A comprehensive annual exam aims to assess a woman's reproductive health and overall well-being.

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Here's what typically happens during such an exam:

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1. Discussion of the patient's medical history, including any past gynecological issues, surgeries, pregnancies, and family medical history to provide context for the exam and may identify any risk factors or concerns.

2. A clinical breast examination to check for any lumps, abnormalities, or changes in the breast tissue, and provide instruction on breast self-examination techniques.

3. An external and internal examination of the reproductive organs, including the vagina, cervix, uterus, and ovaries to check for any signs of infection, inflammation, abnormalities, or masses. A Pap smear may be performed during this exam to screen for cervical cancer or abnormalities in the cervix.

4. Depending on the patient's age, sexual history, and risk factors, the provider may recommend screening for sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV.

5. The provider may discuss contraception options with the patient, including hormonal methods (such as birth control pills, patches, or injections), barrier methods (such as condoms or diaphragms), intrauterine devices (IUDs), and permanent methods (such as tubal ligation). 

6. General health discussions.

7. Follow-up and recommendations.