12 Life-Saving Health Screenings Every Woman Needs (Plus the Exact Age to Start Them)

Regular Health Screenings for Women

Regular visits to your doctor may seem like a chore, but for women, certain screenings and tests can add years to your life. Some tests, like a Pap smear or blood cholesterol check, are ones you’ve probably gotten for years. But others are recommended based on age or lifestyle and may not be familiar to you.

For several tests, the recommended age to start screening has been lowered. And, because of women’s more complex reproductive biology, they have more screening tests than men. It’s crucial to get all the tests you’re eligible for, says Janelle Duah, MD, the clinic lead and a healthcare provider at Luro Health based in New Haven, Connecticut. Screenings allow us to diagnose an illness before it becomes more advanced and harder to manage, she says.

So what screenings should you be getting? Here are a dozen essential screenings women should check in with their doctors about.

1. Check Your Blood Pressure

High blood pressure, also known as hypertension, is one of the key risk factors for cardiovascular disease, the leading cause of death in women. Blood pressure screenings are done with a simple test using a cuff around your arm to measure the force of blood through your vessels.

According to research, adults should get their blood pressure tested annually by their healthcare provider. If your blood pressure reading is higher than average, 120/80 millimeters of mercury (mmHg), or you have other heart disease factors, you may be asked to have it checked more often.

Keep in mind that nervous feelings can cause higher than normal blood pressure readings, so be sure to confirm your results with your doctor before taking any medications or treatments.

2. Test Your Blood Sugar

Adults without risk factors for diabetes should be screened every three years for prediabetes and type 2 diabetes. Adults with obesity and at least one risk factor for diabetes, like family history, should also be screened regularly.

Those with readings indicating prediabetes should be tested annually, or sometimes more frequently, and work with their healthcare provider for important lifestyle interventions, like exercising and following a healthy diet.

Additionally, people who are planning to become pregnant should get screened before they conceive or, for unplanned pregnancies, at their first prenatal visit. First trimester screening for preexisting diabetes is typically for those with risk factors.

Pregnant people should also be screened for gestational diabetes between 24 and 28 weeks of pregnancy.

There are currently four blood tests available that are effective for diabetes testing. One is a nonfasting test called hemoglobin A1C, or A1C, which measures your average blood sugar over the past two to three months. Other screens involve testing blood sugar after an overnight fast, a glucose test that measures blood sugar after you drink a sugary substance, or a random blood sugar test taken at any point in time.

3. Understand Your Cholesterol Levels

A lipid profile, also known as a cholesterol test, is a fasting blood test used to assess levels of cholesterol and triglycerides, blood fats that indicate your risk for heart disease or stroke. Total cholesterol is a measure of all the cholesterol in the blood, including HDL, known as the good cholesterol, LDL, a cholesterol that can be harmful in high amounts, and cholesterol carried by different packages (lipoproteins) that move it through the bloodstream, including triglycerides.

Normal levels include total cholesterol below 200 mg/dL, LDL cholesterol below 100 mg/dL, and, for women, HDL cholesterol between 60 and 80 mg/dL. While those numbers are important to know, the American Heart Association recommends focusing on your overall cardiovascular health including blood pressure, medical conditions, and lipid levels. You can use a risk calculator to help you understand how health conditions may affect your cholesterol.

How often you should have your cholesterol measured depends on your age and risk factors. Younger adults aged 20 to 25 should have their cholesterol measured at least once every five years, and more often if you are at high risk of heart disease. Women 55 to 65 should get screened every one to two years, and those 65 and older should test their cholesterol annually.

4. Screen for Cervical Cancer With Pap Smears

You may remember the days when women got annual Pap smears—a test in which a small brush is used to remove cells from around the cervix. But a better understanding of how cervical cancer develops and improved testing for the human papillomavirus (HPV) that can cause this cancer mean annual screening is unnecessary now, Dr. Duah says.

Current guidelines recommend that women between ages 30 and 65 get a test every three years, or they can instead have either a stand-alone test for HPV or a combined HPV test and Pap smear every five years.

Women older than 65 who have had three prior negative Pap smears or two negative HPV tests do not need any cervical cancer screenings.

Updated guidance from the American Cancer Society allows self-collected vaginal specimens done privately in a clinic or at home, without a healthcare provider present, to serve as HPV testing as part of screening for cervical cancer.

5. Get Your Breasts Checked

A mammogram, which screens for breast cancer, involves compressing the breast between plates so that X-ray images of the breast tissue can be captured. There has long been disagreement about when and how often a woman should have this test, given that the risk for breast cancer increases as you age, and that false-positives from frequent screening can cause some harm.

The most recent guidelines from the U.S. Preventive Services Task Force recommend that women start this screen at age 40 and continue to have one every two years until age 74, the age range when the tests deliver the most benefit.

Meanwhile, according to the American Cancer Society, women should start annual screenings at age 45, and can then switch to a biannual mammogram at age 55. Those 40 to 45 should have the option to screen if they desire.

If you have a family history of the disease, or other concerns, talk to your doctor about the right screening schedule for you.

6. Monitor Your Bone Health

Women should screen for the bone-weakening disease osteoporosis with a bone density test starting at age 65. Those who are postmenopausal but younger than 65 and have risk factors for osteoporosis, such as a low body weight or parental history of fractures, should talk to their doctor about getting screened earlier.

A bone density screen is called a dual energy X-ray absorptiometry, or DEXA scan. You lie on a table while a low-dose X-ray machine captures images of your bones.

7. Colon Cancer Is on the Rise

In 2018, the American Cancer Society revised its screening guidelines to recommend that people of average risk for colon cancer have their first screen at age 45 rather than 50.

The age was lowered because studies showed that the incidence of colorectal cancer was increasing at alarming rates in younger people, says Laura Makaroff, DO, the senior vice president of prevention and early detection at the American Cancer Society.

Regular screens should continue until 75 (or sometimes 85, depending on the person’s overall health and life expectancy). People at increased risk, such as those with a family or personal history of colon cancer or a history of inflammatory bowel disease, should talk to their doctor about screening earlier than age 45.

There are a number of ways to screen for colon cancer, with choice primarily based on personal preference and your personal risk factors. Options include:

• Stool-based tests like the highly sensitive fecal immunochemical test or highly sensitive guaiac-based fecal occult blood test, done once a year
• Multitargeted stool DNA (such as Cologuard) or RNA (such as Colosense) every three years
• Visual exam of the colon and rectum with computed tomography colonography (virtual colonoscopy) or with flexible sigmoidoscopy (rare) that examines the lower colon, done every five years
• Colonoscopy, in which the entire colon is examined, once every 10 years
• The Shield blood test, to check for changes in your blood that may indicate cancer or precancerous growths. This is the least sensitive test, making it a less preferable screening option.

8. Test for Sexually Transmitted Infections

All sexually active women 24 and younger should be screened at least annually for chlamydia and for gonorrhea, and additional testing should be done for all people of any age who have new sex partners or are otherwise at risk.

Adolescents and adults ages 13 to 64 should also be screened for the human immunodeficiency virus (HIV) at least once. Those with ongoing risk factors should be screened at least annually.

How often these screens should be repeated depends on a person’s risk. For example, HIV tests should be repeated whenever you have sex with someone whose HIV status is unknown.

9. Check in on Your Mental Well-Being

Some 1 in 10 women suffer from depression each year, and 1 in 8 experience postpartum depression. In primary care, we believe mental and emotional health are just as important as physical health, Duah says. That’s why many doctors administer short questionnaires to screen for common mental health conditions.

One test is the Patient Health Questionnaire 9, which screens for depression by asking nine basic questions about your mood. Another common screen is the Generalized Anxiety Disorder Assessment, which can reveal signs of this common anxiety disorder.

10. Smokers Should Screen for Lung Cancer

Regular smokers between 50 and 80 years old should be checked for lung cancer once each year if they have a 20 pack-year smoking history and either currently smoke or have quit within the past 15 years. A 20 pack-year smoking history means you’ve smoked one pack a day for 20 years or two packs a day for 10 years.

Lung cancer screens are done with low-dose computed tomography (CT), where a specialized X-ray machine takes detailed images of the lungs.

11. Check Your Skin

Regular screenings increase the chance you will find skin cancer earlier, when it is easier to treat. That’s why guidelines from the American Cancer Society recommend everyone examine their skin at home monthly.

Carefully inspect the skin all over your body, looking for any new moles, blemishes, or changes to existing moles, which can be early signs of skin cancer.

If you’re at increased risk for skin cancer, or have a family history of it, talk to your doctor or dermatologist about how often you should have an in-office exam.

12. Get a Regular Dental Checkup

Bacteria and inflammation in your mouth have been found to play a role in several diseases, including heart disease and pneumonia.

That’s why all adult women need regular dental checkups, generally recommended once or twice a year, though some people may need to visit more frequently. These regular dental checkups involve cleaning and examining the teeth, along with X-rays as needed, to spot early signs of decay and other problems.

How to Keep Up With Your Health Screenings

Thinking about 12 annual screenings may be daunting, but it’s now easier than ever to stay current on tests, thanks to electronic medical records, whose patient portals may alert you to tests you’re due for. You can also remind yourself to schedule annual tests by using a milestone every year, like your birthday or the start of a new year.

Your primary care physician should also inform you when it’s time, but that might not be the case if you use your gynecologist for primary care. Things like the need for a colonoscopy and routine blood work that are outside a gynecologist’s scope can easily be missed, Duah cautions. Let your gynecologist know you don’t have another doctor and request prescriptions for tests that don’t involve your reproductive organs.

Because screens are considered preventive, insurance coverage varies. It’s best to check with your insurance company before you make an appointment. You can also research whether your community offers any of these tests discounted or for free.

The Takeaway

Because of the complex nature of women’s reproductive biology, there are certain tests to be aware of, including Pap smears, mammograms, and screens for osteoporosis.

Take time to check in on your mental and physical well-being throughout the year and annually with your healthcare providers to stay healthy.

Annual screenings allow for health issues to be caught early and allow for early, and often more effective, treatment.