Health screening - women - age 18 - 39?

Answer 1

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 in case of an illness

Alternative NamesHealth maintenance visit - women - age 18 - 39; Physical exam - women - age 18 - 39; Yearly exam - women - age 18 - 39; Checkup - women - age 18 - 39; Women's health - age 18 - 39 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. Likewise, high blood sugar and high cholesterol levels often do not produce 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.
  • If you have Diabetes, Heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Cholesterol screening:
  • By age 45, women should be checked every 5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• 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:
  • After age 19, you should have a tetanus-diphtheria and acellular pertussis (TdAP) vaccine as one of your tetanus-diphtheria vaccines one time. You should have a tetanus-diphtheria booster every 10 years.
  • Your doctor 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.
  • During the first exam, ask to have your cholesterol checked. Other blood tests are not necessary for healthy young people.
  • Your height and weight should be checked at every exam.
• 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 age 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 for 3 times in a row, your doctor 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.

References

U.S. Preventive Services Task Force. Screening for Chlamydial Infection. Rockville, MD: Agency for Healthcare Research and Quality; 2007.

Smith RA, Cokkinides V, Brawley OW. Cancer screening in the United States, 2008: a review of current American Cancer Society guidelines and cancer screening issues. CA Cancer J Clin.2008;58(3):161-179.

Gaziano JM, Manson JE, Ridker PM. Primary and secondary prevention of coronary heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 45.

American Diabetes Assocation. Standards of medical care in diabetes -- 2008. Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.

National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Accessed Feb. 22, 2008.

Answer 2

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 in case of an illness

Alternative NamesHealth maintenance visit - women - age 18 - 39; Physical exam - women - age 18 - 39; Yearly exam - women - age 18 - 39; Checkup - women - age 18 - 39; Women's health - age 18 - 39 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. Likewise, high blood sugar and high cholesterol levels often do not produce 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.
• 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 will be offered 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 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.

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 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

U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services. December 2010.

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.

Mammograms. National Cancer Institute Factsheet. Last reviewed September 22, 2010.

American Academy of Ophthalmology. The Eyes Have It: Exam Frequency. Accessed May 14, 2011.

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

Reviewed By

Review Date: 05/14/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.