• Aspirin to reduce the risk of stroke if you are aged 55­–79 years; talk to your health care provider before starting an aspirin regimen
• Medication to prevent breast cancer (if you are aged 35 years or older and at high risk of breast cancer)
• Breast self-awareness (may include breast self-examination)
• Hormone therapy
• Dental hygiene
• Injury prevention: exercise and sports safety, firearms safety, occupational and recreational hazards, protecting your hearing
• Safe driving practices: seat belt use, no distracted driving or driving while under the influence of substances
• Sun exposure
• Depression and suicide
• Tobacco, alcohol, and other drug use
• Menopausal symptoms
• Urinary and fecal incontinence
• Pelvic support problems

The following exams and screening tests are recommended for women in this age group:

Exam/Screening Test

What and Why

When

Cervical cancer screening
A sample of cells is taken from the cervix to look for changes that could lead to cancer; this test may be combined with testing for human papillomavirus in women aged 30 years and older.
Option 1: Every 3 years after three normal test results in a row and no relevant health risks, or

Option 2: Every 3 years after a negative Pap test result and a negative HPV test result

If you have had a hysterectomy, ask your health care provider if you still need to have cervical cancer screening.

Clinical breast exam
Breast exam by a health care provider
Yearly
Colorectal cancer screening
Screening tests to look for cancer of the colon and rectum
Colonoscopy every 10 years (preferred) or other screening test beginning at age 50 years. African Americans should begin screening at age 45 years.

Other methods include the following tests:

• Yearly fecal occult blood test or fecal immunochemical test with high sensitivity for cancer

• Flexible sigmoidoscopy every 5 years

• Double contrast barium enema test every 5 years

• Computed tomography every 5 years

• Fecal DNA test (interval unknown)

Diabetes testing
A test to measure the level of glucose (a sugar that is present in the blood and is the body’s main source of fuel) because high levels could be a sign of diabetes mellitus.
Every 3 years after age 45 years
Human Immunodeficiency Virus (HIV) test
A test to check for HIV, a virus that can cause acquired immunodeficiency syndrome (AIDS)
At least once during your lifetime; review annually for risk factors to determine if repeat testing is needed
Lipid profile assessment
A test used to assess the risk of heart disease that measures the levels of cholesterol and triglycerides in the blood.
Every 5 years beginning at age 45 years
Mammography
An X-ray of the breast to look for breast cancer.
Yearly
Thyroid-stimulating hormone screening
A test to check if your thyroid gland is working correctly
Every 5 years beginning at age 50 years

At your annual health care visit, you and your health care provider may discuss the following health issues:

Sexuality and Reproductive Planning

• Sexual problems or concerns
• Preventing sexually transmitted diseases (such as condom use)

Fitness and Nutrition

• Physical activity
• Nutrition (including eating disorders and weight concerns)
• Important vitamins and minerals (such as folic acid and calcium)

Cardiovascular Risk Factors

• Family history of heart disease
• Personal risk factors for heart disease, such as high blood pressure, high cholesterol, obesity, and diabetes
• Personal history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension

Your Relationships and Mental Health

• Your family relationships
• Intimate partner violence
• Neglect and abuse
• Lifestyle and stress
• Sleep disorders
• Advance directives

Other Topics

• Use of complementary and alternative medicine
• Aspirin to reduce the risk of stroke if you are younger than 79 years; talk to your health care provider before starting an aspirin regimen
• Medication to prevent breast cancer (if you are aged 35 years or older and at high risk of breast cancer)
• Breast self-awareness (may include breast self-examination)
• Hormone therapy
• Dental hygiene
• Injury prevention: exercise and sports safety, firearms safety, occupational and recreational hazards, prevention of falls
• Safe driving practices: seat belt use, no distracted driving or driving while under the influence of substances
• Sun exposure
• Depression and suicide
• Tobacco, alcohol, other drug use
• Vision
• Tobacco, alcohol, and other drug use
• Menopausal symptoms
• Urinary and fecal incontinence
• Pelvic support problems

If you have certain risk factors, you may need additional exams or tests other than those recommended for your age group. To find out if you need additional exams or tests, answer the following questions:


Are you a postmenopausal woman younger than 65 years and have one of the following:

  • Have a personal history of fracture as an adult
  • Have a family history of osteoporosis
  • Are Caucasian
  • Have dementia
  • Eat a poor diet or are not physically active
  • Smoke cigarettes
  • Have alcoholism
  • Low weight and body mass index
  • Have low levels of estrogen caused by early menopause (younger than 45 years), removal of both ovaries, or absence of menstrual periods for more than 1 year
  • Low lifelong calcium intake
  • Impaired eyesight (despite adequate correction)
  • History of falls

Do you have certain diseases or medical conditions or take certain drugs that increase the risk of osteoporosis?

If you answer yes to any of these questions, bone mineral density screening is recommended.


Have you had a positive test result for BRCA1 or BRCA2 mutations?

Has your mother, sister, or daughter had a positive test result for BRCA1 or BRCA2 mutations, but you have had a negative test result or you have not been tested?

Is your lifetime risk of breast cancer estimated to be 20% or greater based on various questionnaires designed to calculate breast cancer risk?

Do you have a history of breast biopsy results that are associated with a high risk of breast cancer?

Did you receive thoracic irradiation (typically as a treatment for lymphoma) between the ages 10 years and 30 years?

If you answer yes to any of these questions, enhanced breast cancer screening is recommended. Enhanced breast cancer screening may include more frequent clinical breast exams, yearly magnetic resonance imaging tests, and instruction in how to do a breast self-exam.


Do you have a first-degree relative (parent, sibling, or child) younger than 60 years or two or more first-degree relatives of any age who have had colorectal cancer or adenomatous polyps?

Do you have a family history of familial adenomatous polyposis or hereditary nonpolyposis colon cancer?

Do you have a personal history of colorectal cancer, adenomatous polyps, inflammatory bowel disease, chronic ulcerative colitis, or Crohn disease?

If you answer yes to any of these questions, colorectal cancer screening is recommended.


Do you have or will have close contact with an infant aged less than 12 months?

Are you are a health care provider?

If you answer yes to any of these questions, diphtheria and reduced tetanus toxoids and acellular pertussis vaccine (tdap) is recommended.


Are you overweight (BMI equal to or greater than 25) or are not physically active?

Do you have a first-degree relative with diabetes mellitus?

Are you a member of a high-risk race or ethnic group for diabetes (African American, Latin American, Native American, Asian American, or Pacific Islander)?

Have you given birth to a newborn weighing more than 9 pounds or do you have a history of gestational diabetes mellitus?

Do you have high blood pressure?

Do you have a high-density lipoprotein cholesterol level of 35 mg/dL or less or a triglyceride level greater than 250 mg/dL?

Do you have a history of impaired glucose tolerance or impaired fasting glucose?

Do you have polycystic ovary syndrome?

Do you have a history of vascular disease?

Do you have other clinical conditions associated with insulin resistance?

If you answer yes to any of these questions, diabetes testing is recommended.


Are you considering pregnancy? If yes, do any of the following statements apply to you?

You, your partner, or a family member has a history of a genetic disorder or birth defect.

You have been exposed to a substance known to cause genetic defects.

You are of African, Cajun, Caucasian, European, Easter European Jewish, French Canadian, Mediterranean, or Southeast Asian ancestry.

If you answer yes to any of these questions, genetic testing and counseling is recommended.


Are you of Caribbean, Latin American, Asian, Mediterranean, or African ancestry?

Do you have a history of heavy menstrual periods?

If you answer yes to answer of these questions, hemoglobin level assessment is recommended.


Do you have chronic liver disease?

Do you have a clotting factor disorder?

Do you use illegal drugs?

Do you work with hepatitis A virus or nonhuman primates in a research setting?

Are you traveling to a country where hepatitis A is common?

If you answer yes to any of these questions, hepatitis A vaccine is recommended.


Have you had more than one sex partner in the past 6 months?

Are you being evaluated or treated for a sexually transmitted disease?

Have you recently or do you currently inject illegal drugs?

Do you have a job that exposes you to human blood or other body fluids?

Do you have a sexual partner who is infected with hepatitis B virus?

Do you live with someone infected with hepatitis B?

Do you live or work in an institution for the developmentally disabled?

Do you have end-stage renal disease?

Are you on dialysis?

Do you have chronic (long-term) liver disease?

Are you traveling to a country where hepatitis B is common?

Are you infected with human immunodeficiency virus (HIV)?

Are you younger than 60 years and have diabetes?

If you answer yes to any of these questions, hepatitis B vaccine is recommended.


Are you infected with human immunodeficiency virus (HIV)?

Do you have a history of injecting illegal drugs?

Did you received clotting factors before 1987?

Are you on dialysis?

Do you have abnormal liver enzyme test results?

Did you receive blood or have an organ transplant before 1992?

Have you received blood from someone who later tested positive for hepatitis C?

Are you a health care worker who may have been exposed to hepatitis C-positive blood (for example, you have been stuck with a needle used on a person with hepatitis C)?

If you answer yes to any of these questions, hepatitis C testing is recommended.


Have you had more than one sexual partner since your most recent HIV test or do you have a sexual partner with more than one sexual partner since his or her most recent HIV test?

Have you had a past or present sex partner who injects drugs or is HIV positive?

Do you have a history of prostitution?

Do you inject illegal drugs?

Are you an adolescent entering a detention facility?

Have you been diagnosed with a sexually transmitted disease in the past year?

Have you lived for a long period or were you born in an area with high prevalence of HIV infection?

Did you receive a blood transfusion between the years 1978 and 1985?

Do you have invasive cervical cancer?

Are you seeking preconception evaluation?

If you answer yes to any of these questions, human immunodeficiency virus testing is recommended.


Do you have a family history of familial hyperlipidemia?

Do you have a female relative with cardiovascular disease before age 60 years or a male relative with heart disease before age 50 years?

Do you have a history of coronary heart disease or noncoronary atherosclerosis (eg, abdominal aortic aneurysm, peripheral artery disease, carotid artery stenosis)?

Are you obese (body mass index greater than 30)?

Do you have a personal or family history of peripheral artery disease?

Do you have diabetes mellitus?

Do you have multiple risk factors for heart disease, such as smoking or hypertension?

If you answer yes to any of these questions, lipid profile assessment is recommended.


Were born in 1957 or later and you have no proof of immunity or documentation of a dose of measles–mumps–rubella (MMR) vaccine given after your first birthday? If yes, you should be offered one dose of measles-mumps-rubella vaccine.


Were you born in 1963–1967? If yes, you should be offered two doses of measles-mumps-rubella vaccine.


Are you a health care worker?

Are you entering college?

Are you traveling internationally?

Did you just have a baby and you are rubella-negative?

If you answer yes to any of these questions, the measles–mumps–rubella (MMR) vaccine is recommended.


Do you have a spleen or immune disorder?

Are you a first-year college student living in a dormitory?

Are you a military recruit?

Are you traveling to an area where bacterial meningitis is common?

Are you a microbiologist who works with the bacteria that causes meningitis?

If you answer yes to any of these questions, the meningococcal vaccine is recommended.


Do you have a chronic illness?

Are you in an environment where pneumococcal outbreaks have occurred?

Do you have a compromised immune system?

Are you an Alaska Native or belong to certain Native American populations?

If you answer yes to any of these questions, the pneumococcal vaccine is recommended.


Are you of childbearing age and have no evidence of immunity to rubella? If yes, a rubella titer assessment is recommended.


Have you had more than one sexual partner or do you have a partner who has had more than one sexual partner?

Have you had sexual contact with someone with a sexually transmitted disease?

Have you had more than one sexually transmitted disease or been treated at a sexually transmitted disease clinic?

If you answer yes to any of these questions, testing for sexually transmitted diseases is recommended.


Are you a sexually active adolescent and do any of the following statements apply to you?

You exchange sex for drugs or money.

You inject illegal drugs.

You are entering a detention facility.

You live in an area with high rates of syphilis.

If you answer yes to any of these questions, syphilis testing is recommended.


Do you work or play often in the sunlight?

Do you have a family or personal history of skin cancer?

Have you had precancerous lesions?

Do you have fair skin or freckling or light hair?

Are you immunosuppressed?

Do you have xeroderma pigmentosum?

If you answer yes to any of these questions, a skin exam is recommended.


Do you have a strong family history of thyroid disease?

Do you have an autoimmune disorder?

If you answer yes to any of these questions, thyroid-stimulating hormone testing is recommended.


Do you have human immunodeficiency virus (HIV) infection?

Are you in close contact with persons known or thought to have tuberculosis?

Do you have medical risk factors known to increase the risks associated with tuberculosis if infected?

Were you born in a country with high rates of tuberculosis?

Do you abuse alcohol or inject illegal drugs?

Do you live in an institutional setting (including a nursing home, prison or jail, or mental health institution)?

Do you work as a health professional in a high-risk health care facility?

Are you medically underserved or low income?

Do you have X-ray evidence of prior healed tuberculosis?

Have you had a positive tuberculosis skin test result showing an increase of 10 millimeters or more in the size of the skin reaction within the previous 2 years?

If you answer yes to any of these questions, tuberculosis skin testing is recommended.

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Our Office Hours

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9:00 AM – 4:30 PM

Wednesday,  Friday and Saturday
9:00 AM - Noon

Get In Touch

Palm Coast Women's Center

Town Center Medical
21 Hospital Drive
Suite 270
Palm Coast, Florida 32164

386.437.5959
386.437.5390 (fax)