The Annual Physical Exam - What to Expect at Every Age

Many of us avoid going to the doctor, especially when nothing’s wrong. However, an annual physical exam or wellness checkup is a great opportunity to discuss non-urgent health concerns and take preventive steps for optimum health.

For example, a yearly checkup can identify a problem like high blood pressure or other risk factors that are silent and do not cause any symptoms. A yearly exam also helps to maintain a connection with your primary care physician.

Please continue reading to learn more about what to expect during a routine physical exam.

Do you need an annual physical when you’re young?

An annual physical checkup is a great way to keep track of your health. It can help to detect and treat health problems before they become severe. For example, a cholesterol lab test might show abnormal numbers even though you don’t have any symptoms. Your doctor may recommend a diet and exercise plan to reduce your risk of heart disease.

With that said, health concerns are usually uncommon during young adulthood. Therefore, young men and women under the age of 40 can probably get away with less frequent physicals compared to older adults.

According to the Preventive Services Task Force (PSTF) and National Institutes of Health (NIH), women should have two physicals in their 20s and two in their 30s. Men in the 18-39 age group should have a wellness exam with their primary care provider every 2 years. However, men and women with a strong family history of diabetes, heart disease, kidney disease, and certain other health issues may need to see their primary care physicians more often.

Generally speaking, as you grow older, the frequency of your visits to healthcare professionals should increase. Women over 50 should have a physical exam every 1-2 years, and men over 50 should have a yearly checkup.

What is included in an annual physical exam?

Healthcare providers check certain basics like height, weight, and body mass index (BMI) at every annual physical. You will also likely have your blood pressure checked every time you go to your doctor’s office.

Some of the things that are included in an annual physical exam are listed below. Keep in mind that the appointment will be tailored according to your personal health history and family medical history.

Recent Health History

This includes your current medications, vaccinations, nagging health problems, and lifestyle factors such as diet, exercise, weight gain, sleep quality, sexual health, alcohol consumption, smoking, etc.

Vital Signs

Your doctor will check your heart rate, blood pressure, respiratory rate, and body temperature.

General Examination

Your healthcare provider will examine your head, eyes, ears, chest, abdomen, skin, and nervous system (speech, balance, muscle strength, and reflexes).

Physical Examination

This includes more detailed physical exams of different organ systems, such as the heart and lungs, by listening with a stethoscope and doing a blood pressure check. An abdominal exam may involve palpating (touching and applying gentle pressure on your belly). Your doctor may perform an extremities exam by moving your limbs to check joint movements, ask you questions about sensations, or use a rubber hammer to check reflexes. They may also do a complete skin exam to check for skin cancer.

In women over the age of 40, the physical exam may include a breast exam. The healthcare provider will visually examine and palpate your breasts to check for any lumps that may indicate breast cancer or other benign breast problems. They may do a pelvic exam in women to examine the vulva, vagina, and cervix to detect sexually transmitted diseases or other problems.

In men, the healthcare professional may examine the prostate gland and testicles as part of cancer screening. This may involve a digital rectal exam (inserting a gloved and lubricated finger into the rectum).

What is normally done at an annual physical?

There are no standard laboratory tests performed as part of an annual examination. However, your doctor may order certain blood tests based on the results of your physical exam, your medical history, and your family history.

For example, if you have a smoking history and are at high risk of lung disease, they may order spirometry (lung function tests), a chest X-ray, and an electrocardiogram (ECG).

As part of your annual wellness visit, your doctor may take blood samples for laboratory testing and perform the following health screenings:

Laboratory Tests

Complete blood count (CBC)
Chemistry panel (Creatinine, Blood Urea Nitrogen, etc.)
Cholesterol screening for cardiovascular disease
Blood sugar level for diabetes screening
Urinalysis

Screening Tests in Men and Women

Colonoscopy or stool-based test every 10 years to detect colorectal cancer starting at age 50 (more often if there are risk factors for colon cancer).
DEXA scan or bone mineral density to check for weak bones.
Mammogram every 2 years in women between the ages of 50 and 75 who are at low to moderate risk of breast cancer.
Pap smear in women to detect cervical cancer.
Prostate-specific antigen (PSA) in men over 50 years of age. This is a blood test for prostate cancer screening.
Ultrasound to screen for abdominal aortic aneurysm in men over age 65 with a smoking history.

Vaccinations

At the time of your annual wellness visit, your doctor will also make sure you're up-to-date on all the recommended vaccines, including:

Flu vaccine every fall
Shingles vaccine (two doses after age 50)
Tetanus and diphtheria (Td) booster every 10 years
Pneumococcal polysaccharide vaccine (PPSV23) to protect against pneumonia, meningitis, and bloodstream infections (one dose after age 65 or after age 50 in people with certain health conditions)

Frequently Asked Questions

Do you have to take your clothes off for a physical?

You will need to take your clothes off for a complete annual physical exam. Your healthcare providers will give you a paper or cloth gown to wrap around yourself.

Do they check your private parts in a physical?

They will check your private parts during a complete annual checkup. This may include:

A breast exam in women to check for abnormal lumps
A pelvic exam and Pap test in women to check the uterus, ovaries, and cervix
A digital rectal exam in men to check for prostate cancer
A testicular exam in men for testicular cancer screening

How to prepare for an annual physical?

It’s a good idea to write down all your questions, so you don’t forget when you’re in the doctor’s office. This way, you can get advice, diagnosis, or treatment for all your current health issues.

You should also bring a list of your current medications to your annual wellness visit, including prescription drugs, non-prescription medicines, supplements, and herbal remedies. Be sure to bring any additional health information, such as a headache diary, food log, or symptom log.

Last but not least, don’t forget to talk to your healthcare provider about mental health. Tell your doctor if you've had any symptoms of anxiety, depression, or other mental issues since your last annual physical exam.

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