I’m Healthy, Why Do I Need a Checkup?

Have you ever heard the adage “An ounce of prevention is worth a pound of cure?” Well, a yearly checkup with your primary care provider (PCP) serves as an ounce of prevention. A checkup is a time to ask about something you may have read in a health article, address any nagging health issues, and plan preventive measures for your future. 

The purpose of regular checkups is to screen for medical conditions, assess your risk for future medical conditions, update your vaccinations, and establish a relationship with your PCP so you are comfortable with them if a serious condition ever arises. Detecting medical conditions before there are any symptoms makes them easier to treat. If the problem identified is a chronic disease like diabetes, high blood pressure, or heart disease, early detection and management can help prevent long-term complications.

Your PCP will review your family history for any changes and ask about ongoing health issues and any new health concerns. Screening tests will be ordered based on your age, medical history, and current health conditions.

Recommended health screenings for women:

Blood Pressure 

You should have your blood pressure checked at least every 3 to 5 years. Normal blood pressure is less than 120/80. 

You may need to have your blood pressure checked more often if you have heart or kidney disease, you are overweight, your blood pressure is higher than 120/80, you have a family history of high blood pressure, or you had high blood pressure during pregnancy. 

If the top number is higher than 130 and the bottom number is higher than 80, this is considered Stage 1 Hypertension. 

Breast Cancer Screening

Experts do not agree on the effectiveness of self-breast exams related to early detection and saving lives. Ask your PCP what they recommend for you.

• Mammogram screening is not recommended under the age of 40 unless you have a mother or sister who had breast cancer at an early age, or you carry a high-risk genetic marker.
• Women 40 to 49 years of age should have a mammogram every 1 to 2 years. Not all experts agree with this, so discuss it with your PCP.
• Women 50 to 75 should have a mammogram every 1 to 2 years.

Cervical Cancer Screening

All women should have their first PAP test at age 21 unless otherwise recommended by their PCP.

• After the first test, you should have a PAP test every 3 years. Experts do not agree on whether HPV (Human Papilloma Virus) screening should be done in this age group, so you ask your PCP for their recommendation.
• Women 30 to 65 should have a PAP test every 3 years and an HPV test every 5 years, or both tests every 5 years (called “cotesting”).
• Women treated for precancer (cervical dysplasia) should continue to have PAP tests for 20 years after treatment, or age 65, whichever is longer.
• If your uterus and cervix have been removed (total hysterectomy) and you have never been diagnosed with cervical cancer (high-grade cervical neoplasia) or precancer, you do not need cervical cancer screening. 

Ovarian Cancer

There are no screening tests for ovarian cancer (a PAP test does not screen for ovarian cancer). However, all women should be aware of the symptoms, particularly if they have a family history of ovarian cancer.

Signs and Symptoms of ovarian cancer:

• Abdominal bloating or swelling
• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvic area
• Fatigue
• Back pain
• Changes in bowel patterns, like constipation
• Frequent need to urinate.

Contact your PCP for any symptoms that concern you.

Cholesterol Screening

With the increase in childhood obesity, new guidelines for universal cholesterol screening are now recommended for children 9 to 11 and adolescents aged 17 to 21 years. 

• If no cholesterol problems are detected at a young age, and you have no known risk factors, cholesterol screening recommendations are yearly screenings beginning at age 45. 
• If you have normal cholesterol levels and no risk factors, recommendations are for testing every 5 years. It will be more often if you have changes in lifestyle (weight gain and diet), however, most providers screen annually.

Diabetes Screening

Diabetes screening should start at the age of 35 years if you have no risk factors for diabetes. 

Risk factors for diabetes:

• A first-degree relative with diabetes
• Being overweight or obese
• Having prediabetes, high blood pressure, or heart disease

Diabetes screening should be done if you have any of these risk factors, are pregnant, or planning to become pregnant. 

Colorectal Screening

If you are under the age of 45 years colorectal screening is not necessary unless there is a strong family of colorectal cancer or polyps or a history of inflammatory bowel disease (IBD) or polyps.

Screening is recommended for ages 45 to 75 years. There are several options for testing:

• A stool-based fecal occult blood (gFOTB) or fecal immunochemical test (FIT) every year
• A stool sDNA-FIT test every 1 to 3 years
• A flexible sigmoidoscopy every 5 years or every 10 years with stool testing with FIT done every year.
• CT colonography (virtual colonoscopy)

Colonoscopy every 10 years unless you have risk factors for colon cancer (Ulcerative colitis, personal or family history, previous adenomatous polyps).

Recommended Vaccinations

• Flu shot: every year.
• COVID-19 vaccine: talk with your PCP for recommendations.
• Tetanus-diphtheria-acellular pertussis (Tdap): you need one at age 19 or after if you did not get one as an adolescent.
• Tetanus-diphtheria:  you need a booster (or Tdap) every 10 years.
• Varicella: you need 2 doses if you never had chickenpox or the vaccine as a child.
• Measles-mumps-rubella (MMR): you need 1 or 2 doses if you are not immune to MMR. Your PCP can do a blood test to see if you are immune. 
• Human Papilloma Virus (HPV): if you have never had this vaccine or have not completed the series.
• Hepatitis B vaccine: 2, 3, or 4 doses depending on your exact circumstances, if you did not receive these as a child or adolescent, until age 59 years.
• Shingles (Herpes Zoster) at or after age 50 years. 

Be sure to discuss vaccines with your PCP, some health conditions may increase your risk for things like pneumonia, therefore requiring early vaccinations for some conditions.

Infectious Disease Screening

• Women under 25 years, who are sexually active, need to be screened for gonorrhea and chlamydia. Women older than 25 years old should be screened if at high risk. 
• Hepatitis C: every person should have a one-time screening test. Women who are pregnant should be screened with every pregnancy.
• Human Immunodeficiency Virus (HIV): all people 15 to 65 years of age should have a one-time test for HIV.
• Depending on your medical history or lifestyle you may need continued screening for these infectious diseases, as well as screening for other infectious diseases such as syphilis. 

Osteoporosis Screening

If you are between 50 and 64 years of age and have risk factors for osteoporosis, you need to discuss screening with your PCP. 

Risk factors for osteoporosis:

• Long-term steroid use
• Low body weight
• Heavy alcohol use
• Having a fracture after age 50
• Family history of hip fracture or osteoporosis. 

Eye Examination

These recommendations are for people who do not wear glasses or contacts or have any other vision problems. If you wear glasses or contacts or have a vision problem, follow your doctor’s recommendations for follow-up.

• Every 5 to 10 years before age 40 years
• Every 2 years, or as determined by your eye doctor if you have vision problems or are at risk for glaucoma. 
• Every 2 to 4 years at ages 40 to 54 and every 1 to 3 years at ages 55 to 64.
• Every year if you have diabetes. This exam should include an examination of the retina (the back part of your eye).

Dental Examination

Most people don’t understand that there is a link between oral health and general overall health. The health of your teeth and gums directly affects the health of other body systems. Teeth teem with bacteria, mostly harmless, but without proper oral hygiene and the body’s natural defenses keep bacteria growth in check, you may be at risk for serious complications.

Go to the dentist once or twice a year for an exam and cleaning. Your dentist will let you know if you need to go in more often. 

During the visit, your PCP will ask you questions about depression and anxiety to screen you for these conditions. This is typically done with a questionnaire you fill out at each visit. Your PCP will also review your diet, exercise, alcohol use, and smoking, and encourage changes as needed for a healthy lifestyle.

Take control of your health by making yearly checkups with your PCP, optometrist, and dentist. These visits are an important part of self-care. As women we are busy taking care of everyone else, so make sure you take the time to get the care you need too.