Women's Health: What to Expect at Every Age

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What is the right age to start going to the gynecologist? How often do I need a pap smear? Do I really need a mammogram annually? When do I start/stop getting a pap smear? These are questions that gynecologists are asked daily. Here is a basic guide on what you can expect at every age from your gynecological care, and the steps you should take to stay healthy.

A young woman should see a gynecologist (GYN) for the first time between the ages of 13 and 15 years old, according to the American College of Obstetrics and Gynecology. Health, hygiene, body changes, self- esteem, weight and weight-related issues are addressed. This visit begins life long conversations addressing contraception, sexuality, phone and Internet safety, and protection from sexually transmitted infections (STIs). Yearly visits should begin when a woman becomes sexually active.

Beginning at age 19, visits should be yearly. Clinical breast exams (done by a medical professional) should be performed every 1 to 3 years beginning at age 20. 

Cervical cancer screening (pap smears) should start at age 21 years old and be performed every 3 years. In women over 30 years old, testing for human papilloma virus (HPV) at the time of cervical screening increases the interval between testing to 5 years. The recommendations change in high risk populations or if a woman has an abnormal screen. A pelvic exam is still performed to assess the uterus, tubes and ovaries. Even though a pap smear is not done annually, this is an opportunity to discuss:

• Reproductive health, family planning and fertility
• STI screening and prevention
• Breast self awareness and self breast exams
• Exercise, diet and stress and ways to manage each
• Health and wellness behaviors for lowering risks for hypertension, diabetes and chronic illnesses

A woman’s body goes through tremendous changes between the ages of 40 and 64 years old. Subjects addressed during annual visits include fluctuations with menstrual cycle, fertility, pregnancy, peri-menopause and menopause (cessation of periods). Regular exercise, healthy diet and safety are stressed. Intervals between screening tests also change:

• Clinical breast exams, mammograms and pelvic exams are conducted annually
• Cervical cancer screening can be done with HPV every 5 years, or without HPV every 3 years
• Screening colonoscopy begins at 50, and if negative, repeated every 10 years

In women 65 years and older issues of sexuality, safety, fitness and nutrition are discussed annually. Mammograms and breast and pelvic exams are done yearly. Bone density testing is initiated in the absence of risk factors every few years. Cervical cancer screening can be discontinued in women with 10 years of normal screening as well as negative HPV testing.

At every age, smoking, tanning, and excessive drinking are discouraged. Healthy eating and exercising are encouraged. And no matter your age, it's important to commit to taking care of your mind, body and spirit! 

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