Health screening - women - age 18 - 39

Definition

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

• Screen for diseases
• Assess risk of future medical problems
• Encourage a healthy lifestyle
• Update vaccinations
• Maintain a relationship with a doctor or nurse in case of an illness

Alternative Names

Information

Even if you feel fine, it is still important to see your health care provider regularly to check for potential problems. Most people who have high blood pressure don't even know it. The only way to find out is to have your blood pressure checked regularly. High blood sugar and high cholesterol levels often do not cause any symptoms until the disease becomes advanced.

There are specific times when you should see your health care provider. Age-specific guidelines are as follows:

BLOOD PRESSURE SCREENING

• Have your blood pressure checked every 2 years unless it is 120-139/80-89 Hg or higher. Then have it checked every year.
• Watch for blood pressure screenings in your area. Ask your health care provider if you can stop in to have your blood pressure checked. Check your blood pressure using the automated machines at local grocery stores and pharmacies.
• If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your doctor or nurse.
• If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.

CHOLESTEROL SCREENING

• Between age 20 and 45, you should be screened if you have a higher risk for heart disease.
• 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, your health care provider will test your blood sugar levels for diabetes.

DENTAL EXAM

• Go to the dentist every year for an exam and cleaning.

EYE EXAM

• If you have vision problems, have an eye exam every 2 years.

IMMUNIZATIONS

• You should receive a flu vaccine 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 ask your doctor or nurse about the vaccine against human papilloma virus (HPV) if you are between ages 18 and 26.
• You should receive two doses of varicella vaccine if you were born after 1980 and never had chickenpox.
• Your doctor or nurse may recommend other immunizations if you are at high risk for certain conditions, such as pneumonia.

PHYSICAL EXAM

• You should have two physical exams in your 20s.
• Healthy young people do not need most blood tests.
• Your height, weight, and body mass index (BMI) should be checked at every exam.
• Your doctor or nurse may ask you about depression, diet and exercise, alcohol and tobacco use, and safety such as seat belts and smoke detectors.

BREAST SELF-EXAM

• Women may do a monthly breast self-exam.
• Women should contact their health care provider immediately if they notice a change in their breasts, whether or not they do breast self-exams.
• A complete breast exam should be done by a health care provider every 3 years for women ages 20-40.

PELVIC EXAM AND PAP SMEAR

• Screening should start within 3 years after first having vaginal intercourse or by age 21.
• Beginning at age 21, women should have a pelvic exam and Pap smear every 2 years to check for cervical cancer.
• If you are over age 30 or your Pap smears have been negative three times in a row, your doctor or nurse may tell you that you only need a Pap smear every 3 years.
• Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears.
• Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.
• Your provider will tell you how to prevent sexually transmitted infections (STIs) if you are sexually active.
• Your health care provider will ask you questions about alcohol and tobacco, and may ask you about depression.

References

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 14.

American College of Obstetricians and Gynecologists. Cervical cytology screening. ACOG Practice Bulletin No. 109. Obstet Gynecol. 2009; 114:1409-1420.

Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States, 2010. A Review of Current American Cancer Society Guidelines and Issues in Cancer Screening. CA Cancer J Clin. 2010; 60(2):99-119.

Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: A guideline from the American Heart Association. Circulation; 2011;123(11):1243-1262.

Centers for Disease Control and Prevention. Recommended adult immunization schedule -- United States, 2011. MMWR Morb Mortal Wkly Rep. 2011; 60(4):1-4.

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