Health Screenings for Women
Having regular check-ups and getting screening tests are important steps that you can do for yourself. Not all experts, though, agree which tests women should have or how often these tests should be done. Most of the guidelines below are from the US Preventive Services Task Force (USPSTF). This is an independent group of experts who review studies and develop recommendations for doctors to follow. Keep in mind that if you have symptoms or risk factors for certain conditions, then this will affect how often you are screened.
What to Expect
Blood Pressure Measurement
During blood pressure measurement , the nurse will wrap a rubber cuff around your upper arm and inflate the cuff. The air will be slowly released. The nurse will use a stethoscope to listen to the pulse beats in your arm. She will measure your "systolic" and "diastolic" blood pressure levels. These levels correspond to the pressure when your heart contracts and relaxes.
If you are aged 18 years or older, you should have your blood pressure routinely measured. While USPSTF does not specify a screening schedule, blood pressure screening usually takes place at each doctor's visit. If your blood pressure is less than 120/80 mmHG, you may be tested every two years. But, if the systolic number is 120-139 mmHG or diastolic number is 80-90 mmHG, you may be tested every year.
Blood Tests
Since your blood travels throughout the body, blood samples can offer a range of information about your health. Usually blood is drawn from your arm with a needle connected to a tube. During your physical exam, you may have a blood test done to check for type 2 diabetes if your blood pressure is over 135/90 mmHG. If you are aged 20 years or older and have increased risk for coronary heart disease, your doctor may also check your cholesterol levels.
USPSTF does not recommend routine screening for conditions like thyroid disorder or anemia. But, if you have symptoms or risk factors, a complete blood count (CBC) may be done to analyze your red blood cells, white blood cells, and platelets.
Urinalysis
An analysis of a urine sample can indicate possible problems, such as diabetes, kidney problems, liver problems, or bacterial infection. Other than during pregnancy, there are few reasons to have a urinalysis for the purpose of health screening (as opposed to diagnosis). If a urinalysis is indicated for you, you will be asked to urinate in a special container.
Clinical Breast Exam
During the clinical breast exam, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. While the USPSTF does not have specific recommendations for this, your doctor may check your breasts at your routine physical exam.
Mammogram
On the day of the mammogram , you should not wear powder, cream, or deodorant on your upper body. If you experience breast tenderness before your period, you may want to schedule the test at a point in your menstrual cycle when your breasts are less sensitive. You will undress from the waist up. Your breasts will be pressed between plates, and x-rays will be taken.
USPSTF offers these guidelines for mammograms:
- If you are aged 40-49 years—The decision to have a mammogram every two years is an individual one. You should make your decision after you understand the risk and benefits that apply to you. Talk to your doctor.
- If you aged 50-74 years—Have a mammogram every two years.
Talk to your doctor about the right screening schedule for you. If you are at high risk for breast cancer , you will need to have mammograms at an earlier age.
Pelvic Exam and Pap Smear
At your routine physical exam, a pelvic exam may be done. During the pelvic exam, you will lie on your back with your knees bent and your feet in footrests. The doctor will feel your pelvic organs and use an instrument called a speculum to look inside your vagina at your cervix. After the pelvic exam, your doctor may also do a Pap smear . This will involve scraping cells from the cervix. These cells will then be sent to a lab to check for signs of infection, disease, and cervical cancer.
If you are sexually active or 21 years old, USPSTF recommends that you get screened for cervical cancer at least every 3 years. If you are aged 65 years or older, you may be able to stop having screenings if you have had normal Pap smears and do not have any risk factors. Your doctor can help you to determine the right screening schedule for you.
Tests for Sexually Transmitted Diseases (STDs)
If you are under the age of 25 and sexually active, then your doctor will likely test you for certain STDs, like chlamydia and gonorrhea . If you are 25 and older and are at an increased risk for STDs or have symptoms, then your doctor may test you for certain STDs. Risk factors include having multiple sex partners, having sex with someone who has an STD, or having sex without a condom. Examples of STDs that you may be tested for include:
Colorectal Exams
These important exams screen for colorectal cancers and other possible problems in your digestive tract, such as an ulcer or infection. If you are aged 50-75 years, USPSTF recommends:
- Fecal occult blood every year—This is a test to detect the presence of blood in the stool.
- Flexible sigmoidoscopy every five years—This is a visual exam of the rectum and lower portion of the colon.
- Colonoscopy every 10 years—This is a visual exam of the rectum and colon.
Skin Exam
While USPSTF does not offer specific guidelines for skin cancer screening, your doctor will most likely exam your skin during your routine physical exam. You doctor will look for suspicious moles that have uneven borders, have more than one color, are asymmetrical shape, or are a size larger than a pencil eraser. If you notice any new or changing moles, tell your doctor.
Other Health Exams
Beyond your physical exam, it is also important that your oral and eye health are checked.
Dental Exams
The American Dental Association recommends that you have regular dental cleanings and oral exams. This may occur every six months, or more often if you are prone to plaque or gingivitis . Proper dental hygiene also includes:
- Brushing teeth with fluoride toothpaste after meals or at least twice per day
- Daily flossing between teeth and gums
Eye Exam
During an eye exam, you may need to read letters on a chart, set at a distance. You may get eye drops to numb your eye or dilate your pupil to test for glaucoma and to check your retina. Your eye specialist (ophthalmologist) may test how your eye moves and responds to light. How often you should have eye exams depends on factors, like your age, medical history, and date of your last exam. The American Academy of Ophthalmology offers these general guidelines:
- If you are aged 20-39 years—Have an eye exam at least once between the ages of 20-29, and at least twice between the ages of 30-39.
- If you are aged 40-64 years—Get a baseline screening at age 40, then get follow-up exams based on the results.
- If you are aged 65 or older—Get an eye exam every 1-2 years.
Getting regular exams can be part of your healthy lifestyle.
RESOURCES:
Lab Tests Online
http://www.labtestsonline.org/
Women's Health.gov
http://www.womenshealth.gov/
CANADIAN RESOURCES:
Canadian Women's Health Network
http://www.cwhn.ca/en
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
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Last reviewed March 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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