From the Guidelines
Annual gynecology visits for a 46-year-old female should include questions about reproductive planning, chronic disease management, and social and behavioral history.
Key Questions to Ask
- Reproductive planning: Discuss reproductive goals and issues, including plans for pregnancy, contraception, and birth spacing 1
- Chronic disease management: Assess and manage chronic diseases such as hypertension, diabetes mellitus, depression, and anxiety disorders 1
- Social and behavioral history: Screen for alcohol consumption, tobacco use, and drug use, as well as assess social history and lifestyle issues that may affect pregnancy 1
- Family and genetic history: Assess pregnancy risks based on maternal age, maternal and paternal health, obstetric history, and family history 1
- STI risk assessment: Assess STI risk and provide counseling and immunizations as indicated to prevent acquisition of STIs 1
- Weight and body mass index: Counsel women with a body mass index greater than or equal to 30 kg per m2 or less than 18.5 kg per m2 about possible infertility issues and risks during and after pregnancy 1
- Cervical cancer screening: Follow guidelines for cervical cancer screening, which recommend screening every 2-3 years for women 21-29 years old and every 3 years for women 30 years and older with a normal Pap test result 1
Additional Considerations
- Folic acid supplementation: Advise all women of reproductive age to take folic acid and consume a balanced, healthy diet including folate-rich foods 1
- Immunization status: Review and update immunization status annually 1
- Physical, sexual, and emotional abuse: Screen for current, recent past, or childhood physical, sexual, or emotional interpersonal violence and refer to appropriate resources when needed 1
From the Research
Annual Gynecology Visit Questions for a 46-year-old Female
During an annual gynecology visit, the following questions should be asked:
- What are the patient's current symptoms and past medical and gynecologic history? 2
- What is the patient's family history, and how does it impact her personal risk factors? 2
- What is the patient's reproductive life plan, and how do her current and future plans align with medical testing and treatments? 2
- Are there any concerns or issues related to sexual health, such as sexual dysfunction or pain during intercourse? 3
- Are there any questions or concerns about menopause, perimenopause, or postmenopausal health? 2
- What are the patient's beliefs and values regarding routine pelvic examinations, and are they necessary based on her medical history and symptoms? 4, 5
Components of the Physical Examination
The physical examination may include:
- A breast examination, which may be indicated based on the patient's medical history and symptoms 2
- A pelvic examination, which may be performed when indicated by medical history or symptoms, but is not necessarily routine for asymptomatic women 4
- An external pelvic examination, which may be indicated during the initial reproductive health visit, but an internal pelvic examination is generally unnecessary unless issues or problems are discovered in the medical history 6
Shared Decision Making
Shared decision making between the patient and her obstetrician-gynecologist or other gynecologic care provider is important for: