Here are the most up to date recommendations from American College of Obstetricians and Gynecologists - just released today

"The American College of Obstetricians and Gynecologists (the College) has reviewed the recommendations from the American College of Physicians about annual pelvic examinations and continues to stand by its guidelines, which complement those released recently by the American College of Physicians.

The College’s guidelines, which were detailed in this year’s Committee Opinion on the Well-Woman Visit, acknowledge that no current scientific evidence supports or refutes an annual pelvic exam for an asymptomatic, low-risk patient, instead suggesting that the decision about whether to perform a pelvic examination be a shared decision between health care provider and patient, based on her own individual needs, requests, and preferences.

However, the College continues to firmly believe in the clinical value of pelvic examinations, through which gynecologists can recognize issues such as incontinence and sexual dysfunction. While not evidence-based, the use of pelvic exams is supported by the clinical experiences of gynecologists treating their patients. Pelvic examinations also allow gynecologists to explain a patient’s anatomy, reassure her of normalcy, and answer her specific questions, thus establishing open communication between patient and physician.

Of course, pelvic examinations represent just one part of the annual well-woman visit, which can help to identify health risks for women and which can also feature clinical breast examinations, immunizations, contraceptive care discussions, and health care counseling. Importantly, annual well-woman visits help to strengthen the patient-physician relationship.

“We continue to urge women to visit their health care providers for annual visits, which play a valuable role in patient care,” said John C. Jennings, MD, President of the College. “An annual well-woman visit can help physicians to promote healthy living and preventive care, to evaluate patients for risk factors for medical conditions, and to identify existing medical conditions, thereby opening the door for treatment. Annual well-woman visits are important for quality care of women and their continued health.”

For more information on well-woman visits, please visit www.acog.org/wellwoman"

Birth control pills have been used for decades by millions of women around the world and are among the safer pharmaceutics you can use. However, there are some contraindications to use of amongst women with some other health concerns. Here is a short list not inclusive of all but at least some common contraindications. If you are currently using oral contraceptive pills with one of the listed conditions, you may want to explore alternatives with your gynecologist

Pain with periods and pain with sex are the most common symptoms of endometriosis. Diagnosis cannot be confirmed without laparoscopy but usually symptoms can be controlled with simple medical treatments with the assumption of endometriosis without the need for surgery. These treatments include medications like Ibuprofen known as NSAIDs and oral contraceptive pills which can be used continuously by skipping the placebo week and avoiding a menstrual period. Not having a period and using oral contraceptive pills can prevent worsening of symptoms, treat pain and prevent ovarian cysts. 

Laparoscopy is only indicated for the following
*Severe pain not improved with medical treatment
*Desiring conception
*Large ovarian cyst
*Diagnosis unclear and need for confirmation

• 20 Minutes After Quitting
  Your heart rate drops.
• 12 hours After Quitting
  Carbon monoxide level in your blood drops to normal.
• 2 Weeks to 3 Months After Quitting
  Your heart attack risk begins to drop.
  Your lung function begins to improve.
• 1 to 9 Months After Quitting
  Your coughing and shortness of breath decrease.
• 1 Year After Quitting
  Your added risk of coronary heart disease is half that of a smoker’s.
• 5 Years After Quitting
  Your stroke risk is reduced to that of a nonsmoker’s 5-15 years after quitting.
• 10 Years After Quitting
  Your lung cancer death rate is about half that of a smoker’s.
  Your risk of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases.
• 15 Years After Quitting
  Your risk of coronary heart disease is back to that of a nonsmoker’s.

If you currently smoking and are over 35 here are some contraceptive that are acceptable for use - IUDs - Skyla, Mirena and Paragard, Nexplanon, Depo-Provera, Progesterone only oral contraceptive pill, Essure or laparoscopic permanent sterilization

Osteoporosis risk assessment - FRAX
Breast cancer risk assessment - Gail model

Irregular bleeding is one of the commonest reasons to see your gynecologist. 
Here are tips on what constitutes irregular bleeding.
Bleeding more than 2 weeks
Bleeding between periods
Bleeding more than a pad an hour
And most importantly bleeding after 6 months of no periods (presumed menopause)
Common causes are polyps, fibroids, hormonal fluctuations, endometrial thinning and most serious pre cancer and cancer of the lining of the uterus
Your gynecologist will recommend evaluation by pelvic examination, pap smear, hormone testing, ultrasound and sometimes endometrial biopsy. 
Treatment depends on the condition/cause of the bleeding and most often can be medical management or a minimally invasive or even no cuts procedure with a quick recovery so you can get back to normal in no time.