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The information contained on this page is provided as general health information and is not intended to substitute as medical advice and direction from your physician or health care provider. Please direct any questions related to your health care provider. In an emergency, call 9-1-1 or go to the nearest emergency center.


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 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 the top number is greater than 140 or the bottom number is greater than 90, schedule an appointment with your provider.
  • 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.

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 140/80 mm Hg or above, 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. 
  • 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.
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.
  • 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.
  • 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
  • Not completed the full vaccine series (you should catch up on this shot)

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 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 about alcohol and tobacco and may ask you about depression.

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

American Academy of Ophthalmology website. Policy statement: frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed June 1, 2018.

American Cancer Society website. Breast cancer early detection and diagnosis. www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-toc. Updated October 9, 2017. Accessed June 1, 2018.

American College of Obstetricians and Gynecologists (ACOG) website. Mammography and other screening tests for breast problems. www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems. Updated September 2017. Accessed June 1, 2018.

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. 168: cervical cancer screening and prevention. Obstet Gynecol. 2016;128(4):e111-e130. PMID: 27661651 www.ncbi.nlm.nih.gov/pubmed/27661651.

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 June 1, 2018.

American Diabetes Association. Standards of medical care in diabetes -- 2018. Diabetes Care. 2018;41(Suppl 1):S1-S2. PMID: 29222369 www.ncbi.nlm.nih.gov/pubmed/29222369.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 15.

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. 704 summary: human papillomavirus vaccination. Obstet Gynecol. 2017;129(6):1155-1156. PMID: 28538494 www.ncbi.nlm.nih.gov/pubmed/28538494.

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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, Riley LE, Harriman KH, Hunter P; Advisory Committee on Immunization Practices. Recommended immunization schedule for adults aged 19 years or older, United States, 2018. Ann Intern Med. 2018;168(3):210-220. PMID: 29404596 www.ncbi.nlm.nih.gov/pubmed/29404596.

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 www.ncbi.nlm.nih.gov/pubmed/25355838.

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.

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Stone NJ, Robinson JG, 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):S1-S45. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.

US Preventive Services Task Force website. Draft evidence review for cervical cancer: screening, October 2017. www.uspreventiveservicestaskforce.org/Page/Document/draft-evidence-review/cervical-cancer-screening2. Accessed June 1, 2018.

US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(23):2564-2575. PMID: 27304597 www.ncbi.nlm.nih.gov/pubmed/27304597.

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 www.ncbi.nlm.nih.gov/pubmed/27458948.