A physical examination, often called a well-child visit or an annual wellness check, is a routine appointment designed to monitor a person’s overall health, growth, and development. For girls and young women, these visits serve as an opportunity to establish a trusting relationship with a healthcare provider and discuss health topics in a confidential setting. The focus of these checks is on preventive care and ensuring that all systems are functioning properly as the body changes.
The Standard Physical Exam: What to Expect
The initial part of any physical exam involves several straightforward, non-invasive measurements and checks that are standard for all patients. The healthcare team will first record basic measurements, including height, weight, and blood pressure, which help track growth patterns and screen for conditions like hypertension. These objective numbers are compared against established medical benchmarks to ensure a person is developing within expected ranges.
The provider will then perform a head-to-toe examination. This usually includes listening to the heart and lungs with a stethoscope to check function and rhythm. They will also gently feel the abdomen to check the size and texture of internal organs, and look into the eyes, ears, nose, and throat. Checking reflexes and assessing posture and joint movement ensures the musculoskeletal and nervous systems are healthy.
Addressing the Genital Exam Question
A full internal pelvic examination, which involves using a speculum or inserting fingers into the vagina, is not a routine part of a standard physical for adolescents and young women who do not have symptoms. Major medical organizations recommend against performing this procedure on asymptomatic patients, especially those who are not sexually active. This internal procedure is typically reserved for specific medical indications or age-related screenings.
A full internal exam is distinct from an external visual check, which may be performed as part of the physical. This external check involves a brief, visual inspection of the external genitalia to assess pubertal development and look for visible abnormalities, such as rashes or lesions. The healthcare provider should always explain exactly what they are doing and why, and the patient has the right to refuse any procedure.
For any sensitive part of the examination, including an external visual check, a medical chaperone will often be offered or required to be present. A chaperone acts as a witness to ensure patient comfort, safety, and privacy during the exam. This practice supports a trusting environment and helps protect both the patient and the healthcare provider.
When a Focused Examination Is Necessary
While internal exams are not routine for asymptomatic patients, a focused genital or pelvic examination may be recommended if a girl presents with specific medical symptoms. These symptoms include unexplained pelvic pain, abnormal vaginal discharge, unusual bleeding, or severe menstrual issues. In these cases, the focused exam is medically necessary to diagnose the underlying issue and guide appropriate treatment.
A pelvic exam may also be necessary when prescribing certain forms of contraception, such as an intrauterine device (IUD), or for specific screening purposes. Current guidelines recommend that routine cervical cancer screening, which involves a Pap test and requires an internal exam, should begin at age 21.
If an adolescent is sexually active, a focused exam might be offered for screening of sexually transmitted infections (STIs). However, many STI tests can now be performed using urine samples or self-collected vaginal swabs, often avoiding the need for an internal exam.
Before any focused or internal examination takes place, the healthcare provider must discuss the procedure with the patient and obtain clear, informed consent. The decision to proceed is a collaborative one, emphasizing open communication between the patient and the medical team.