Health screening - women - ages 18 to 39
You should visit your health care provider from time to time, even if you are healthy. The purpose of these visits is to:
- Screen for medical issues
- Assess your risk for future medical problems
- Encourage a healthy lifestyle
- Update vaccinations
- Help you get to know your provider in case of an illness
Health maintenance visit - women - ages 18 to 39; Physical exam - women - ages 18 to 39; Yearly exam - women - ages 18 to 39; Checkup - women - ages 18 to 39; Women's health - ages 18 to 39; Preventive care - women - ages 18 to 39
Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.
There are specific times when you should see your provider. Below are screening guidelines for women ages 18 to 39.
BLOOD PRESSURE SCREENING
- Have your blood pressure checked every 3 to 5 years. If the top number (systolic number) is between 120 to 139, or the bottom number (diastolic number) is between 80 to 89 mm Hg, you should have it checked every year.
- If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often, at least once a year.
- Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. Or, check your blood pressure using the automated machines at local grocery stores and pharmacies.
- If the top number is greater than 140 or the bottom number is greater than 90, schedule an appointment with your provider.
- Recommended starting ages for cholesterol screening are between 20 to 45 for women.
- Women with normal cholesterol levels do not need to have the test repeated for 5 years.
- Repeat testing sooner than needed if changes occur in lifestyle (including weight gain and diet).
- If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
- If your blood pressure is above 135/80 mm Hg, your provider will test your blood sugar level for diabetes.
- If you have a body mass index (BMI) greater than 25 and have other risk factors for diabetes, you should be screened. Having a BMI over 25 means that you are overweight. Asian Americans should be screened if their BMI is greater than 23.
- Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.
- If you have vision problems, have an eye exam every 2 years or more often if recommended by your provider.
- Have an eye exam at least every year if you have diabetes.
- You should get a flu shot every year.
- After age 19, you should have one tetanus-diphtheria and acellular pertussis (TdAP) vaccine as one of your tetanus-diphtheria vaccines. You should have a tetanus-diphtheria booster every 10 years.
- You should receive 2 doses of varicella vaccine if you were born after 1980 and never had chickenpox or the varicella vaccine.
- If you were born after 1956 your provider will determine if you should receive at least one dose of the measles, mumps, and rubella (MMR) vaccine.
- Your provider may recommend other immunizations if you are at high risk for certain conditions, such as pneumonia.
Ask your provider about the human papilloma virus (HPV) vaccine if you are between ages 18 to 26 and you have:
- Not received the HPV vaccine in the past (you will need all three shots)
- Not completed the full vaccine series (you should catch up on this shot)
- Your blood pressure should be checked at least every 3 to 5 years.
- Screening for cervical cancer should begin at age 21.
- Your height, weight, and BMI should be checked at every exam.
During your exam, your provider may ask you about:
- Diet and exercise
- Alcohol and tobacco use
- Safety issues, such as using seat belts and smoke detectors
BREAST SELF-EXAM AND MAMMOGRAM
- Women may do a monthly breast self-exam. However, experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.
- Screening mammogram is not recommended for most women under age 40.
- If you have a mother or sister who had breast cancer at a young age, consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.
- If you have other risk factors for breast cancer, your provider may recommend a mammogram, breast ultrasound, or MRI scan.
- Contact your provider right away if you notice a change in your breasts, whether or not you do breast self-exams.
- If you are between ages 20 to 40, your provider may do a clinical breast exam.
PELVIC EXAM AND PAP SMEAR
- Beginning at age 21, women should have a pelvic exam and Pap smear every 3 years to check for cervical cancer.
- If you are over age 30 and your Pap smear and HPV test are normal, you only need a Pap smear every 5 years.
- If you have had your uterus and cervix removed (total hysterectomy) and you have not been diagnosed with cervical cancer you may not need to have Pap smears.
- Women who are sexually active should be screened for chlamydia and gonorrhea up until age 25. Women 25 years and older should be screened if at high risk.
- Your provider will tell you how to prevent infections spread through sexual contact. These are called sexually transmitted infections (STIs).
- Your provider will ask you questions about alcohol and tobacco and may ask you about depression.
- The ACS recommends a skin exam as part of a periodic exam by your provider, if it is indicated.
- The USPSTF does not recommend for or against performing a skin self-exam.
- You should talk with your provider concerning colon cancer screening if you have a strong family history of colon cancer or polyps, or if you have had inflammatory bowel disease or polyps yourself.
- Routine bone density screening of women under 40 is not recommended.
American College of Obstetricians and Gynecologists. Committee opinion no. 641: human papillomavirus vaccination. Obstet Gynecol. 2015;126(3):e38-e43. PMID: 26287792 www.ncbi.nlm.nih.gov/pubmed/26287792.
American College of Obstetricians and Gynecologists. Practice bulletin no. 157: cervical cancer screening and prevention. Obstet Gynecol. 2016;127(1):e1-e20. PMID: 26695583 www.ncbi.nlm.nih.gov/pubmed/26695583.
American College of Obstetricians and Gynecologists. Practice bulletin no. 131: screening for cervical cancer. Obstet Gynecol. 2012;120(5):1222-1238. PMID: 23090560 www.ncbi.nlm.nih.gov/pubmed/23090560.
American Dental Association. Questions about going to the dentist. www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed July 24, 2015.
American Optometric Association. Comprehensive adult eye and vision examination. Updated February 6, 2015. www.aoa.org/Documents/EBO/Adult%20Eye%20and%20Vision%20Examination%20Guideline%20Peer-Public%20Review%20Document.pdf. Accessed July 24, 2015.
Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 15.
Centers for Disease Control and Prevention. Assessing immunity to varicella. Updated August 22, 2013. www.cdc.gov/chickenpox/hcp/immunity.html. Accessed July 24, 2015.
Chamberlain JJ, Rhinehart AS, Shaefer CF Jr, Neuman A. Diagnosis and management of diabetes: synopsis of the 2016 American Diabetes Association standards of medical care in diabetes. Ann Intern Med. 2016;164(8):542-552. PMID: 26928912 www.ncbi.nlm.nih.gov/pubmed/26928912.
Committee on Adolescent Health Care of the American College of Obstetricians and Gynecologists; Immunization Expert Work Group of the American College of Obstetricians and Gynecologists. Committee opinion no. 588: human papillomavirus vaccination. Obstet Gynecol. 2014;123(3):712-718. PMID: 24553168 www.ncbi.nlm.nih.gov/pubmed/24553168.
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359-2381. PMID: 25182228 www.ncbi.nlm.nih.gov/pubmed/25182228.
De Paula FJA, Black DM, Rosen CJ. Osteoporosis and bone biology. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 29.
James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.
Kim DK, Bridges CB, Harriman KH; Advisory Committee on Immunization Practices (ACIP), ACIP Adult Immunization Work Group. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older -- United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(4):88-90. PMID: 26845417 www.ncbi.nlm.nih.gov/pubmed/26845417.
Meschia JF, Bushnell C; American Heart Association Stroke Council; et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.
Moyer VA; US Preventive Services Task Force. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;156(12):880-891. PMID: 22711081 www.ncbi.nlm.nih.gov/pubmed/22711081.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines): breast cancer screening and diagnosis. Version 3.2015 www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed July 24, 2015.
Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2014;311(5):474-476. PMID: 24352710 www.ncbi.nlm.nih.gov/pubmed/24352710.
Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 42.
Saslow D, Solomon D, Lawson HW, et al; ACS-ASCCP-ASCP Cervical Cancer Guideline Committee. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147-172. PMID: 22422631 www.ncbi.nlm.nih.gov/pubmed/22422631.
Siu AL; US Preventive Services Task Force. Screening for high blood pressure in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778-786. PMID: 26458123 www.ncbi.nlm.nih.gov/pubmed/26458123.
Smith RA, Brooks D, Cokkinides V, Saslow D, Brawley OW. Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening. CA Cancer J Clin. 2013;63(2):88-105. PMID: 23378235 www.ncbi.nlm.nih.gov/pubmed/23378235.
Stone NJ, Robinson J, Lichtenstein AH, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S46-S48. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.
US Preventive Services Task Force. Cervical cancer: screening. Updated March 2012. www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening?ds=1&s=cervical%20cancer. Accessed July 24, 2015.
US Preventive Services Task Force. Draft recommendation statement: statin use for the primary prevention of cardiovascular disease in adults: preventive medication. Updated December 2015. www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement175/statin-use-in-adults-preventive-medication1. Accessed April 19, 2016.
US Preventive Services Task Force. Final recommendation statement: cervical cancer: screening. Updated October 2014. www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/cervical-cancer-screening. Accessed April 19, 2016.
US Preventive Services Task Force. Final update summary: breast cancer: screening. Updated January 2016. www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1. Accessed March 9, 2016.
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Internal review and update on 08/05/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial update 04/19/2016.