Here are the screening tests and immunizations that most women ages 18 to 39 need. This plan does not include recommendations for pregnancy. Although you and your health care provider may decide that a different schedule is best for you, this plan can guide your discussion.
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Screening
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Who needs it
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How often
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Alcohol misuse
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All adults
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At routine exams
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Blood pressure
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All adults
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Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:
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Every 2 years if blood pressure reading < 120/80 mm Hg, or
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Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg
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Breast cancer
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Women ages 20 years and older*
Women under the age of 20, talk with your health care provider and make an informed decision about performing monthly breast self-exams based on your family history, current medical condition, and personal values
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Clinical breast exam every 3 years*
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Cervical cancer
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Women ages 21 and older
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According to the American Cancer Society (ACS), all women should have Pap tests starting at age 21. Women between ages 21 and 29 should have a Pap test every 3 years. Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years. A woman who has had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious precancer should not be screened. A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
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Chlamydia
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Sexually active women ages 24 and younger, and women at increased risk for infection
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Every 3 years if at risk or if you have symptoms
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Depression
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All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
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At routine exams
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Diabetes mellitus, type 2
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Adults with no symptoms who have sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg
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At least every 3 years
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Gonorrhea
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Sexually active women at increased risk for infection
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At routine exams
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HIV
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Anyone at increased risk for infection
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At routine checkups
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Obesity
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All adults
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At routine checkups
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Syphilis
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Women at increased risk for infection
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At routine exams if at risk
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Tuberculosis
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Anyone at increased risk for infection
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Check with your health care provider
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Vision
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All adults1
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At least one comprehensive exam in your 20s, and two in your 30s
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Counseling
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Who needs it
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How often
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Breast cancer, chemoprevention
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Women at high risk
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When risk is identified
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BRCA mutation testing for breast and ovarian cancer susceptibility
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Women with increased risk
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When risk is identified
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Diet, behavioral counseling
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Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease
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When diagnosed
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Tobacco use and tobacco-related disease
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All adults
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Every visit
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Immunization
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Who needs it
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How often
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Human papillomavirus (HPV)
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Recommended for all females ages 11 to 26
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Three doses
The second dose should be given 1 to 2 months after the first dose, and the third dose should be given 6 months after the first dose
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Tetanus/diphtheria/pertussis (Td/Tdap) booster
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All adults
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Td: every 10 years
Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years
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Chickenpox (varicella)
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All adults ages 19 to 49 who have no documentation of previous infection or vaccinations
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Two doses; the second dose should be given 4 to 8 weeks after the first dose
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Measles, mumps, rubella (MMR) vaccine
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All adults ages 19 to 49 who have no documentation of previous infection or vaccinations
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One or two doses
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Flu vaccine (seasonal)
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All adults
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Yearly, when the vaccine becomes available in the community
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Hepatitis A vaccine
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People at risk2
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Two doses given at least 6 months apart
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Hepatitis B vaccine
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People at risk3
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Three doses; second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)
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Meningococcal
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People at risk4
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One or more doses
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Pneumococcal (polysaccharide)
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People at risk5
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One or two doses
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*According to the ACS, women ages 20 to 39 years should have a clinical breast exam as part of their routine health exam every 3 years, and breast self-exams are an option for women starting in their 20s.
Other guidelines are from the U.S. Preventive Services Task Force
