You have a standing appointment with your gynecologist every year—for a pelvic exam, to discuss birth control issues, and to undergo tests. Thing is, some of the testing guidelines have shifted in the last few years, and a lot of women (and some gynos too) missed the memo. That’s scary, because not being screened for the right things at the proper intervals can have big repercussions. “Getting a Pap test, STD screening, and other diagnostics can prevent cancer and fertility issues and even save your life,” says Alyssa Dweck, M.D., an ob-gyn in Westchester, New York, and couthor of V Is for Vagina. Confused about the tests you need? Here are the up-to-date guidelines.
At age 21, every woman should have her first Pap (when your gyno brushes a wand against your cervix to pick up cell samples that may reveal potentially serious cervical changes). If the Pap comes back negative, you can wait three years before your next one. “Cervical cancer is so slow-growing, an every-three-years Pap will likely detect any precancerous cervical changes before these changes possibly become malignant,” says Dweck.
Starting at age 30 and until you hit 70, you can continue with a three-year Pap schedule, though some doctors opt to do co-testing, which involves undergoing a Pap test and an HPV test simultaneously every five years. HPV tests aren’t recommended for women under 30 because the virus is so common in this age group, ob-gyns worry that a positive result will leave women panicked for no reason. Also, when women in their 20s get HPV, their bodies tend to clear the virus quickly with no side effects, says Dweck. If you do get a positive result, at any time, don’t panic: HPV is so rampant, 69 percent of men and women can expect to contract at least one strain of HPV at some point in life.
If you’re 24 or under, you should be screened for chlamydia and gonorrhea every year. “Rates of these STDs are highest in this age range, and they tend to have no symptoms,” says Dweck. At 25, your gyno will offer to test you if she feels it’s warranted—say, if you have a strange discharge, or you’ve started seeing someone new. She’s playing it safe because untreated chlamydia or gonorrhea can affect your fertility, says Dweck. Women of all ages will also be offered a yearly HIV test.
At 40, start having annual mammograms. “If you have a family history of breast cancer, your doctor will probably opt to start mammograms when you’re younger, depending on your situation,” says Dweck. Should your mammogram reveal that you have dense breasts, many states mandate that your doc conduct a breast ultrasound as well, which can better detect suspicious growths amid dense breast tissue.