A well-woman exam is a yearly exam that puts your health needs at the top of the priority list. The team evaluates your current health and well-being, and the exam includes preventive screenings that help maintain your health. Many women's health problems — including breast cancer, cervical cancer, and many sexually transmitted diseases — don't show symptoms in their early stages. Well-woman exams are the time to screen for these potentially serious issues and catch them when they're most treatable.

The first well-woman exam should occur between the ages of 13 and 15, and doesn't usually involve a pelvic exam (unless there is an underlying condition). This visit allows the patient to build a relationship with the team and discuss any health issues, such as puberty and menstruation. Visits also address symptoms like irregular bleeding, unusual vaginal discharge, and pelvic pain.

At the beginning of your exam, the team takes your vitals — blood pressure, weight — and reviews your medical history. This is also the time to raise any concerns about symptoms or issues like birth control, menopause, or family planning. They perform a pelvic exam and Pap smear (if you're due) to check for cells that could suggest cervical cancer, and evaluate your uterus and pelvic organs for fibroids or irregular tissue. The team may also perform a breast exam and make recommendations for further testing like a mammogram. Afterward, they may recommend diet, exercise, and lifestyle habits to improve your overall health.

Hormonal health refers to the balance of hormones in your body. Hormones are chemical messengers that control your menstrual cycle, mood, sleep-wake cycle, metabolism, bone health, and sex drive. Female sex hormones — estrogen and progesterone — influence your menstrual cycle and may play a role in mood changes throughout life stages.

The team recommends an evaluation if you have a mood disorder related to your hormones. Hormone-related mood disorders include:

Premenstrual dysphoric disorder (PMDD)

PMDD causes depression, anxiety, and irritability the week before your period. Though symptoms go away within a few days after your period starts, they can affect your quality of life.

Postpartum depression

Postpartum depression can occur after childbirth, with feelings of sadness and despair that affect your ability to care for yourself and your baby.

Perimenopausal mood disorder

Refers to the mood changes that occur in the years leading up to menopause, when sex hormone levels fluctuate and cause mood swings and low-level depression.

The team customizes your hormonal health treatment plan based on your symptoms, hormone levels, and stage of life. Treatment may include antidepressants, hormonal birth control, hormone therapy, referral to psychotherapy, and stress management. They work closely with you to design a plan that eases your symptoms and improves your physical and emotional well-being.

Birth control refers to the various methods available that prevent you from getting pregnant. The best method depends on your current and future pregnancy plans as well as your health. The team specializes in helping patients find the right birth control that fits their needs.

You have many options when it comes to birth control:

Sterilization

A permanent form of birth control recommended only if you have no future pregnancy plans. During this minimally invasive procedure, they cut or block your fallopian tubes.

Long-acting reversible contraceptives (LARCs)

Include intrauterine devices (IUDs) and birth control implants, which prevent pregnancy for 3–10 years and can be removed when you're ready.

Short-acting hormonal methods

Birth control pills, patches, and shots that must be used as directed for best effectiveness.

Barrier methods

Condoms, diaphragms, and the cervical cap — used each time you have sex. Condoms also protect against some STDs.

The specifics depend on your family planning needs. The team asks detailed questions to fully understand your current and future pregnancy plans, then discusses your birth control options and helps you decide what method works best.

Endometriosis is a condition in which endometrial tissue grows outside the uterus. Every month, endometrial tissue grows along the wall of your uterus in anticipation of pregnancy. With endometriosis, endometrial-like growths may appear on your ovaries, fallopian tubes, or the outer lining of your uterus. Like normal endometrial lining, this tissue grows and sheds with your menstrual cycle — but it has nowhere to go, causing inflammation and scarring.

Pelvic pain is the most common symptom. You may have severe pain during your period or all the time. Other symptoms include:

• Abnormal bleeding
• Pain during intercourse
• Pain during a bowel movement
• Bloating
• Diarrhea or constipation

Many women with endometriosis also struggle with infertility.

The team conducts a thorough evaluation reviewing your symptoms, menstrual cycle, gynecological history, and family history. They perform a physical and pelvic exam and may run ultrasound tests. They may prescribe hormonal birth control or GnRH to confirm the diagnosis. Laparoscopy — a minimally invasive procedure — can confirm diagnosis and provide tissue samples. Treatment is customized based on your pregnancy plans: hormonal birth control for those with no pregnancy plans, or GnRH and possible surgical removal of growths for those hoping to conceive.

Your ovaries are two almond-shaped organs that produce the eggs released during ovulation. Small cysts sometimes form on the ovaries but disappear on their own. In some cases, however, cysts can grow large, cause pain and discomfort, or become cancerous. When a cyst grows large, it has the potential to move and twist your ovary — causing immediate, extreme pain. This, along with cyst ruptures, are emergencies that require prompt medical attention.

Ovarian cysts don't usually cause symptoms when they're small. But they can cause:

• Bloating
• A heavy feeling in the abdomen and pelvic region
• Sharp pain or a dull ache in the lower belly on the side where the cyst exists

The team may also discover benign, non-symptomatic cysts during a routine pelvic exam or ultrasound. Cysts that develop after menopause are of special concern because they're more likely to be cancerous.

For small cysts not causing symptoms, the team recommends a watch-and-wait approach with periodic ultrasounds. For large or growing cysts, minimally invasive surgery is suggested to prevent complications like torsion or rupture. Cysts that persist through two or three menstrual cycles, cause pain, or appear cancerous are also candidates for removal. The team uses tiny incisions, which means less scarring, faster recovery, and fewer complications. Whenever possible, the ovary is preserved.

Infertility may be due to underlying factors in either partner. The primary causes of female infertility include:

• Irregular ovulation, such as with polycystic ovary syndrome (PCOS)
• Fallopian tube blockages or damage
• Abnormalities in the cervix or uterus
• Endometriosis
• Early menopause
• Cancer or cancer treatment
• Scar tissue in the reproductive organs

In most cases, a couple can still have a healthy pregnancy with the right care.

If you've been actively trying to get pregnant for 12 months with no success, it may be time to schedule an evaluation. For women 35 or older, an evaluation is recommended after just six months. Women who've had repetitive miscarriages may also benefit from an infertility evaluation.

The team offers comprehensive screenings including diagnostic ultrasound, laparoscopy, blood tests, tubal patency evaluation, and semen analysis. Treatment options include:

• Lifestyle modifications for healthy weight and nutrition
• Fertility tracking for optimal timing
• Oral hormones or medications to stimulate ovulation
• Artificial insemination
• Minimally invasive surgery to remove scar tissue or endometriosis
• Referral to a reproductive specialist for IVF and advanced therapies

Menopause is the stage when you have gone 12 straight months without a period or ovulation. The average age of menopause is 51. Symptoms associated with menopause usually occur for several months or years as your hormones start to shift, and for many women can interfere with quality of life.

Not all women experience symptoms — others find them quite mild. For some, however, menopause symptoms are a serious health concern. Signs that indicate menopause or perimenopause include:

• Hot flashes and night sweats
• Vaginal dryness
• Sleep disruptions
• Painful intercourse
• Mood swings
• Loss of libido
• Depression or anxiety
• Headaches and racing heartbeat
• Urinary incontinence

Many women also experience unwanted weight gain, fatigue, and mental fog.

The team may recommend hormone therapy to better balance estrogen and progesterone levels. The type of therapy and dosage depend on the nature and severity of your symptoms. Hormone therapy is available through injections, oral medications, pellets inserted under the skin, and creams — helping ease hot flashes, vaginal dryness, mood swings, and poor sleep. The team also addresses post-menopausal health concerns like osteoporosis, heart disease, and urinary incontinence.

Childbirth is the stage of your pregnancy when you deliver your baby. Though women give birth every day, no labor and delivery are alike. The team provides education and support for childbirth and does their best to follow your birth plan while keeping you and your baby safe.

The team offers many options for bringing your baby into the world:

Natural childbirth

Also called vaginal delivery, this is the most common and safest form. You follow your contractions and push the baby out through the vaginal canal with guidance and support — usually without medication for pain control.

Assisted vaginal delivery

Includes tools like forceps or vacuum extraction to help guide your baby out. Breaking your water and inducing labor are also forms of assisted vaginal delivery.

Cesarean section (C-section)

A surgery that removes your baby through a cut in your lower abdomen. The team may recommend a C-section early in pregnancy if conditions like placenta previa exist, or during vaginal delivery if it's not progressing safely.

You work closely with the team to determine what type of childbirth is best for you. They discuss your birth plan and how they can make it work, as well as other childbirth options and when they're needed. The goal is always the safest, most positive experience for you and your baby.

Abnormal bleeding includes any uterine bleeding outside the normal menstrual cycle. A normal cycle runs 21–35 days, with a period lasting up to seven days. Bleeding between periods, periods longer than seven days, or heavy periods that affect daily life are all abnormal. Not having a period for more than three months or having an irregular period (7–9 periods a year) is also abnormal.

Common causes include:

• Endometriosis
• Fibroids
• Polycystic ovary syndrome (PCOS)
• Polyps
• Sexually transmitted diseases (STDs)
• Gynecological cancer
• Adenomyosis
• Bleeding disorders

Hormonal birth control, the onset of your period, and the years leading up to menopause can also cause abnormal bleeding.

The team customizes your treatment plan based on the cause. Initially, medications such as hormonal birth control or tranexamic acid are recommended. If these fail to improve your bleeding, surgical intervention may be suggested — such as removal of fibroids, or endometrial ablation (a procedure that destroys the endometrial lining to stop heavy bleeding).

Whether this is your first or fourth pregnancy, you need expert pregnancy care. The team takes care of you before, during, and after your delivery. Pregnancy care includes prenatal care, monitoring, screenings, and support provided during the nine months of your baby's gestation — as well as support through labor, delivery, and the immediate postnatal period.

Prenatal care ensures you and your baby stay healthy during pregnancy. During regular prenatal visits, the team detects any potential problems early. Prenatal visits usually occur:

• Once per month during weeks 4–28
• Once every two weeks during weeks 28–36
• Once per week during weeks 36–40

High-risk situations — such as maternal age over 35, a pre-existing health condition, or pregnancy with multiples — may require more frequent visits.

At your first pregnancy visit, the team establishes your due date, detects the baby's heartbeat, does a pelvic exam, and runs blood work. At later visits, you'll undergo screening tests like ultrasounds that provide valuable information about your health and your baby's progress. The team may recommend prenatal vitamins and encourages questions about diet, exercise, travel, medications, and other lifestyle issues at every visit.

All women should start getting Pap smears at age 21 and every three years until about age 65. If you regularly get tested for human papillomavirus (HPV) and have had no abnormal results, the team suggests testing every five years. Certain strains of HPV cause cancerous changes in cervical cells. The team can recommend a testing schedule that suits your health and lifestyle.

An abnormal Pap smear result may not be an indication of cervical cancer. Many factors could cause this result, including:

• Normal inflammation
• Yeast infection
• Herpes
• Human papillomavirus (HPV)

Having intercourse close to the time of your test can also cause abnormal results. That said, abnormal results might also indicate precancerous cells — which is why follow-up is important.

The team may recommend another Pap test in a few weeks, as abnormal cells often disappear on their own. Additional diagnostic testing such as colposcopy (a magnifying lens examination of cervical cells) or biopsy may be needed. If precancerous cells are confirmed, treatment options include cryotherapy (freezing abnormal tissue) or a LEEP procedure (a heated wire loop that removes problematic cells from the cervix with minimal discomfort).