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Prevention Guidelines for Women 18-39

Prevention Guidelines for Women 18–39

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.

Screening

Who needs it

How often

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:

  • Every 2 years if blood pressure reading < 120/80 mm Hg, or

  • Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg

Breast cancer

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

Clinical breast exam every 3 years*

Cervical cancer

Women ages 21 and older

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.

Chlamydia

Sexually active women ages 24 and younger, and women at increased risk for infection

Every 3 years if at risk or if you have symptoms

Depression

All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

At routine exams

Diabetes mellitus, type 2

Adults with no symptoms who have sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At least every 3 years

Gonorrhea

Sexually active women at increased risk for infection

At routine exams

HIV

Anyone at increased risk for infection

At routine checkups

Obesity

All adults

At routine checkups

Syphilis

Women at increased risk for infection

At routine exams if at risk

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider

Vision

All adults1

At least one comprehensive exam in your 20s, and two in your 30s

Counseling

Who needs it

How often

Breast cancer, chemoprevention

Women at high risk

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with increased risk

When risk is identified

Diet, behavioral counseling

Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease

When diagnosed

Tobacco use and tobacco-related disease

All adults

Every visit

Immunization

Who needs it

How often

Human papillomavirus (HPV)

Recommended for all females ages 11 to 26

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

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All adults

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

Chickenpox (varicella)

All adults ages 19 to 49 who have no documentation of previous infection or vaccinations

Two doses; the second dose should be given 4 to 8 weeks after the first dose

Measles, mumps, rubella (MMR) vaccine

All adults ages 19 to 49 who have no documentation of previous infection or vaccinations

One or two doses

Flu vaccine (seasonal)

All adults

Yearly, when the vaccine becomes available in the community

Hepatitis A vaccine

People at risk2

Two doses given at least 6 months apart

Hepatitis B vaccine

People at risk3

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)

Meningococcal

People at risk4

One or more doses

Pneumococcal (polysaccharide)

People at risk5

One or two doses

*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.

**Exceptions may exist; please discuss with your health care provider

1Recommendation from the American Academy of Ophthalmology

2For complete list, see the CDC website

3For complete list, see the CDC website

4People ages 19 to 21 years and who are first-year college students or have one of several medical conditions

5For complete list, see the CDC website

Other guidelines are from the U.S. Preventive Services Task Force

Immunization schedule from the CDC

 

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