Women's Health

Annual Women Well Check Exam

Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. Which exams and screenings you need depends on your age, health and family history, and lifestyle choices such as what you eat, how active you are, and whether you smoke.

To make the most of your next check-up, here are some things to do before you go:

  • Review your family health history

  • Find out if you are due for any general screenings or vaccinations

  • Write down a list of issues and questions to take with you

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NIH: National Institutes of Health

Pap Smear

What is a Pap Smear?

A Pap smear is a test for women that can help find or prevent cervical cancer. During the procedure, cells are collected from the cervix, which is the lower, narrow end of the uterus that opens into the vagina. The cells are checked for cancer or for signs that they may become cancer. These are called precancerous cells. Finding and treating precancerous cells can help prevent cervical cancer. The Pap smear is a reliable way to find cancer early, when it's most treatable.

Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique

What is it used for?

A Pap smear is a way to detect abnormal cervical cells before they become cancer. Sometimes the cells collected from a Pap smear are also checked for HPV, a virus that can cause cell changes that may lead to cancer. Pap smears, along with HPV testing, are considered cervical cancer screening tests. Cervical cancer screening has been shown to greatly reduce the number of new cervical cancer cases and deaths from the disease.

Why do I need a Pap smear?

Most women between the ages of 21 and 65 should have regular Pap smears.

  • Women between the ages of 21 and 29 should be tested every three years.

  • Women ages 30–65 can be tested every five years if the test is combined with an HPV test. If there is no HPV test, the Pap should be done every three years.

Regardless of your age, your health care provider may recommend a Pap smear if you:

  • Had an abnormal Pap smear in the past

  • Have HIV

  • Have a weakened immune system

  • Were exposed to a drug called DES (Diethylstilbestrol) before birth. Between the years 1940–1971, DES was prescribed to pregnant women as a way to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it during the pregnancy.

Women older than 65 who have had normal Pap smears for several years or have had surgery to remove the uterus and cervix may not need to have Pap smears anymore. If you are unsure whether you need a Pap smear, talk to your health care provider.

 

NIH: National Institutes of Health

Human Papillomavirus Test (HPV)

The human papillomavirus (HPV) test detects the presence of human papillomavirus, a virus that can lead to the development of genital warts, abnormal cervical cells or cervical cancer.

Your doctor might recommend the HPV test if:

  • Your Pap test was abnormal, showing atypical squamous cells of undetermined significance (ASCUS)

  • You're age 30 or older

The HPV test is available only to women; no HPV test yet exists to detect the virus in men. However, men can be infected with HPV and pass the virus along to their sex partners.

The HPV test is a screening test for cervical cancer, but the test doesn't tell you whether you have cancer. Instead, the test detects the presence of HPV, the virus that causes cervical cancer, in your system. Certain types of HPV — including types 16 and 18 — increase your cervical cancer risk.

Knowing whether you have a type of HPV that puts you at high risk of cervical cancer means that you and your doctor can better decide on the next steps in your health care. Those steps might include follow-up monitoring, further testing, or treatment of abnormal or precancerous cells.

Routine use of the HPV test in women under age 30 isn't recommended, nor is it very helpful. HPV spreads through sexual contact and is very common in young women, so, frequently, the test results will be positive. However, HPV infections often clear on their own within a year or two. Cervical changes that lead to cancer take several years — often 10 years or more — to develop. For these reasons, you might follow a course of watchful waiting instead of undergoing treatment for cervical changes resulting from an HPV infection.

As with any screening test, an HPV test carries the risk of false-positive or false-negative results.

  • False-positive. A false-positive test result indicates that you have a high-risk type of HPV when you really don't. A false-positive result could lead to an unnecessary follow-up procedure, such as colposcopy or biopsy, and undue anxiety over the test results.

  • False-negative. A false-negative test result means you really do have an HPV infection, but the test indicates that you don't. This might cause a delay in appropriate follow-up tests or procedures.

No special preparation is necessary before you have an HPV test. However, since an HPV test often is done at the same time as a Pap test, you can take these measures to make both tests as accurate as possible:

  • Avoid intercourse, douching, or using any vaginal medicines or spermicidal foams, creams or jellies for two days before the test.

  • Try not to schedule the test during your menstrual period. The test can be done, but your doctor can collect a better sample of cells at another time in your cycle.

An HPV test is usually done at the same time as a Pap test — a test that collects cells from your cervix to check for abnormalities or the presence of cancer. An HPV test can be done using the same sample from the Pap test or by collecting a second sample from the cervical canal.

 

NIH: National Institutes of Health

Breast Exam

Breast cancer screenings can help find breast cancer early, before you notice any symptoms. In many cases, finding breast cancer early makes it easier to treat or cure. But screenings also have risks, such as missing signs of cancer. When to start screenings may depend on your age and risk factors.

Mammograms

A mammogram is the most common type of screening. It is an x-ray of the breast using a special machine. This test is done in a hospital or clinic and only takes a few minutes. Mammograms can find tumors that are too small to feel.

Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. Mammography is generally recommended for:

  • Women starting at age 40, repeated every 1 to 2 years. (This is not recommended by all expert organizations.)

  • All women starting at age 50, repeated every 1 to 2 years.

  • Women with a mother or sister who had breast cancer at a younger age should consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.

Mammograms work best at finding breast cancer in women ages 50 to 74. For women younger than age 50, the screening can be helpful, but may miss some cancers. This may be because younger women have denser breast tissue, which makes it harder to spot cancer. It is not clear how well mammograms work at finding cancer in women age 75 and older.

 

NIH: National Institutes of Health

Pregnancy Test

A pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG). HCG is a hormone produced during pregnancy. It appears in the blood and urine of pregnant women as early as 10 days after conception.

How the Test is Performed

A pregnancy test is done using blood or urine. There are 2 types of blood tests:

  • Qualitative, which measures whether the HCG hormone is present

  • Quantitative, which measures how much HCG is present

The blood test is done by drawing a single tube of blood and sending it to a laboratory. You may wait anywhere from a few hours to more than a day to get the results.

The urine HCG test is most often performed by placing a drop of urine on a prepared chemical strip. It takes 1 to 2 minutes for a result.

For the urine test, you urinate into a cup.

For the blood test, the health care provider uses a needle and syringe to draw blood from your vein into a tube. Any discomfort you might feel from the blood draw will only last a few seconds.

How the Test will Feel

For the urine test, you urinate into a cup.

For the blood test, the health care provider uses a needle and syringe to draw blood from your vein into a tube. Any discomfort you might feel from the blood draw will only last a few seconds.

Why the Test is Performed

This test is done to:

  • Determine if you are pregnant

  • Diagnose abnormal conditions that can raise HCG levels

  • Watch the development of the pregnancy during the first 2 months (quantitative test only)

 

NIH: National Institutes of Health