A healthy life: Advice for women in their 20s, 30s and 40s

Find out which preventive screenings are the best for you.

By: Lacey Krebsbach, MD .

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Benjamin Franklin has been credited as saying “an ounce of prevention is worth a pound of cure”. His idea was to be proactive to find and minimize risks before they turn into problems. This is the exact idea behind preventative medicine and screening tests. In medicine today we focus much of our attention on diagnosing and treating medical problems that are already there. We should also focus our attention on preventing those problems from developing.

And how do we do that, you might ask? By screening you for risk factors. You may not realize this, but your annual physical exam (you know, the one that we ALL get every year) is one big screening test. Guidelines and recommendations for when you may need specific tests do change, but the annual exam is still very important to help prevent disease.

There are certain things that every woman should be screened for every year. When we measure your height, weight and body mass index (BMI), it gives us so much more information than your dress size. It helps us to find women at risk for diabetes, heart disease and osteoporosis.

Blood pressure measurements and other vital signs may indicate a risk for cardiovascular disease. All women should be screened for safety, depression, and tobacco and alcohol use every year. There are also immunizations that are recommended yearly for most people, such as the flu shot. Immunizations are viewed as preventative medicine too, something to keep you healthy and avoid a serious medical problem.

Every woman should see her primary care doctor once a year for an annual exam and screening. During that time your doctor will figure out what diseases you may be at high risk for (risk factors). Your risk factors can come from your past medical problems, your lifestyle, your family history of disease, or current medications that you are using. This is why it is important to discuss these risks honestly with your doctor. Also, there are specific things that you may need to be screened for depending on your age. So, let me get more specific.

Women in their 20’s need:

  • Annual exam with pelvic exam and breast exam
  • Practice breast self-awareness at home
  • At age 21 and over: Pap smear every one to three years depending on your risks and history
  • Sexually transmitted disease screening: gonorrhea and chlamydia annually until at least 25 years old. Longer if you have risk factors
  • HIV testing at least once, maybe annually depending on your risks
  • HPV immunizations up to age 26
  • Meningococcal immunization, first year college students up to age 21 living in the dorm
  • If you have certain risk factors, you may also need screening for skin cancer, high cholesterol, diabetes or Hepatitis B and C

Women in their 30’s need:

  • Annual exam with pelvic exam and breast exam
  • Practice breast self-awareness at home
  • Pap smears: every three to five years depending on your history and risks and type of test done
  • Sexually transmitted disease screening if high risk
  • HIV testing at least once or annually depending on your risks
  • If you have certain risk factors, you may also need screening for skin cancer, high cholesterol, diabetes or Hepatitis B and C

Women in their 40’s need:

  • Annual exam with pelvic exam and breast exam
  • Practice breast self-awareness at home
  • Mammograms*
  • Pap smears: every three to five years depending on your history and risks and type of test done
  • Sexually transmitted disease screening if high risk
  • HIV testing at least once or annually depending on your risks
  • If you have certain risk factors, you may also need screening for skin cancer, high cholesterol, diabetes, Hepatitis B and C, and colon cancer

*Not all organizations agree on mammogram guidelines. For instance, ACOG (American College of Obstetrics and Gynecology) recommends annual mammograms starting at age 40. The American Cancer Society, the National Comprehensive Cancer Network and other organizations recommend that women begin in their 40s. But the U.S. Preventive Services Task Force mammogram guidelines recommend women begin screening at age 50. Some organizations recommend screening every year and others recommend screening every two years.

As you can see the annual exam and screening tests are not a “one size fits all.” You need to make an appointment to discuss your personal risk factors and which tests are recommended for you.