Preventive Health for Women

Every woman should consider undergoing a well-woman check, even in the absence of noticeable medical issues. This comprehensive examination by a gynecologist includes:

• Health screening
• Risk assessment
• Depression screening
• Domestic violence screening
• Substance abuse screening
• Vaccinations
• Cancer screening
• STD testing
• Weight management
• Birth control options
• Preconception counseling
• Addressing menstrual issues

Key Vaccinations

Rubella Vaccine

• Girls should receive this vaccine before planning a pregnancy.
• Avoid pregnancy for one month (28 days) after receiving the MMR vaccine and confirm immunity with a blood test.

Tdap Vaccine

• Administered during the third trimester of pregnancy to protect both mother and child against diphtheria, tetanus, and whooping cough.
• If not given during pregnancy, it should be administered immediately postpartum.
• Family members should also be vaccinated to protect the newborn (cocooning).

Influenza Vaccine

• Recommended for everyone over 6 months of age during flu season (October - March).
• Pregnant women should receive it after the first trimester.

HPV Vaccine

• Prevents cervical cancer and warts.
• Target age for vaccination is 11-12 years for both girls and boys.
• Two doses six months apart for those under 15; three doses for those aged 15-26.
• Bivalent, quadrivalent, and 9-valent vaccines are available, with the 9-valent recommended by ACIP.

Cancer Prevention and Screening

Cervical Cancer

• Stop smoking.
• Use barrier contraception like condoms.
• Get the HPV vaccine (recommended for ages 9-45; avoid during pregnancy).
• Regular Pap smears:
• Under 21: No Pap test needed; STD testing if sexually active.
• Ages 21-29: Pap smear every three years if sexually active.
• Above 30: Pap smear every three years, or co-testing for HPV every five years.
• Annual Pap testing for high-risk individuals (e.g., HIV positive, organ transplant recipients, or those with a history of high-grade cervical dysplasia).

Breast Cancer

• Perform monthly self-examinations starting at age 20.
• Clinical breast exams every three years from age 20-35, then annually after 35.
• Mammography:
• ACOG recommends annual screenings starting at age 40.
• AAFP suggests individualizing screening for women under 50 and biennial screenings for ages 50-74.
• The UK’s NHS offers routine screening every three years for women aged 50-70, with additional screenings available upon request for women over 70.

Ovarian Cancer

• High-risk individuals (e.g., BRCA1/2 positive or those with a family history of ovarian cancer) should have annual pelvic exams, CA125 blood tests, and ultrasounds every two years.

Lung Cancer

• Screening recommended for those with a 30-pack-year smoking history who haven’t quit within the last 15 years, starting at age 50 with an annual low-dose CT scan.

Colon Cancer

• Screening begins at age 50 for those at average risk.
• Options include annual high-sensitivity fecal occult blood testing, flexible sigmoidoscopy every five years with high-sensitivity fecal occult blood testing every three years, or colonoscopy every 10 years.

Bone Health

Osteoporosis Prevention

• Bone Mineral Density (BMD) test recommended for women:
• Over 65.
• Who broke a bone before age 50.
• Menopausal with risk factors.
• With a family history of osteoporosis.
• Who experienced premature menopause.
• With infrequent periods.
• Factors increasing risk include low BMI, certain medical conditions (e.g., thyroid disorders), specific medications (e.g., steroids), limited mobility, smoking, alcohol consumption, and low calcium/vitamin D levels.

Prevention Strategies

• Lifestyle changes: Reduce smoking, alcohol intake, physical inactivity, and steroid use.
• Exercise: Weight-bearing and muscle-strengthening activities for 30 minutes at least four days a week.
• Dietary supplements:
• Calcium: 1000 mg/day for women under 50, 1200 mg/day for women over 50.
• Vitamin D: 400-800 IU/day for women under 50, 800-1000 IU/day for women over 50.

Heart Disease Prevention

Heart disease is the leading cause of death in post-menopausal women. Preventive measures include:

• Healthy diet.
• Regular physical activity: At least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise weekly.
• Weight management.
• Quitting smoking.
• Cholesterol-lowering medication if needed.
• Annual health check-ups including physical exams, BMI, blood pressure, and blood tests for cholesterol, triglycerides, and diabetes screening.

By adhering to these preventive health guidelines, women can significantly reduce their risk of developing serious health issues and maintain overall well-being.