Women's health screening guidelines

A well-woman exam is one of the most important steps you can take to protect your well-being. The visit is an annual checkup to discuss your health and perform preventive screenings.  

Screenings for women ages 18-29

We recommend scheduling the first well-woman exam in the late teenage years. Women should begin annual visits around age 21. These visits include:  

• Breast exam: Your provider looks at and feels your breast tissue to detect any irregularities.  
• Immunizations: We recommend getting the human papillomavirus (HPV) vaccination before age 26. Young women should also get a yearly influenza (flu) vaccine, a tetanus shot every 10 years and the measles, mumps and rubella (MMR) vaccine if you didn’t receive it as a child. 
• Pap test: Your provider takes a small cell sample from your cervix and sends it to a lab for analysis. A Pap test detects abnormal cells, which can be precancerous or cancerous. Women should begin Pap tests at 21 and continue them every three years. 
• Pelvic exam: Your provider feels the tissue in the vagina. They examine the uterus, ovaries and cervix for any irregularities.  

Screenings for women ages 30-64

After 30, women continue many of the same annual screenings, with a few adjustments. These include:  

• Breast exams and mammograms: You continue in-office breast exams. A mammogram is an X-ray that checks your breast tissue for early signs of cancer. Most women should start yearly mammograms at age 40. You may begin sooner, depending on your family history and breast cancer risk. 
• Colorectal cancer screening: Women should start having screening colonoscopies at age 45 and continue them every 10 years. You may need more frequent testing, depending on your test results and risk factors.  Learn what you need to know about getting a colonoscopy.
• Immunizations: You continue yearly flu shots and tetanus shots every 10 years. Your provider may recommend additional vaccines based on your risk factors.  
• Pap tests and pelvic exams: Women continue getting pelvic exams from their provider. After age 30, your provider may recommend getting a Pap test every five years along with an HPV test. 
• Thyroid-stimulating hormone (TSH) test: A TSH test gives us information about how well your thyroid is working. We recommend starting TSH testing at age 35 and continuing every five years. 

Screenings for women ages 65 & older  

Women 65 and older continue in-office pelvic and breast exams along with TSH testing every five years. After 65, many screening guidelines change and may include:  

• Bone density tests: You get a bone density scan, also known as a DEXA scan, starting at 65. The test measures your bone density and checks for signs of osteoporosis. How often you need this test depends on your test results and risk factors. 
• Colorectal cancer screening: Women with average risk should continue colonoscopies every 10 years until age 75. Between ages 76-85, your provider gives specific recommendations based on your risk. Women older than 85 typically don’t need colorectal cancer screenings.  
• Immunizations: Women 65 and older should continue annual flu vaccines and tetanus shots every 10 years. They should also get vaccinated for pneumonia and shingles. 
• Mammograms: We typically recommend yearly mammograms until age 74. After that, you and your provider discuss whether mammograms are still right for you.  
• Pap tests: After age 65, not all women need Pap tests. You and your provider discuss whether it’s right for you based on your health history and risk factors.  

Learn more about comprehensive women’s health care and the conditions we commonly treat.