McKesson Clinical Reference Systems: Women's Health Advisor 2002.2

Routine checkups can find treatable problems early. For many medical problems, early treatment can help prevent more serious problems. The value of checkups and how often you have them depends mainly on your age and sex. Your personal and family medical histories are also important.

The recommendations listed below are based on guidelines developed by the American Academy of Family Physicians and the U.S. Preventive Health Task Force. They are guidelines for how often you should see your health care provider for routine exams, measurements, and lab tests. These schedules should be used for "well care." If you have any ongoing health problems, you will probably need checkups more often.

What needs to be checked and how often?

Health care problems for women vary by age. Abnormal Pap smears and cancer of the cervix are more common in younger women. Breast cancer is more common in middle-aged and older women. For these reasons health care recommendations are different for different age groups.

Women 18 to 39 years old:

• Every year:
  • breast exam
  • Pap smear until you have had three normal ones and if you are still with the same sexual partner; then you can have one Pap smear every 3 years, unless you change partners or have an abnormal Pap smear
  • dental exam.
• Every 2 to 3 years:
  • blood pressure check
  • height and weight measurement
  • brief physical exam, including a pelvic exam, to screen for cancers of the thyroid, lymph nodes, ovaries, and skin.
• Every 5 years:
  • cholesterol check
  • blood sugar test if you are overweight.

Women 40 to 65 years old:

• Every year:
  • physical exam, including a pelvic exam, to screen for cancers of the breast, skin, thyroid, ovaries, uterus, lymph nodes, and rectum; exam includes a Pap smear every 1 to 3 years, depending on your personal history
  • dental exam
  • mammogram if you are 50 years old or older.
• Every 1 to 2 years:
  • height and weight measurement
  • blood pressure check
  • stool sample checked for blood
  • if you are 40 to 49 years old, a mammogram according to the schedule you and your health care provider have determined is best for you, based on your age and risk factors
  • vision and glaucoma check.
• Every 3 to 5 years:
  • cholesterol check
  • blood sugar check
  • sigmoidoscopy or colonoscopy after age 50 to screen for colon cancer.

Women over 65 years old:

• Every 6 months: dental exam.
• Every year:
  • weight measurement
  • blood pressure check
  • mammogram
  • physical exam, including a pelvic exam, to screen for cancers of the skin, breast, thyroid, ovaries, uterus, lymph nodes, and rectum
  • stool sample checked for blood.
• Every 1 to 3 years:
  • blood count
  • cholesterol check
  • blood sugar check
  • hearing check
  • vision and glaucoma check
  • Pap smear (consider discontinuing if previous regular screenings have always produced normal results).
• Every 5 years: consider a sigmoidoscopy or colonoscopy to screen for colon cancer.

What immunizations do I need to get?

Every young woman needs to be protected with a shot against rubella (German measles). If you are not immunized and become infected with the measles virus during pregnancy, the baby could also become infected and develop severe deformities and disabilities. Vaccinations against mumps, measles, and rubella (MMR) are usually given as 2 shots to children after the age of 1 year. If you do not know if you are protected against German measles, you can check with a blood test, or you can have an MMR shot if you are not pregnant.

You should also have the following shots as an adult:

• flu shot every year, especially if you are over 50 years old
• tetanus (Td) booster shot at least every 10 years to protect against lockjaw
• varicella (chickenpox) shot if you have never had a varicella shot and you do not know if you have had chickenpox
• pneumococcal pneumonia shot at age 65.

What other health care problems should be a concern?

You should expect your health care provider to counsel you regularly on other ways to stay healthy. Some of these may include:

• Breast self-exams: Check your breasts every month.
• Substance use: Don't use tobacco. Avoid using alcohol and drugs while driving, swimming, boating, etc.
• Diet and exercise: Try to maintain your weight at a comfortable, healthy level. Limit fat and cholesterol. Include a lot of grains, fruits, and vegetables in your diet. Get regular physical activity or exercise.
• Injury prevention: Use lap and shoulder belts while driving. Use motorcycle and bicycle helmets. Try to prevent falls. Practice safe handling of firearms. Install smoke detectors. Set your hot water heater to less than 120 degrees F. Get CPR training.
• Dental health: Visit your dentist regularly. Brush your teeth with fluoride toothpaste daily. Also floss your teeth daily.
• Sexual behavior: Prevent sexually transmitted diseases by avoiding high-risk sexual behavior and by using condoms.
• Hormone use: During or after menopause, discuss use of estrogen and progesterone replacement with your health care provider.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.