Examine the ovaries, uterus, and external genitalia.
Give advice on menstruation and birth control.
Recommendation: teen gets the first gynecological visit at eighteen years or within three years of becoming sexually active.
Assess the breasts in all high-risk women and women over the age of about thirty
evaluate the breasts for symmetry, lumps, abnormalities of the skin, inversion of the nipples, or indentations/puckering of the skin.
Training on breast self-exam.
Mammogram:
Every 2 years between ages 40 and 50 years.
Every year after the age of 50 years.
If a first-degree relative with breast cancer or ovarian cancer: mammograms sooner and more often: blood testing for BRCA1 or BRCA2 gene.
Evaluation of external genitalia: Bartholin duct cyst, lesions suggestive of any sexually-transmitted disease: herpes simplex or human papillomavirus.
Vagina: papillomas or other evidence of STD.
Cervix: dysplasia or infection with an STD, Pap test is done.
HPV DNA test and is only done over thirty years of age.
Uterus: size, masses, or pain on movement.
Fallopian tubes and ovaries: size, and masses.
Orientation on menopausal symptoms: hot flashes, night sweats, oligomenorrhea or amenorrhea, mood disruption, insomnia, vaginal dryness, and urinary symptoms.
Risk for osteoporosis.
Decreased libido.
Management: estrogen replacement therapy. Possible side effects to be discussed.
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