Medical Tests Women Need in Their 20s

Being adventurous and bold and a risk-taker is a great thing. Just not with your health.

Read more from our #MEDICALTESTS primer here.

You’re following your dreams and shaping your world according to your definition of success. At the moment, age-related health concerns are probably the last thing on your mind. But don’t be seduced by a healthy halo (or your parents’ health insurance plan, which has you covered until you’re 26). These are the years to lay down solid preventive-care habits that will make a difference down the road.

Though you’re busy setting career goals, hanging out with friends, and swiping, don’t skip out on baseline health screenings, or blow off a doctor’s visit if you need one. This is prime time to find a primary care physician you like, and trust. Even if the annual physical is beginning to fall out of favor, if you haven’t had a checkup since you headed off to college, you’re probably due.

Most health insurance plans cover one routine visit per year, which includes screenings for blood pressure and BMI (body mass index)—a measure of body fat based on height and weight. Your PCP will listen to your heart and lungs, and may also request a blood work-up to check your cholesterol and blood glucose levels, among other things. Fill your doctor in on your family’s health history, and be completely honest about past or current issues or indiscretions—alcohol and drug use, safe (or unsafe) sex practices. And don’t be embarrassed to ask questions. They’ve heard it all.

Hopefully you’re not smoking, and are eating nutritious food and getting exercise and plenty of sleep.  Stress management is also an important preventive-care tool, said Stephan C. Schimpff, M.D., author of Fixing the Primary Care Crisis and clinical professor at the University of Maryland School of Medicine. Taking self-care seriously early on can cut your risk of health issues that tend to crop up as we age, such as high blood pressure and diabetes. It also means when you gorge on bacon cheeseburgers and drink tequila shots till 3 a.m., you can still get up at seven the next morning, ready to take on the world. Here are some tests you should schedule sooner rather than later.

Vaccine Update

According to guidelines at vaccines.gov, you could be due for updated Tdap (tetanus-diphtheria-pertussis) and varicella (chickenpox) vaccines, since the immunizations you had as a child lose effectiveness over time. Same with the MMR (measles, mumps, rubella) vaccine. If you haven’t gotten an HPV vaccine (given in three equally spaced doses), consider it now. It can protect you and your partners from cervical and other cancers. Your doctor may recommend additional vaccinations, including Hepatitis A and B, if you have any risk factors. Most doctors also recommend an annual flu shot.

Pelvic Exam and PAP Smear

These two screenings used to be a yearly ritual for most women, but current recommendations suggest that healthy women between the ages of 21 and 65 get a pelvic exam and/or PAP smear about once every three years. During the exam, your doctor should also test for the human papilloma virus (HPV) regardless of whether or not you’ve had the HPV vaccine, since the vaccine doesn’t protect you from all strains of the virus. Some types have no symptoms and resolve on their own, while others can cause health problems including genital warts and cancers. HPV is so common that nearly all sexually active men and women get it at some point in their lives.

According to the U.S. Preventive Services Task Force, women should start getting a PAP smear and HPV test in their early 20s (or soon after becoming sexually active), and then every three years after consistently negative results.

STD/HIV Screening

The truth is you can never be too sure. And while it may be scary to think about unfavorable results, knowing your status will put you in line for whatever treatment may be necessary. The CDC recommends all sexually active adults get tested for chlamydia and gonorrhea, and that all patients seen in any healthcare setting receive HIV testing unless the patient opts out. New HIV diagnoses declined 40 percent among women from 2005 to 2014—encouraging news—however, that’s not to say if you’re hooking up with new or multiple partners you’re not at risk. Women made up 19 percent (8,328) of the estimated 44,073 new HIV diagnoses in the United States in 2014.

Clinical Breast Exam and Self-Exam

Doctors at Memorial Sloan Kettering Cancer Center recommend that all women, no matter their risk, “perform an optional monthly breast self-examination beginning at age 20,” and advise women to be aware of any changes in their breasts. Though you probably won’t do it every month, get a feel for the girls and the changes tied to your cycle. MSK also recommends annual clinical breast examinations (by a physician) beginning at age 25.

Dental and Vision Exams

It’s almost too easy to let these exams slide, but don’t. According to Kyle Stanley, DDS, “It’s common for people’s dental health to fall apart after they move out [of their parents’ home] and start living on their own.” An annual comprehensive dental exam is suggested if your teeth are healthy, and Stanley recommends cleanings twice per year. As for a comprehensive eye exam, The Mayo Clinic recommends having your eyes checked once every five to 10 years during your 20s and 30s if you have no symptoms or vision problems. However the American Academy of Opthalmology notes that if you have a family history of eye disease, or you have diabetes or wear contacts, talk to your doctor about how often you should be seen. The Academy also points out that myopia, or nearsightedness, can develop in your 20s, so if you notice any change in your vision, schedule a checkup.