Prevention Guidelines for Women 18 to 39

Screening tests and vaccines are an important part of managing your health. A screening test is done to find diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes and checkups can reduce the risk of disease. Or the goal may be to find it early to treat it most effectively. Screening tests are not used to diagnose a disease. But they are used to see if more testing is needed. Health counseling is important, too. Below are guidelines for these, for women ages 18 to 39. Talk with your healthcare provider to make sure you’re up to date on what you need.

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 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. HPV testing is not advised. Women between the ages 30 and 65 should have a Pap test plus an HPV test every 5 years or a Pap test alone every 3 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
Diabetes mellitus, type 2	Adults with no symptoms who are overweight or obese and have 1 or more extra risk factors for diabetes (such as having a close relative with diabetes or having had diabetes in a previous pregnancy)	At least every 3 years (annual testing if blood sugar has begun to rise)
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 no risk factors for eye disease
Counseling	Who needs it	How often
Breast cancer, chemoprevention	Women at high risk	When risk is noted
BRCA mutation testing for breast and ovarian cancer susceptibility	Women with increased risk	When risk is noted
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	2-3 doses (depending on the age at which the vaccine series began). If 3 doses are advised, the second dose should be given at least 1 month after the first dose and the third dose should be given at least 5 months after the first dose.
Tetanus/diphtheria/pertussis (Td/Tdap) booster	All adults	Td: every 10 years Tdap: Have a 1-time dose of Tdap instead of 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 vaccine	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 vaccines	1 or 2 doses
Flu vaccine (seasonal)	All adults	Yearly, when the vaccine is available
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 3 doses depending on medical situation (protects against 23 types of pneumococcal bacteria) The type of vaccine used and the number of doses depends on age and medical situation. Talk with your healthcare provider about when and which type of vaccine is best for you.

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

**There may be exceptions may exist. Talk with your healthcare provider.

1 From the American Academy of Ophthalmology

2 For full list, see the CDC website.

3 For full list, see the CDC website.

4 People ages 19 to 21 who are first-year college students or have 1 of several medical conditions

5 For full list, see the CDC website.

***People who are 18 years old and not up to date on their childhood vaccines should get catch-up vaccines advised by the CDC.

Other guidelines are from the USPSTF.

Vaccine schedule from the CDC