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Health screenings for women ages 18 to 39

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

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 or receive specific health screenings. The US Preventive Services Task Force publishes a list of recommended screenings. Below are screening guidelines for women ages 18 to 39.

BLOOD PRESSURE SCREENING

Your blood pressure should be checked at least once every 3 to 5 years if:

  • Your blood pressure is in the normal range (top number less than 120 mm Hg and bottom number less than 80 mm Hg)
  • You don't have risk factors for high blood pressure

Your blood pressure should be checked every year if any of the following are true:

  • The top number is 120 to 129 mm Hg or the bottom number is 70 to 79 mm Hg
  • You have diabetes, heart disease, kidney problems, are overweight, or have certain other health conditions
  • You have a first-degree relative with high blood pressure
  • You are Black
  • You had high blood pressure during a pregnancy

If the top number is 130 mm Hg or greater or the bottom number is 80 mm Hg or greater, this is considered stage 1 hypertension. Schedule an appointment with your provider to learn how you can reduce your blood pressure.

Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.

BREAST CANCER SCREENING

  • 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.

Your provider may discuss and recommend mammograms, MRI scans, or ultrasounds if you have an increased risk for breast cancer, such as:

  • A mother or sister who had breast cancer at a young age (most often starting screening earlier than the age the close relative was diagnosed)
  • You carry a high-risk genetic marker

CERVICAL CANCER SCREENING

Cervical cancer screening should start at age 21 years.

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 or both tests every 5 years (called "cotesting").
  • 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.

CHOLESTEROL SCREENING

Cholesterol screening should begin at:

  • Age 45 for women with no known risk factors for coronary heart disease
  • Age 20 for women with known risk factors for coronary heart disease

Repeat cholesterol screening should take place:

  • Every 5 years for women with normal cholesterol levels
  • More often if changes occur in lifestyle (including weight gain and diet)
  • More often if you have diabetes, heart disease, kidney problems, or certain other conditions

DIABETES SCREENING

You should be screened for diabetes starting at age 35 and then repeated every 3 years if you have no risk factors for diabetes.

Screening may need to start earlier and be repeated more often if you have other risk factors for diabetes (01_001214), such as:

  • You have a first degree relative with diabetes.
  • You are overweight or have obesity.
  • You have high blood pressure, prediabetes, or a history of heart disease.

Screening for diabetes should be done if you are planning to become pregnant and you are overweight and have other risk factors such as high blood pressure.

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.
  • You should have an eye exam that includes an examination of your retina (back of your eye) at least every year if you have diabetes.

IMMUNIZATIONS

Commonly needed vaccines include:

  • Flu shot: get one every year.
  • Tetanus-diphtheria and acellular pertussis (Tdap) vaccine: have one at or after age 19 as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent.
  • Tetanus-diphtheria: have a booster (or Tdap) every 10 years.
  • Varicella vaccine: receive 2 doses if you never had chickenpox or the varicella vaccine.
  • Hepatitis B vaccine: receive 2, 3, or 4 doses, depending on your exact circumstances.
  • Measles, mumps, and rubella (MMR) vaccine: receive 1 to 2 doses if you are not already immune to MMR. Your provider can tell you if you are immune.

Ask your provider about the human papillomavirus (HPV) vaccine if:

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

Ask your provider if you should receive other immunizations if you have certain health problems that increase your risk for some diseases such as pneumonia.

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 for chlamydia and gonorrhea if at high risk.

Screening for hepatitis C:

  • All adults ages 18 to 79 should get a one-time test for hepatitis C.
  • Pregnant people should be screened at every pregnancy.

Screening for human immunodeficiency virus (HIV):

  • All people ages 15 to 65 should get a one-time test for HIV.

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

All adults should visit their provider from time to time, even if they are healthy. The purpose of these visits is to:

  • Screen for disease
  • Assess your risk of future medical problems
  • Encourage a healthy lifestyle
  • Update your vaccinations
  • Maintain a relationship with a provider in case of an illness

Your height, weight, and BMI should be checked at every exam.

During your exam, your provider may ask you about:

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

SKIN SELF-EXAM

Your provider may check your skin for signs of skin cancer, especially if you're at high risk, such as if you:

  • Have had skin cancer before
  • Have close relatives with skin cancer
  • 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, 2022. www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. Updated February 17, 2022. Accessed August 9, 2022.

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 August 9, 2022.

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 January 14, 2022. Accessed August 9, 2022.

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 November 2020. Accessed August 9, 2022.

American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated April 2021. Accessed August 9, 2022.

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 August 9, 2022.

American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Suppl 1):S17-S38. PMID: 34964875. pubmed.ncbi.nlm.nih.gov/34964875/.

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.

Centers for Disease Control and Prevention website. HIV testing. www.cdc.gov/hiv/testing/index.html. Updated June 9, 2022. Accessed August 9, 2022.

Centers for Disease Control and Prevention website. Human papillomavirus (HPV). HPV vaccine schedule and dosing. www.cdc.gov/hepatitis/hcv/index.htm. Updated November 1, 2021. Accessed August 9, 2022.

Centers for Disease Control and Prevention website. Viral hepatitis. www.cdc.gov/hepatitis/hcv/index.htm. Updated July 28, 2020. Accessed August 9, 2022.

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/.

Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated February 10, 2022. Accessed August 9, 2022.

US Preventive Services Task Force website. A and B recommendations. www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: Medication use to reduce risk. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-medications-for-risk-reduction. Updated September 3, 2019. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. Updated January 11, 2016. Accessed August 9, 2022.

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 August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed August 9, 2022.

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 August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Human immunodeficiency virus (HIV) infection: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Published June 11, 2019. Accessed August 9, 2022.

US Preventive Services Task Force website. Hypertension in adults: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening. Published April 27, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Osteoporosis to prevent fractures: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening. Published June 26, 2018. Accessed August 9, 2022.

US Preventive Services Task Force, Davidson KW, Barry MJ, Mangione CM, et al. Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(8):736-743. PMID: 34427594 pubmed.ncbi.nlm.nih.gov/34427594/.

US Preventive Services Task Force website. Prediabetes and type 2 diabetes: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes. Published August 24, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Skin cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/skin-cancer-screening. Updated April 18, 2023. Accessed April 21, 2023.

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/.

  • Physical exam frequency

    Animation

  •  

    Physical exam frequency - Animation

    When you feel perfectly fine, the last thing you want to think about is going to the doctor. But that's exactly when you should be thinking about getting a physical exam. Regular physicals, as well as certain tests and vaccinations can be powerful ways to protect health. Let's talk about physical exams. You might feel well on the outside, but it's hard to know exactly what's going on inside your body. Many conditions that threaten your health don't have any symptoms. For example, you might have no idea that you have high blood pressure or high cholesterol, until they make you really sick. How often you need to see your doctor and what tests you get depends on your age and gender. Regular physicals are important for keeping tabs on your health. Plan to see your doctor once every 1 to 5 years, depending on what conditions you have. After age 65, you'll visit the doctor at least once a year. At each physical, your height and weight will be checked and your hearing will be tested. Your doctor should ask whether you've experienced depression, and about your use of alcohol and tobacco. Get your blood pressure checked once every two years, once a year if you're over 65. Look for blood pressure screenings at health fairs or drug stores in your area, or visit your doctor. If you have a health condition like diabetes, heart disease, or kidney problems, you may need to check your blood pressure more often. If your blood pressure is high, you should also have your blood sugar levels tested for diabetes. Men who are over 34 and women over 45 need a cholesterol test once every 5 years. People with certain health conditions may need to have their cholesterol checked more often. Everyone between ages 45 and 75 should be screened for colon cancer. You can have a colonoscopy every 10 years, a stool test every year, or a flexible sigmoidoscopy every 5 years. Women need a Pap smear to check for cervical cancer once every 2 to 3 years. They should also have a mammogram to check for breast cancer every 1 to 2 years, depending on their risks. Because bones can become brittle with age, women over 65 need to have a bone density scan. Younger women and men should talk to their doctor about whether they need this test, based on their risks. To keep your teeth strong and healthy, visit your dentist once a year for a cleaning and exam. Also see an eye doctor for an exam every 2 years, especially if you have glaucoma or another vision problem. One of the best ways to avoid unexpected doctor's visits is to get the vaccines that are right for you. Vaccines aren't just a kids issue. Many adults benefit from a flu vaccine each fall or early winter to protect them for the whole season. Once every 10 years, get a Tdap vaccine, which protects against tetanus, diphtheria, and acellular pertussis. Older adults may also need to get vaccinated against pneumonia and shingles. Getting regular physicals when you aren't sick can help you stay on top of your health. Being proactive will let you and your doctor prevent and find potential problems before you have a chance to get sick.

  • Pap smear

    Animation

  •  

    Pap smear - Animation

    If you're a woman 21 or over, it's important to begin getting regular pelvic examinations to take charge of your health. An important part of this pelvic exam may include a test, called a Pap smear, to detect the often life-threatening disease, cervical cancer, even before it starts. And here's the key, cervical cells become abnormal years before they turn to cancer. That gives an excellent window of opportunity. So, what is a Pap smear? A Pap smear is a microscopic examination of cells scraped from the opening of the cervix. The cervix is the lower part of the uterus, or womb, that opens at the top of the vagina. The test looks for cervical cancer or abnormal cells. Most cervical cancers can be found, and treated early, or even before they start, if women have routine Pap smears and pelvic examinations. For this test, you will lie on a table and place your feet in stirrups. The doctor will insert an instrument called a speculum into the vagina and open it slightly to see inside the vaginal canal. Cells are gently scraped from the cervix area, and sent to a lab for examination. When a Pap smear shows abnormal changes, you will need further testing. The next step depends on the results of the Pap smear, and on your previous history of Pap smears, and risk factors you may have for cervical cancer. You may need a biopsy using a light and a low-powered microscope, called colposcopy. You may also need a test to check for infection with human papilloma virus, or HPV, which can cause cervical cancer. If you are diagnosed with cervical cancer, the doctor will order more tests to determine how you should be treated, and how far the cancer has spread. This is called staging. Treatment will depend on the stage of the cancer, the size and shape of the tumor, your age and general health, and your desire to have children in the future. Early cervical cancer can be treated with surgery to remove the abnormal tissue, or freeze abnormal cells, or burn abnormal tissue. Treatment for more advanced cervical cancer may include radical hysterectomy, removal of the uterus and much of the surrounding tissue, including lymph nodes and the upper part of the vagina. Radiation may be used to treat cancer that has spread beyond the pelvis, or if cancer returns. The woman may also have chemotherapy to kill the cancer if the cervical cancer's advanced. The Pap smear test is not 100% accurate and cervical cancer may be missed in a small number of cases. Fortunately, cervical cancer develops very slowly in most women and follow-up Pap smears should identify worrisome changes in plenty of time for treatment. Make sure your doctor knows about all the medicines you are taking. Some, including estrogen and progestins, may affect the result of your Pap smear. Pap smears can be a wonderful, life saving tool.

  • Pap smear - illustration

    A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.

    Pap smear

    illustration

  • Physical exam frequency

    Animation

  •  

    Physical exam frequency - Animation

    When you feel perfectly fine, the last thing you want to think about is going to the doctor. But that's exactly when you should be thinking about getting a physical exam. Regular physicals, as well as certain tests and vaccinations can be powerful ways to protect health. Let's talk about physical exams. You might feel well on the outside, but it's hard to know exactly what's going on inside your body. Many conditions that threaten your health don't have any symptoms. For example, you might have no idea that you have high blood pressure or high cholesterol, until they make you really sick. How often you need to see your doctor and what tests you get depends on your age and gender. Regular physicals are important for keeping tabs on your health. Plan to see your doctor once every 1 to 5 years, depending on what conditions you have. After age 65, you'll visit the doctor at least once a year. At each physical, your height and weight will be checked and your hearing will be tested. Your doctor should ask whether you've experienced depression, and about your use of alcohol and tobacco. Get your blood pressure checked once every two years, once a year if you're over 65. Look for blood pressure screenings at health fairs or drug stores in your area, or visit your doctor. If you have a health condition like diabetes, heart disease, or kidney problems, you may need to check your blood pressure more often. If your blood pressure is high, you should also have your blood sugar levels tested for diabetes. Men who are over 34 and women over 45 need a cholesterol test once every 5 years. People with certain health conditions may need to have their cholesterol checked more often. Everyone between ages 45 and 75 should be screened for colon cancer. You can have a colonoscopy every 10 years, a stool test every year, or a flexible sigmoidoscopy every 5 years. Women need a Pap smear to check for cervical cancer once every 2 to 3 years. They should also have a mammogram to check for breast cancer every 1 to 2 years, depending on their risks. Because bones can become brittle with age, women over 65 need to have a bone density scan. Younger women and men should talk to their doctor about whether they need this test, based on their risks. To keep your teeth strong and healthy, visit your dentist once a year for a cleaning and exam. Also see an eye doctor for an exam every 2 years, especially if you have glaucoma or another vision problem. One of the best ways to avoid unexpected doctor's visits is to get the vaccines that are right for you. Vaccines aren't just a kids issue. Many adults benefit from a flu vaccine each fall or early winter to protect them for the whole season. Once every 10 years, get a Tdap vaccine, which protects against tetanus, diphtheria, and acellular pertussis. Older adults may also need to get vaccinated against pneumonia and shingles. Getting regular physicals when you aren't sick can help you stay on top of your health. Being proactive will let you and your doctor prevent and find potential problems before you have a chance to get sick.

  • Pap smear

    Animation

  •  

    Pap smear - Animation

    If you're a woman 21 or over, it's important to begin getting regular pelvic examinations to take charge of your health. An important part of this pelvic exam may include a test, called a Pap smear, to detect the often life-threatening disease, cervical cancer, even before it starts. And here's the key, cervical cells become abnormal years before they turn to cancer. That gives an excellent window of opportunity. So, what is a Pap smear? A Pap smear is a microscopic examination of cells scraped from the opening of the cervix. The cervix is the lower part of the uterus, or womb, that opens at the top of the vagina. The test looks for cervical cancer or abnormal cells. Most cervical cancers can be found, and treated early, or even before they start, if women have routine Pap smears and pelvic examinations. For this test, you will lie on a table and place your feet in stirrups. The doctor will insert an instrument called a speculum into the vagina and open it slightly to see inside the vaginal canal. Cells are gently scraped from the cervix area, and sent to a lab for examination. When a Pap smear shows abnormal changes, you will need further testing. The next step depends on the results of the Pap smear, and on your previous history of Pap smears, and risk factors you may have for cervical cancer. You may need a biopsy using a light and a low-powered microscope, called colposcopy. You may also need a test to check for infection with human papilloma virus, or HPV, which can cause cervical cancer. If you are diagnosed with cervical cancer, the doctor will order more tests to determine how you should be treated, and how far the cancer has spread. This is called staging. Treatment will depend on the stage of the cancer, the size and shape of the tumor, your age and general health, and your desire to have children in the future. Early cervical cancer can be treated with surgery to remove the abnormal tissue, or freeze abnormal cells, or burn abnormal tissue. Treatment for more advanced cervical cancer may include radical hysterectomy, removal of the uterus and much of the surrounding tissue, including lymph nodes and the upper part of the vagina. Radiation may be used to treat cancer that has spread beyond the pelvis, or if cancer returns. The woman may also have chemotherapy to kill the cancer if the cervical cancer's advanced. The Pap smear test is not 100% accurate and cervical cancer may be missed in a small number of cases. Fortunately, cervical cancer develops very slowly in most women and follow-up Pap smears should identify worrisome changes in plenty of time for treatment. Make sure your doctor knows about all the medicines you are taking. Some, including estrogen and progestins, may affect the result of your Pap smear. Pap smears can be a wonderful, life saving tool.

  • Pap smear - illustration

    A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.

    Pap smear

    illustration

 

Review Date: 4/30/2022

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. Editorial update 04/18/2023.

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