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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

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 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.

CHOLESTEROL SCREENING

  • 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.

DIABETES SCREENING

  • 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.

DENTAL EXAM

  • 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.

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.
  • 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 3 shots)
  • Not completed the full vaccine series (you should catch up on this shot)

PHYSICAL EXAM

  • 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:

  • Depression
  • 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.

SKIN SELF-EXAM

  • 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.

OTHER SCREENING

  • 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.

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

References

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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.

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Review Date 5/22/2015

Updated 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.

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