Prevention Guidelines for Women 18 to 39

Here are the screening tests and immunizations that most women ages 18 to 39 need. A screening test is done to find possible disorders or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to reduce the risk of disease, or to detect it early enough to treat it most effectively. Screening tests are not considered diagnostic, but are used to determine if more testing is needed. This plan does not include recommendations for pregnancy. Although you and your healthcare 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	At routine exams
Blood pressure	All adults	Yearly checkup if your blood pressure is normal* Normal blood pressure is less than 120/80 mm Hg* If your blood pressure reading is higher than normal, follow the advice of your healthcare provider
Breast cancer	All women in this age group should talk with their healthcare providers about breast self-awareness	At routine exams
Cervical cancer	Women ages 21 and older	Women between ages 21 and 29 should have a Pap test every 3 years; women between the ages 30 and 65 should have a Pap test plus an HPV test every 5 years.
Chlamydia	Sexually active women ages 24 and younger, and women at increased risk for infection	Every 3 years if at risk or if you have symptoms
Depression	All women in this age group	At routine exams
Type 2 diabetes	All women with no symptoms who are overweight or obese and have 1 or more additional risk factors for diabetes	At least every 3 years (annual testing if blood sugar has begun to rise)
Type 2 diabetes or prediabetes	All women diagnosed with gestational diabetes	Lifelong testing every 3 years
Type 2 diabetes	All women with prediabetes	Every year
Gonorrhea	Sexually active women at increased risk for infection	At routine exams
Hepatitis C	Anyone at increased risk for infection	At routine exams
HIV	All women	At routine exams
Obesity	All adults	At routine exams
Syphilis	Women at increased risk for infection	At routine exams if at risk
Tuberculosis	Anyone at increased risk for infection	Check with your healthcare provider
Vision	Women in this age group1	Every 5 to 10 years if not risk factors for eye disease
Counseling	Who needs it	How often
Breast cancer, chemoprevention	Women at high risk	When risk is identified
BRCA mutation testing for breast and ovarian cancer susceptibility	Women with increased risk	When risk is identified
Diet and exercise	Women who are overweight or obese	When diagnosed and at routine exams
Domestic violence	Women at the age in which they are able to have children	At routine exams
Sexually transmitted infection prevention	Women who are sexually active	At routine exams
Skin cancer	Prevention of skin cancer in fair-skinned adults through age 24	At routine exams
Tobacco use and tobacco-related disease	All adults	Every exam
Immunizations***	Who needs it	How often
Human papillomavirus (HPV)	All women in this age group up to age 26	3 doses The second dose should be given 1 to 2 months after the first dose, and the third dose should be given 6 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 after age 18, then boost with Td every 10 years
Chickenpox (varicella)	All adults in this age group who have no record of previous infection or vaccinations	2 doses; the second dose should be given 4 to 8 weeks after the first dose
Measles, mumps, rubella (MMR) vaccine	All adults in this age group who have no record of previous infection or vaccinations	1 or 2 doses
Flu vaccine (seasonal)	All adults	Yearly, when the vaccine becomes available in the community
Haemophilus influenzae Type B (HIB)	Women at increased risk for infection – talk with your healthcare provider	1 to 3 doses
Hepatitis A vaccine	People at risk2	2 doses given at least 6 months apart
Hepatitis B vaccine	People at risk3	3 doses; second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)
Meningococcal	People at risk4	1 or more doses
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)	People at risk5	PCV13: 1 dose ages 19 to 65 (protects against 13 types of pneumococcal bacteria) PPSV23: 1 to 2 doses through age 64, or 1 dose at 65 or older (protects against 23 types of pneumococcal bacteria)

* American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines

**Exceptions may exist; please discuss with your healthcare provider

1Recommendation from the American Academy of Ophthalmology

2For complete list, see the CDC website

3For complete list, see the CDC website

4People ages 19 to 21 years and who are first-year college students or have one of several medical conditions

5For complete list, see the CDC website

***Those who are 18 years of age, who are not up to date on their childhood immunizations, should receive all appropriate catch-up vaccines recommended by the CDC.

Other guidelines are from the USPSTF

Immunization schedule from the CDC