Overdue Your Annual Physical Exam? A Checklist for Women of Every Age

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When you're dealing with a health problem, it's natural to reach out for help. But, did you know that it's just as important to see your doctor when you're feeling well? In fact, experts recommend that all women - including teenagers and young adults - have a checkup at least once every year. Most of the time, your annual physical will be done by your primary care provider. Or, for a child, a pediatrician will do the exam.

A note before we go on: Although we're using the term "doctor" to refer to your primary care provider, in reality, there are two other types of healthcare professionals that people often see for annual exams: a physician's assistant (PA) or nurse practitioner (NP). Whether you're seeing a medical doctor (MD or DO), physician's assistant, or nurse practitioner, your experience and the quality of care will be similar.

Let's take a closer look at what to expect at your annual visit, including what screening tests and vaccinations you'll need at every age.

What is an annual physical exam?

An annual physical exam is your yearly checkup with your primary care provider. It goes by other names, too:

• Annual physical

• Wellness visit

• Well-woman exam

Your annual physical is a type of preventive care visit. This means it's designed to prevent health problems or to catch and treat problems as early as possible. It often includes:

• A conversation

• A physical exam

• Health recommendations

• Additional screening tests

• Vaccinations

Going to your annual exam can help you stay healthy and protect you from having bigger problems down the road. It's also a great time to ask questions and to get information about your health.

What to expect at an annual physical exam

Most of the time, an annual physical exam follows the same basic format. Here's what to expect.

Checking in

Your visit begins when you arrive at the clinic and check in at the front desk. You may need to show identification and your health insurance card (if you're covered). You might also be asked to fill out a questionnaire about your health.

Moving to the examination room

After a short wait, you'll be shown to a private examination room by a nurse or medical assistant. They might also:

• Measure your height and weight

• Take your blood pressure

• Ask you what medications and vitamins you're taking

The nurse or medical assistant will let you know whether or not you need to undress for your appointment. If you do, they'll give you a drape or hospital gown to wear.

Remember: You have the right to feel comfortable at every step of the way during your visit. If you'd prefer to not be weighed or would like to keep your clothes on, it's OK. Just let the staff know.

Seeing the doctor, nurse practitioner, or physician's assistant

After you're settled in the exam room (and changed into your gown, if needed), your primary care provider will come in for your visit. They will start with some questions about:

• Your health

• Your lifestyle

• Your medical history

• Your family history

Then, they'll move on to a physical exam.

During the physical exam, your doctor may:

• Listen to your heart and lungs with a stethoscope

• Tap your chest and feel your abdomen with their hands

• Look in your ears, nose, and mouth with a special light

• Do a pelvic exam or a breast exam

Again, when it comes to the interview and physical exam, you have the right to feel safe, comfortable, and supported along the way. It's fine to ask questions or ask to skip parts of the exam.

Wrapping up

At the end of your visit, your doctor may have some health suggestions for you. They might also ask you to go for lab tests or other procedures.

Before you finish the visit, be sure to ask any questions you have. If there's something you didn't understand, it's totally acceptable to ask your doctor to explain it again (or more clearly).

Annual physical exam checklist by age

Your annual physical exam will change throughout your lifetime. The right screening tests you have will depend on many factors, such as your:

• Age

• Risk factors

• Family health history

• Past medical history

• Overall health

• Personal preferences

Here are the general recommendations for what your annual physical exam should include at every age.

Age 13 to 20

• Blood pressure check (starting at age 18)

• Pregnancy and STI testing, as needed

• Conversations about birth control options, if needed

• Cholesterol screening (once, between age 17 to 21)

Age 21 to 29

• Blood pressure check

• Pregnancy and STI testing, as needed

• Conversations about family planning and birth control, as needed

• Cholesterol screening every 4 to 6 years

• Pelvic exam and cervical cancer screening (Pap test) every 3 years

Age 30 to 50

• Blood-pressure check

• Pregnancy and STI testing, as needed

• Conversations about family planning and birth control, as needed

• Cholesterol screening every 4 to 6 years

• Pelvic exam and cervical cancer screening (Pap or HPV test) every 3 to 5 years

• Diabetes screening every three years (starting at age 35)

• Mammograms every 2 years (starting at age 40)

• Colorectal cancer screening at regular intervals (starting at age 45)

Age 50 and beyond

• Blood pressure check

• Pregnancy and STI testing as needed

• Check-in conversations about birth control, as needed, usually until menopause or age 50 to 55

• Cholesterol screening every 4 to 6 years

• Pelvic exam and cervical cancer screening (Pap or HPV test) every 3 to 5 years, until aged 65

• Diabetes screening every 3 years

• Mammograms every 2 years (through age 74)

• Colorectal cancer screening at regular intervals until age 75 (then, as needed, from age 76 to 85)

• Yearly lung cancer screening as needed, based on your smoking history

• Osteoporosis screening starting at age 65

Why do you need to have screening tests?

Screening tests can help to catch health problems early on - even before you have symptoms. Let's take a closer look at common screening tests you might encounter at your annual exam, and why your doctor may recommend them.

Blood pressure screening

High blood pressure (hypertension) increases your risk of heart disease. Catching high blood pressure early is important because it can be treated. And it will cause less damage the earlier it's caught.

Screening for high blood pressure is done with a cuff that wraps around your arm. This cuff measures the pressure in your arteries when your heart pumps blood and when it rests.

Cholesterol screening

High cholesterol can increase yourrisk for heart disease and stroke. Just like high blood pressure, finding it early can help prevent problems later on. Screening for high cholesterol is done with a blood test.

Sexually transmitted infection screening

Sexually transmitted infections (STIs) are common. And getting screened for them regularly is important for anyone who's sexually active.

But STI screening is especially important for women because STIs can be harder to diagnose in women.

If you want to become pregnant, STIs can make it hard to do so. And, if you are pregnant, some STIs can be passed from a pregnant parent to their baby.

There are different screening tests for different STIs. Sometimes, you might need to give a urine sample or do a blood test. Other times, you might need a swab of your genitals to check for certain germs.

Cervical cancer screening

Cervical screening catches cervical cancer very early, when it's easiest to treat and cure. Cervical screening involves twodifferent tests: the Pap smear (Pap test) and HPV test. Both tests are done during a pelvic exam.

Diabetes

Type 2 diabetes can lead to various medical problems, including heart disease, vision loss, and kidney disease. Keep in mind that if you have risk factors (like a family member with diabetes), your provider may screen you earlier and more often.

Diabetes screening can be done with several different blood tests, such as fasting glucose and A1C. A1C is the best test for diagnosing diabetes. It measures your average blood sugar levels over the past 2 to 3 months.

Breast cancer screening

Breast screening can detect breast cancer very early, when it's still easy to treat. A mammogram (breast X-ray) is the most common screening test. Depending on your age and medical history, other imaging tests - such as ultrasound or MRI - may be offered.

Colorectal cancer

By getting screened for colorectal cancer, you're more likely to find precancerous lesions (called polyps) before they turn into cancer. And a gastroenterologist can then remove any polyps you have.

Colon cancer screening tests may involve a:

• Stool test

• Colonoscopy (a camera test that takes pictures of your entire colon)

• Sigmoidoscopy (a camera test that takes pictures of the last part of your colon)

• CT scan

Your doctor can help you figure out which type of screening is right for you.

Osteoporosis

About1 in 10 women over the age of 60 have osteoporosis. Many people don't realize they have it until they break a bone. So, screening for this condition is especially important. This screening is done with a type of low-dose X-ray called a DEXA scan.

Lung cancer

Lung cancer is the leading cause of cancer death in U.S. adults. Screening with a CT scan is recommended in people between the ages of 55 and 80, who meet both of these criteria:

• You currently smoke, or you quit in the last 15 years.

• You have smoked 20 pack-years or more. (A pack-year is an average of one pack of cigarettes per day for 1 year.)

Other mental and physical health conditions

Here are some other screening tests that are important for your health. These tests might also be included as part of your annual visit. Some of them involve just answering a few questions or filling out a questionnaire.

Your primary care provider may talk to you about:

• Alcohol, tobacco, and substance use

• Anxiety and depression

• Contraceptive counseling and methods

• Fall prevention

• Interpersonal and domestic violence

• Skin cancer screening and counseling

• Urinary incontinence

What vaccinations do you need as an adult?

Vaccinations are another important part of staying healthy. They help prevent infections and accompanying health problems.

Based on public health guidelines, most vaccines are given during childhood. But some vaccines are recommended for teenagers and adults, too.

Here are the routine vaccines recommended for most women:

• HPV vaccine: HPV vaccination is recommended for teens and adults aged 26 or younger who didn't get vaccinated earlier in life. It's optional for adults between the ages of 27 to 45. It's not recommended for women after age 45.

• Meningitis vaccine: Some states require this vaccine for students starting college. If live in a dorm or residence hall, this vaccine is recommended during your first year of college.
  Flu vaccine: An annual flu vaccine is recommended for all teens and adults.

• Tetanus, diphtheria, and pertussis vaccines (Tdap or Td): All adults should have a Tdap or Td vaccine every 10 years.

• Shingles vaccine: The shingles vaccine is recommended for adults aged 50 and older.

• Pneumococcal vaccine: The pneumococcal vaccine is recommended for adults age 65 and older.

• COVID-19 vaccine: The CDC currently recommends all teens and adults have the updated 2023-2024 COVID-19 vaccine.

And, remember, vaccine recommendations are different for everyone. You may need additional (or fewer) vaccines depending on:

• Which vaccines you received as a child

• Your current health

• Your age and birth year

• Your past medical history

• Whether or not you're pregnant

• Your upcoming travel plans

• Your job

For example, certain adults over 60 might benefit from RSV vaccination. Your doctor can help you understand which vaccines are right for you, based on these different factors.

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