16 Health Screenings All Women Need
You feel perfectly fine – and maybe you are. But that’s not always the case, hence why health screenings – physical exams, tests and procedures used to detectdisease early – are so important. From mammograms to colonoscopies and Pap smears, These 16 screenings are what women need according to experts:
All women need regular check-ups with their OB-GYN, starting at age 13 to 15, says Shannon Clark, an associate professor in the Division of Maternal-Fetal Medicine at University of Texas Medical Branch Hospitals. Frequency varies until age 21, when appointments – which cater to preventive health services – should become annual. “It’s very important that all women establish care with an OB-GYN and be routinely seen,” Clark says.
History and physical exam
“History changes for everyone,” says Mary Rosser, an obstetrician and gynecologist at Montefiore Medical Center. An annual reassessment “may flag risk factors early, before they cause harm or lead to serious or chronic medical conditions.” In addition to reviewing changes in family history, doctors should inquire about menstrual history, sexual practices and orientation, social habits, and emotional, physical and sexual abuse. The other component – the physical exam – is an opportunity to assess blood pressure, weight and body mass index, Rosser says.
Clinical breast exam
During this physical exam, a doctor will look at and feel your breasts and under your arms for lumps or anything that seems unusual. CBEs should begin at age 20 and be repeated every one to three years for women ages 20 to 39, and yearly beginning at age 40, Clark says. Self-checks, meanwhile, are easy to do at home – and you ought to check for lumps every month or so.
Mammograms are key to the prevention – and early detection – of breast cancer, Rosser says. This is a low-dose X-ray exam of the breasts, and beginning at age 40, women should undergo yearly mammograms. If you’re at high risk – with a family history of breast cancer, for example – your doctor may recommend earlier mammograms.
All women need to be screened for sexually transmitted diseases once they become sexually active, Clark says. Those 25 and younger should receive yearly gonorrhea and chlamydia screenings; after that age, screening depends on risk factors or symptoms. Screening “consists of a cervical culture or urine test for gonorrhea and chlamydia, and a blood test for HIV,” Clark says.
A colonoscopy can lead to the early detection and treatment of colon cancer, which is the third most common cancer diagnosed in both men and women in the U.S. The screening should start at age 13 to 18 for those with pancolitis or who have a history of familial adenomatous polyposis – a genetic condition that’s diagnosed when someone develops more than 100 adenomatous colon polyps. Women ages 19 to 49, meanwhile, should be screened if they’re high risk – which includes having inflammatory bowel disease or Crohn’s disease. In general, women should undergo a colonoscopy every 10 years starting at age 50, or age 45 for African-Americans, who have increased incidence and earlier age of onset.
Beginning at age 45, women should be screened for diabetes every three years, Rosser says – and earlier if someone is at high risk with factors such as obesity or family history. The disease is “the leading cause of heart disease and on the rise in the U.S. due to the obesity epidemic,” Rosser says. “Early intervention is crucial.”Testing is typically done via a fasting plasma glucose test or hemoglobin A1C test.
Lipid profile assessment
This panel of blood tests will assess your risk of developing heart disease, plus measure your cholesterol and triglyceride levels. Start at age 13 to 44 if you’re at high risk – for example, obese or have a genetic predisposition. Routine screening, repeated every five years, starts at age 45, Rosser says. “There are dietary changes which may reduce these levels,” she adds. “Medications are available if diet changes aren’t working.”
Hepatitis B and C
Women at high risk need to think about these screenings beginning at ages 13 to 18, Clark says. Hepatitis B risk factors, for example, include injection drug users, those born in countries where the prevalence of infection is 2 percent or greater, and HIV-positive people. And risk of hepatitis C increases if you’ve been exposed to an infected needle, perhaps via tattoo; your birth mother had the disease; or you had a blood transfusion before 1992. Screening frequency depends on your doctor’s recommendations.
During a Pap smear, cells are scraped from the opening of the cervix to screen for cervical cancer.Though annual screening is common, the United States Preventive Services Task Force recommends a Pap smear every three years, starting at age 21 and ending at 65. “Any mild irregularities will prompt an HPV test to check for the high-risk strains of the HPV virus,” says Keri Peterson, an internist based in New York.
Human papillomavirus, the most common STD in the U.S., causes cervical and other types of cancer. An HPV test – often done at the same time as a Pap smear – is recommended every five years for women ages 30 to 65. Since HPV is so common in women under 30, and experts say it often goes away on its own, the test typically isn’t recommended for this age group unless there’s an abnormal Pap test result.
Pelvic organ prolapse
About one-third of women are affected by prolapse or a similar condition over their lifetime, which means one or more of their pelvic organs – bladder, uterus, vagina, small bowel and rectum – stop working properly. Beginning at age 65, women should be screened yearly, Peterson says. Often, patients are aware there’s a problem – and notice a change in bladder or bowel habits – but aren’t sure what it traces back to.
Women ages 65 and up should have a bone density scan every two years, Rosser says. And if you have risk factors for osteoporosis – such as an eating disorder or sedentary lifestyle – your doctor may recommend the test at a younger age. During a bone density scan, X-rays measure how many grams of calcium and other bone minerals are in a segment of bone; these tests often center on the spine, hip and forearm.
Thyroid-stimulating hormone testing
This blood test checks for thyroid problems, such as hyperthyroidism or hypothyroidism. It should begin as recommended between ages 19 to 49 in high-risk women – such as those with an autoimmune disease or family history – and every five years starting at age 50, Clark says.
Visit a dermatologist for a thorough skin exam every other year, Peterson says – or sooner if you notice any suspicious spots. “Once a month, check for any new or unusual spots,” she says. “Remember A-B-C-D-E: asymmetry, border irregularity, uneven color, diameter bigger than 6 millimeters and evolving shape and size.”
You know this test: It measures the smallest letters you can read on a standardized chart held 20 feet away. The American Optometric Association recommends eye exams at least once every two years, Peterson says – though annual exams are suggested for anyone with current vision problems. After the basic test, you’ll likely look at an eye chart through a variety of lenses, which will help your doctor determine your glasses or contact lens prescription.