Women can prevent or reduce the risk of many medical problems by taking care of themselves. Regular check-ups and immunizations are an important part of preventive health care.

Recommendations about the frequency of health screenings vary, so consult your own physician or nurse practitioner to find out just when you should have the following check-ups and immunizations.

Physical Examinations

Young adult women should have the following examinations every five years. After the age of 50, these exams are generally recommended every one to two years.

• Height and weight checks with an assessment of nutritional status at all ages
• Evaluation of blood pressure in females over the age of 21
• Pelvic examination and Pap smear in sexually active women and women over the age of 18
• Clinical breast examination in adult women
• Occult blood testing after the age of 40
• Evaluation of hearing and vision
• Inspection of the skin

Immunizations

Tetanus and diphtheria toxoid: Vaccinations should be repeated every 10 years and again in the event of a severe wound occurring more than five years after the last immunization.

Influenza: Women over the age of 65, health care workers, women in the second or third trimester of pregnancy during flu season, and women with chronic illnesses should receive a vaccination each year.

Pneumonia Vaccine: Women over the age of 65, women who have had splenectomy or splenic dysfunction, and women with chronic illnesses should receive this vaccination. Consult your physician about how often you should receive this vaccination.

Measles and Mumps: Women entering college or traveling to foreign countries and women born after 1956 who do not have documentation of immunization on or after their first birthday need vaccination.

Rubella: Women without documentation of immunization on or after their first birthday and women whose blood tests indicate a need for the vaccination.

Hepatitis B: Women working in health care or who have exposure to blood products in their occupation; women on hemodialysis or receiving regular blood products.

Hepatitis A: Food handlers, women traveling to high-risk areas, and women practicing unsafe sex or IV drug use.

Varicella: Women without a history of varicella or vaccination and women whose blood tests indicate a need for vaccination.

Poliovirus: Unvaccinated mothers whose children will be receiving polio vaccine.

Laboratory Testing

Some of the following tests are important for all women, while some are important for women in certain categories.

Cholesterol levels: Every five years or more often for persons with high cholesterol or a family history of heart disease.

Thyroid function: Women over age 60 and those with a family history of thyroid disease.

Blood count: Periodically in menstruating females. Consult your physician about how often you should have this test.

Liver function: Women engaged in unsafe sexual practices or using IV drugs.

Serologic tests: Women engaged in unsafe sexual practices or using IV drugs.

Syphilis: Women engaged in unsafe sexual practices or using IV drugs.

Aquired Immune Deficiency Syndrome (AIDS): Women engaged in unsafe sexual practices or using IV drugs.

Other Routine Tests

The following tests may be necessary for women with certain medical conditions.

• Routine chest x-ray
• Routine EKG
• Routine blood chemistry profiling
• Routine urine analysis
• Blood type and Rh
• Upper endoscopy

Disease Screenings

Screenings for specific diseases or women are available and may be advisable. Again, consult your physician or nurse practitioner.

Ovarian cancer: Screening generally begins after the age of 50 with a frequency of every two years.

Breast cancer: Mammography is generally recommended yearly after the age of 50. Some physicians recommend every other year for women ages 40 to 50. A strong family history may warrant earlier testing.

Diabetes: Some experts recommend measurement of fasting plasma glucose in all women at age 45 and periodically thereafter. A value less than or equal to 110 mg/dL is considered normal. Any woman who is obese or has a family history of diabetes esting should be tested.

Colon Cancer: Screening usually begins at age 50. Several tests are used, including digital rectal examination, fecal occult blood testing, screening sigmoidoscopy about every five years, double-contrast barium enema every five to 10 years, and colonoscopy every 10 years. Some combination of the above tests may be recommended.

Glaucoma: Women over the age of 40 need a comprehensive eye examination. Women without risk factors for glaucoma should have an exam every three to five years. Women with risk factors should be screened every one to two years. African-Americans are at higher risk for glaucoma. Other risk factors include high blood pressure, cupping of the optic disk, diabetes, and family history.

Osteoporosis: Testing of bone density is valuable for women who are unable or unwilling to take estrogen after menopause and for persons with a history of risk factors including eating disorders, hyperparathyroidism, kidney stones and amenorrhea.

Cervical cancer: All sexually active women and women older than 18 should have a pelvic examination and Pap smear annually.

Julie Hall-Barrow, M.S., is director of health promotion and wellness in the UAMS College of Nursing and director of education for the UAMS Rural Hospital Program.

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