A Guide to Recommended Screenings for Women
It’s no secret that women are often more focused on caring for their families or their careers than they are in making their own health a priority. Furthermore, there is a common misconception that women’s health mostly relates to childbirth and gynecology. The truth is that women have a wide variety of unique health needs during each decade of their life.
Here is a guide to recommended screenings for women during key life stages:
A young woman should have her first gynecologist appointment between the ages of 13 and 15. During her teen years, a gynecological exam will typically include a medical history talk. This is a great opportunity for teenage patients to learn more about caring for their bodies. These exams also include a basic physical and breast exam. An external examination of the genitalia will also be performed in order to check for any swelling, sores, or other issues. An internal examination is usually only necessary if other problems have been discovered. Pap smears are not necessary until the age of 21. STD testing is not necessary unless the gynecologist has reason to believe the patient is or has been sexually active.
20s and 30s
Women between 20 and 30 years of age can use their Body Mass Index (BMI), a simple calculation of body weight in relation to height, to determine whether or not their weight is within a normal, healthy range. Starting at 20 years of age, women should begin getting cholesterol screenings every five years. Women should also have their first Pap test and pelvic exam between 18 and 21 years of age, and subsequently every three years after their initial checkup. Women with a strong family history of ovarian cancer should also begin screenings for ovarian cancer during this time in their lives.
As women age, so do the number of recommended screenings. Women between 40 and 64 years of age should have their blood pressure checked every two years. After age 45, it’s important to have a blood glucose screening. This may be recommended earlier if women have risk factors for diabetes, such as obesity, family history, high blood pressure and inactive lifestyles. Starting at 40 years of age, women should also begin having breast exams and mammograms every one to two years for the prevention and early detection of breast cancer.
50s and 60s
After 50 years of age, women experience an increased likelihood of some health conditions so a few more screenings are recommended. In addition to the exams and screenings conducted in their 40s, women beginning their 50s should be screened for colon cancer. A physician should recommend the frequency of colon cancer screenings, which are based on risk factors, including family and personal medical history and lifestyle-related factors. All women, especially those older than 50 years of age, should notify their physicians of any skin changes, which could be indicative of skin cancer. For women age 65 years and older, bone density screenings for the prevention and/or early detection of osteoporosis becomes extremely important. These screenings may be recommended sooner than age 65 years if a woman possesses applicable risk factors.
Most likely, there is someone in your life who has been affected by breast cancer. According to the American Cancer Society, breast cancer is the most common cancer among American women, except for skin cancers. About 1 in 8 (12 percent) women in the US will develop invasive breast cancer during their lifetime. The American Cancer Society estimates that approximately 226,870 new cases of invasive breast cancer will be diagnosed in women and approximately 39,510 women will die from breast cancer in 2012.
There is an effective screening method for the early detection of breast cancer. Regular mammograms are the most effective tool for helping detect breast cancer early, sometimes even before anything can be felt during a physical exam. With routine screenings, breast cancer can be found in its early stages, when it can be more easily and successfully treated.
What is breast cancer and what are the risks?
Breast cancer is an abnormal overgrowth of the cells in the breast that leads to a malignant tumor. Some risks for breast cancer include being 50 years of age or older, prior personal history of breast cancer, family history of breast cancer, genetic factors and gynecological history.
Who should be screened?
Every woman more than 40 years of age or who has risk factors for breast cancer should be screened.
What is the screening process?
The screening process should include annual visits to a physician for yearly breast exams and to discuss any questions or concerns. A physician may recommend monthly self–breast exams as well. You should have your first mammogram at 40 years of age and then again every one to two years. After age 50, you should have yearly mammograms. Make an appointment to speak with your doctor if you have symptoms, breast changes or a family history of breast cancer, as earlier testing may be recommended.
What is a mammogram?
A mammogram is a special type of X-ray test of the breasts. It looks for early signs of breast cancer or other abnormalities. Digital mammography, which provides more detailed views of the breast, is recommended.
What if the mammogram results are abnormal?
An abnormal mammogram does not automatically mean that breast cancer has been found. Make sure to follow up with a doctor, who will recommend other tests or exams (for example, MRIs, ultrasounds or biopsies) and may refer you to a breast specialist or surgeon. These additional tests or exams will need to be completed before a definite diagnosis can be made.
Are all breast changes bad?
No. Breast changes may be related to normal variances, hormonal changes, infections or benign lumps. You should see your doctor if you notice breast changes such as lumps, swelling, warmth, redness, dimpling or puckering, itching, rash, sudden nipple discharge or bleeding, persistent pain or changes in size or shape.
Where can I get a mammogram?
A well-woman exam is an annual checkup for women who are sexually active and/or over the age of 18. Your well-woman exam is an opportunity to have health problems checked out, get screened for potential health problems, and set health goals. At Steward Medical Group Women’s Health Associates, board-certified health care providers use the well-woman exam as an opportunity to form bonds with their patients and encourage them to take matters of their own health seriously.
Why have a well-woman exam?
Numerous studies have shown that patients who have a primary care physician (PCP) tend to live longer, healthier lives. (For women, this PCP role is sometimes fulfilled by an OB/GYN, midwife or women’s health nurse practitioner. But, it’s best to always ask first if the provider can assume this role.) There are many reasons for the PCP/good health correlation. For one, if you regularly see a primary care provider, then you have the benefit of a physician who’s familiar with your health history, goals, and the progression of your particular health conditions. Also, your go-to provider can help coordinate more advanced care, referring you to specialists and surgeons when necessary. This saves time and money in the event of a serious illness. Lastly, when you do get sick, having a PCP makes the decision of who to go to an easy one.
What happens in a well-woman exam?
There are several components to a well-woman exam:
Your Well-Woman exam may begin with a conversation about your medical/health history. If this is your first visit with an OB/GYN or midwife, then this conversation is especially important, as it allows your healthcare provider an opportunity to get to know you and your special needs. All of the following topics may be up for discussion during this part of the exam: exercise, nutrition, sexual activity, menstrual cycles, use of alcohol, tobacco, and drugs, and your family history with certain diseases. If your gynecologist neglects to bring up an issue you feel is important, then feel free to speak up. Your Well-Woman exam is your opportunity to get the education and treatment you deserve. It’s up to you to make the most of it!
A doctor or a nurse may perform your physical exam. In this part of the exam, the healthcare professional will measure your height and weight, calculate your body mass index (BMI), and check your blood pressure. Certain screenings, such as a breast exam and pelvic exam (discussed below), are routine for all women. Depending on your age, sexual activity, and other risk factors, your healthcare team at Steward Medical Group Women’s Health Associates may perform additional screenings, including:
- Screenings for certain types of cancer
- HPV testing
- HIV and STD testing
- High blood pressure
If you are at high-risk for a particular health condition, your provider may recommend additional screenings.
Every woman should have an annual clinical breast exam. During the exam, your provider will ask you to slowly raise the arms. The gynecologist will look for any abnormalities and use the pads of three fingers to feel for any lumps. This exam is then performed once more while you lie on your back. All women should perform a version of this test themselves (a “breast self-exam,” BSE) on a monthly basis. If you have any questions about how to do this, you should feel free to ask your gynecologist at Steward Medical Group Women’s Health Associates.
Pelvic Exam & Pap Smear
During a pelvic exam, your gynecologist examines the outer parts of your sexual organs, as well as the inner organs using a speculum. This annual exam is useful for detecting and diagnosing any abnormalities in the reproductive system. A pap smear is another test that should be done as a part of your wellness exam. In this test, which screens for signs of cancer, a small spatula and brush are used to take sample cells from the cervix. The cells are then sent to a lab for testing. Though the test is not painful, you may find it a little uncomfortable.
Who should have a pap smear?
The American College of Obstetricians and Gynecologists provides the following pap smear recommendations:
- Women ages 21-29: pap test once every three years
- Women ages 30-65: pap test and HPV test once every five years (preferred). It is acceptable to have a pap test alone (without HPV testing) every three years.
Once testing is complete, your gynecologist may ask you about your current health goals. Some of these goals – such as “quit smoking” and “lose weight” – you may have had since well before your appointment. Other goals may come to mind over the next few days or weeks as you process what you learned during your Well-Woman exam.
Whatever your health goals may be, your gynecologist at Steward Medical Group Women’s Health Associates is here to help you achieve them. If you would like to discuss a health issue that your gynecologist did not bring up during your Well-Woman exam, please feel free to do so. Well-Woman exams are available through Steward Medical Group Women’s Health Associates in Gilbert, Mesa and Tempe, AZ.
Schedule a Well-Woman Exam in Gilbert, Mesa or Tempe, AZ
To schedule your well-woman exam with a board-certified OB/GYN or midwife call Steward Medical Group Women’s Health Associates at 480-632-2004.
This information is provided by Steward Medical Group Women’s Health Associates as general information only. Please note, this information should not substitute a medical checkup or consultation with a physician.