Prevention Guidelines for Women 18-39

Here are the screening tests and immunizations that most women ages 18 to 39 need. 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 and pregnant women

At routine exams

Anemia - Iron Deficiency

All pregnant women

At prenatal visits, especially the first

Asymptomatic Bacteriuria (with urine culture)

All pregnant women

At 12–16 weeks' gestation or the first prenatal visit, if later

Blood pressure

All adults

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

Every two years if blood pressure reading < 120/80 mm Hg, and

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

Breast cancer

Women ages 20 years and older*

Women under the age of 20 years, talk to 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 three years*

Cervical cancer

Women ages 21 and older

According to the American Cancer Society, all women should have Pap tests starting at age 21. Women between ages 21 and 29 should have a Pap test every three years. Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every five years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every three 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 pre-cancer 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, pregnant women ages 24 and younger, and women at increased risk for infection

At routine exams

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 who are asymptomatic with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At routine exams

Gonorrhea

Sexually active women at increased risk for infection, and pregnant women

At routine exams

Hepatitis B virus

All pregnant women

At first prenatal visit

HIV

Anyone at increased risk for infection, and pregnant women

At routine checkups

Obesity

All adults

At routine checkups

Preeclampsia

Given the availability of new evidence, USPSTF has decided to update this recommendation. The recommendation below may contain information that is out of date. Please consult your health care provider.

All pregnant women

This recommendation below may contain information that is out of date. Please consult your health care provider.

At routine checkups

h (D) Incompatibility

All pregnant women

First prenatal visit

Rubella

Given the availability of new evidence, USPSTF has decided to update this recommendation. The recommendation below may contain information that is out of date. Please consult your health care provider.

All pregnant women

The recommendation below may contain information that is out of date. Please consult your health care provider.

At routine checkups

Syphilis

Women at increased risk for infection, and all pregnant women

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider.

Counseling

Who needs it

How often

Breast cancer, chemoprevention

An update to this recommendation is currently in progress and being reviewed by the USPSTF. The recommendation below may contain information that is out of date. Please consult your health care provider.

Women with high risk

The recommendation below may contain information that is out of date. Please consult your health care provider.

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with increased risk

When risk is identified

Breastfeeding

All pregnant women

During pregnancy and after delivery

Diet, behavioral counseling

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

When diagnosed

Tobacco use and Tobacco-Cause Disease

All adults

Every visit

Immunization

Who needs it

How often

Human papillomavirus (HPV)

Recommended for all females ages 11 to 26 years

Three doses

The second dose should be given one to two months after the first dose, and the third dose should be given six 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--Once after age 18

Chickenpox (varicella)

All adults ages 19 to 49 years and who lack evidence of immunity (for example, no documentation of prior infection or vaccinations)

Pregnant women should be assessed for evidence of immunity.

Two doses. The second dose should be administered four to eight weeks after the first dose.

Measles, mumps, rubella (MMR) vaccine

All adults ages 19 to 49 years and who lack evidence of immunity (for example, no documentation of prior infection or vaccinations)

One or two doses

Flu vaccine (seasonal)

People at risk**

Yearly

Hepatitis A vaccine

People at risk**

Two doses.

Schedule:

Zero and 6 to 12 months (Havrix), OR

Zero and 6 to 18 months schedule (Vaqta)

Hepatitis B vaccine

People at risk**

Three doses. Second dose should be administered one month after the first dose; the third dose should be administered at least two months after the second dose (and at least four months after the first dose)

Meningococcal

People at risk**

One or more doses

Pneumococcal (polysaccharide)

People at risk**

One or two doses

*According to the American Cancer Society, women ages 20 to 39 years should have a clinical breast exam as part of their routine health exam every three years, and breast self-exams are an option for women starting in their twenties.

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

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

Immunization schedule from the CDC

Medical Reviewer: [Mukamal, Kenneth MD, Oken, Emily MD] Copyright: Health Ink & Vitality Communications

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