• If you have a mother or sister who had breast cancer at a young age, consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.

• If you have other risk factors for breast cancer, we may recommend a mammogram, breast ultrasound, or MRI scan.

• DIABETES SCREENING

If you have a body mass index (BMI) greater than 25 and have other risk factors for diabetes, you should be screened. Asian Americans should be screened if their BMI is greater than 23.

•IMMUNIZATIONS

• Cervical cancer vaccine

• Know about the human papilloma virus (HPV) vaccine if you are between ages 10 to 45 and you have:

• Not received the HPV vaccine in the past (you will need all three shots)

• Not completed the full vaccine series (you should catch up on this shot)

• You should get a flu shot every year.

• Contact if you notice a change in your breasts, whether or not you do breast self-exams.

• If you are between ages 20 to 40, we may do a clinical breast exam.

• PELVIC EXAM AND PAP SMEAR

• Beginning at age 21, women should have a pelvic exam and Pap smear every 3 years to check for cervical cancer.

• If you are over age 30 and your Pap smear and HPV test are normal, you only need a Pap smear every 5 years.

• If you have had your uterus and cervix removed (total hysterectomy) and you have not been diagnosed with cervical cancer you may not need to have Pap smears.

• OTHER SCREENING

• Routine bone density screening of women under 40 is not recommended.

FAQ:

• Do I Need to Do Anything to Prepare for a Pelvic Exam?

• Because a Pap test is typically performed during a routine pelvic exam, you should schedule the exam when you are not having your period .In addition, for 48 hours prior to the exam, you should not:

• Douche

• Use a tampon

• Have sex

• Use birth control foam, cream, or jelly

• Use medicine or cream in your vagina

• What Can I Expect During a Pelvic Exam?

• You can expect to feel a little discomfort, but you should not feel pain during a pelvic exam. The exam itself takes about 10 minutes.

• Perform a smear or liqid based cytology (LBC).We will use a plastic spatula and small brush to take a sample of cells from the cervix (A sample of fluid also may be taken from the vagina to test for infection.)

Patients Younger Than 21 Years

The first visit to the obstetrician–gynecologist for screening and the provision of preventive services and guidance take place between the ages of 13 years and 15 years. This visit generally does not include pelvic examination. The focus of this visit should be on patient education. During this visit, the obstetrician–gynecologist can establish the clinician–patient relationship and engage in age-appropriate discussion of anatomical development, body image, self-confidence, weight management, immunizations (including the human papillomavirus vaccine), contraception, and prevention of STIs .