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Health screenings for women ages 18 to 39

Definition

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

Alternative Names

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

Information

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 at least once every 2 years. If the top number (systolic number) is from 120 to 139, or the bottom number (diastolic number) is from 80 to 89 mm Hg, you should have it checked every year.
  • If the top number is 130 or greater or the bottom number is 80 or greater, schedule an appointment with your provider to learn how you can reduce your blood pressure.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often, but still 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.

CHOLESTEROL SCREENING

  • Recommended starting ages for cholesterol screening are age 45 for women with no known risk factors for coronary heart disease and age 20 for women with known risk factors for coronary heart disease.
  • 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.

DIABETES SCREENING

  • If your blood pressure is 130/80 mm Hg or above, your provider may 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. 
  • If you have other risk factors for diabetes, such as a first degree relative with diabetes or history of heart disease, your provider will likely screen you for diabetes.
  • If you are overweight and have other risk factors such as high blood pressure and are planning to become pregnant, screening is recommended

DENTAL EXAM

  • Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you need more frequent visits.

EYE EXAM

  • 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.

IMMUNIZATIONS

  • You should get a flu shot every year.
  • At or after age 19, you should have one tetanus-diphtheria and acellular pertussis (Tdap) vaccine as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent. You should have a tetanus-diphtheria booster every 10 years.
  • You should receive two doses of varicella vaccine if you never had chickenpox or the varicella vaccine.
  • You should receive one to two doses of the measles, mumps, and rubella (MMR) vaccine if you are not already immune to MMR. Your doctor can tell you if you are immune .
  • 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 ages 19 to 26 and you have:

  • Not received the HPV vaccine in the past
  • Not completed the full vaccine series (you should catch up on this shot)

 INFECTIOUS DISEASE SCREENING

  • 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.
  • All adults ages 18 to 79 should get a one-time test for hepatitis C.
  • Depending on your lifestyle and medical history, you may also need to be screened for infections such as syphilis and HIV, as well as other infections.
PHYSICAL EXAM
  • Your blood pressure should be checked at least every 1 to 2 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:

  • Depression
  • Diet and exercise
  • Alcohol and tobacco use
  • Safety issues, such as using seat belts and smoke detectors

BREAST CANCER SCREENING 

  • 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 age 18 to 39, your provider may do a clinical breast exam.

CERVICAL CANCER SCREENING

Cervical cancer screening should start at age 21. After the first test:

  • Women ages 21 through 29 should have a Pap test every 3 years. HPV testing is not recommended for this age group.
  • Women ages 30 through 65 should be screened with either a Pap test every 3 years or the HPV test every 5 years.
  • If you or your sexual partner has other new partners, you should have a Pap test every 3 years.
  • Women who have been treated for precancer (cervical dysplasia) should continue to have Pap tests for 20 years after treatment or until age 65, whichever is longer.
  • 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.

SKIN SELF-EXAM

  • Your provider may check your skin for signs of skin cancer, especially if you're at high risk.
  • People at high risk include those who have had skin cancer before, have close relatives with skin cancer, or have a weakened immune system.

OTHER SCREENING

  • Talk with your provider about 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.

References

Advisory Committee on Immunization Practices. Recommended immunization schedule for adults aged 19 years or older, United States, 2020. www.cdc.gov/vaccines/schedules/index.html. Updated February 3, 2020. Accessed April 18, 2020.

American Academy of Ophthalmology website. Clinical statement: frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed April 18, 2020.

American Cancer Society website. Breast cancer early detection and diagnosis: American Cancer Society recommendations for the early detection of breast cancer. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Updated March 5, 2020. Accessed April 18, 2020.

American College of Obstetricians and Gynecologists (ACOG) website. FAQ178: Mammography and other screening tests for breast problems. www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems. Updated September 2017. Accessed April 18, 2020.

American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated December 2018. Accessed April 18, 2020.

American College of Obstetricians and Gynecologists. FAQ191: Human papillomavirus vaccination. www.acog.org/patient-resources/faqs/womens-health/hpv-vaccination. Updated June 2017. Accessed April 18, 2020.

American Dental Association website. Your top 9 questions about going to the dentist -- answered. www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed April 18, 2020.

American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2020. Diabetes Care. 2020;43(Suppl 1):S14–S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 12.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2019 Jun 25;73(24):3237-3241]. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/30423393/.

Meschia JF, Bushnell C, Boden-Albala B; 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 pubmed.ncbi.nlm.nih.gov/25355838/.

National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated April 29, 2020. Accessed June 9, 2020.

Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 45.

Siu AL; US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement [published correction appears in Ann Intern Med. 2016 Mar 15;164(6):448]. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.

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 pubmed.ncbi.nlm.nih.gov/26458123/.

Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2019;69(3):184-210. PMID: 30875085 pubmed.ncbi.nlm.nih.gov/pubmed/30875085.

US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(4):429-435. PMID: 27458948 pubmed.ncbi.nlm.nih.gov/27458948/.

US Preventive Services Task Force website. Final recommendation statement. Cervical cancer screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Published August 21, 2018. Accessed April 18, 2020.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published June 15, 2016. Accessed April 18, 2020.

US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(24):2521-2531. PMID: pubmed.ncbi.nlm.nih.gov/29946735/.

US Preventive Services Task Force website. Final recommendation statement. Hepatitis C virus infection in adolescents and adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Published March 2, 2020. Accessed April 18, 2020.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2018 May 15;71(19):2275-2279]. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.


Review Date: 4/19/2020
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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