5 questions to ask at your well-woman exam

Chances are, you have questions—a lot of them—about your reproductive health. And the perfect time to ask them is at your annual well-woman exam.

“When we do an annual exam, we like to discuss the basics, such as menstrual cycles, birth control, and concerns regarding female anatomy, including breasts,” says Sandhia Varyani, MD, OB-GYN at University Hospitals based in Cleveland, Ohio. “If a patient is having symptoms and no longer needing birth control, we discuss menopause and those concerns. The annual exam is a basic review and exam including a Pap test.”

5 questions to ask a gynecologist

What questions should you ask? Really anything—be it a concern or a curiosity. If it has to do with your reproductive or even your general health, it’s fair game. Here, five questions to consider.

1. Is my period normal? 

“Normal” varies from woman to woman. Menstrual cycles are counted from the first day of bleeding one month to the first day of bleeding the next month, according to Planned Parenthood. On average, that’s about 25-30 days, although having a cycle that’s as short as every 21 days or as long as every 35 days is also considered normal. Bleeding generally lasts two to seven days, but that can vary based on factors such as your age and your birth control method. 

How does a medical professional determine whether you might have a problem with your menstrual cycle? “We look at a woman’s personal and family history, her hormonal status [for example, if she’s ovulating or in menopause], bleeding disorders as well as anatomic concerns, just to name a few things,” says Dr. Varyani. “Testing depends on many findings.” Your doctor may look into include:

• Blood work
• Imaging
• Medication
• Surgery or medical procedures 

2. Should I be screened for an STI? 

Sexually transmitted infections (STIs), and the sexually transmitted diseases (STDs) they cause, are ailments passed from person to person via oral, vaginal, or anal sex. (They can also be passed through the sharing of needles.) These conditions, which include things like chlamydia, HIV, gonorrhea, and genital herpes, can impact a woman’s health and fertility, leading to things like cervical cancer, pelvic pain, and ectopic pregnancy (when a pregnancy grows outside the uterus). 

STIs and STDs are common. April of every year is STD Awareness Month, dedicated to improving understanding of these health conditions. The Centers for Disease Control (CDC) reports that on any given day in 2018, 1 out of every 5 people in this country had an STI. To make matters worse, their symptoms can be silent, meaning an infection can be passed unknowingly between partners whenever they have unprotected sex.

“Screening for sexually transmitted infections should be part of every annual well-woman visit,” says Amanda Henne, MD, OB-GYN with Ochsner Health. “Your gynecologist will likely ask you questions about your sexual practices to better assess if you’re at higher risk and to help guide screening recommendations.” 

Some questions you’re likely to be asked include:

• Are your sexual partner(s) men, women, or both?
• How many sexual partners have you had?
• What kind of sexual contact are you having or have you had in the past? Genital, anal, oral?
• Are you and your partner(s) using protection against STIs? 
• Have you or your partner ever been diagnosed with an STI? 

3. Do I really need to do a monthly breast exam?

You might if you’re at a higher-than-average risk of breast cancer (for example, you have a mother, sister, or child with breast cancer). 

If you’re at average risk, both the American College of Obstetricians and Gynecologists (ACOG) and the American Cancer Society say that a breast self-exam is not essential, as there’s little evidence that it detects cancer or improves survival rates. These experts also note that many women normally have lumpy, bumpy breasts, so a self exam can produce a lot of needless worry and unnecessary biopsies. What experts do recommend, however, is developing “breast self-awareness.” To do that, they advise that you become familiar with the way your breasts look and feel so if changes do occur you can spot them early and talk about them with your health care provider.

“In the average-risk patient, it’s recommended [by ACOG] to have a clinical breast exam [which is performed by a healthcare provider] every one to three years from ages 25-39 and annually at age 40; yearly mammograms should also begin at age 40,” says Caitlyn Ranger, MD, an OB-GYN at Ochsner Health. “These recommendations may differ for someone who has a higher lifetime risk based on their own or their family history.” Additionally, the American Cancer Society no longer recommends routine clinical breast exams, so it’s good to ask an OB-GYN or your primary care provider about what’s best for you.

4. Am I the only woman in America who’s not that interested in sex?

You’re in good company. “Female sexual interest/arousal disorder, often referred to as decreased libido or sex drive, is extremely common. In fact, approximately 43% of American women report sexual dysfunction at some point in their life,” says Dr. Henne. 

What can cause a sex slump? A lot of things, including:

• Sleep disturbances
• Certain medications, such as some antidepressants and anti-anxiety drugs
• Medical conditions like diabetes
• Hormonal fluctuations
• Relationship problems 

“It’s important that your physician knows your medical, social, and surgical history, as well as the medications and over-the-counter supplements you’re taking,” says Dr. Henne. “This may help in diagnosing the underlying cause of your sexual dysfunction and guide the treatment options, which can range from lifestyle modifications, exercises, and therapy to certain medications.”

5. Am I using the right birth control?

As your life and your relationships change, so might your birth control method. What seemed like a good choice when you were 25 and dating may not be the optimal option when you’re 40, married, and have completed your family.

When choosing the right contraceptive for you, you and your health care provider need to ask a number of questions. For example, how often do you have sex? Are you in a mutually monogamous relationship? Do you want children in the near future? Do you have any health risks that would eliminate certain birth control options (e.g., women over 35 who smoke or women at high risk of heart disease shouldn’t use certain birth control methods containing hormones). Based on the answers, you and your healthcare provider can narrow down your choices and select the right option for you.

RELATED: Questions to ask a gynecologist before pregnancy

What questions do providers ask at a well-woman exam?

As part of your well-woman exam, your healthcare provider will ask you routine questions to get a better sense of your overall and sexual health. These are aimed at better understanding your reproductive health, and if any additional screenings might be necessary. Some common questions your healthcare provider might ask include:

• Are you sexually active?
• Are you using birth control or STI protection?
• Are you happy with your birth control method?
• Do you feel safe with your sexual partner?
• Are your periods regular?
• Do you have any pain or bleeding during sex?
• Have you noticed any changes in the appearance or odor of your vaginal discharge?
• Are you experiencing any itching or unusual sores?
• Have you done a breast check recently?
• Has anything else in your medical history changed since your last visit?

These questions might feel uncomfortable, or too personal. But they are necessary to give your provider a full picture of your health. Try to answer as openly and honestly as you can.