The CheckUp by SingleCare recently published an article about the seven medical tests you need when you turn 30, and I contributed to the topic to discuss HIV and STI screening, pelvic exams and more.
Is the Big 3-0 knocking on your door? That means you’ve got quite a few things to consider, not the least of which is your health.
Have you had an STD screening recently? What about a breast exam or a pap smear? Your 20s are one of the greatest times of your life, but there are also when a lot of health issues may begin to appear. Early detection can be a life-saving preventative measure.
Here are three screenings and exams you should (read: have to) get before 30.
1. Pelvic exam
To maintain a healthy life, it’s important for women ages 21 and above to have a pelvic exam every three years, though some experts recommend annual screenings. Pelvic exams often accompany crucial screenings for sexually transmitted infections (STI) and general gynecologic health — such as requesting birth control — so it’s possible for some health issues to require one before you turn 21. And depending on your medical history, your doctor might suggest you have them more regularly.
During a pelvic exam, your gynecologist examines your vulva, vagina, cervix, ovaries, fallopian tubes, uterus, rectum and pelvis for any abnormalities. For example:
👉 Unusual vaginal bleeding or discharge.
👉 A family history of cancer.
👉 Concerns about ovarian cancer, cysts, sexually transmitted diseases (STD) and other gynecological problems.
Here’s how doctors screen you during a pelvic exam:
👩⚕️ Visual exam: We visually inspect your vagina and vulva for redness, irritation, discharge, cysts, or anything that indicates an STD, like sores.
👩⚕️ Speculum exam: We insert a duck-bill-shaped (sometimes cold!) instrument into your vagina to open the walls and examine it along with your cervix.
👩⚕️ Pap smear: With the speculum in place, we also conduct pap smear exams to screen for cervical cancer, STDs and gather cells for further analysis.
👩⚕️ Manual exam: Through manual exams, we can determine the size of your uterus, detect pregnancy, and check for irregularities in the uterus, ovaries or fallopian tubes. To do this, we insert two fingers into your vagina to inspect your internal reproductive and sexual organs, while the other hand presses down on your abdomen.
Pelvic exams can prevent and detect many critical health issues. Please don’t wait until you’re 30 to receive one — they’re an important component of evaluating your pelvic health, even if you don’t plan to have children.
2. Breast exams: self, clinical and mammograms
Breast exams are one of the most important early breast cancer screenings. While doctors don’t typically offer annual mammograms until women are 40 or 50 years old, I always encourage my patients to perform a monthly self-breast check.
So, what’s the difference between a mammogram and a clinical breast exam? Great question.
🔑 During a breast exam, your doctor observes the shape, size and texture of your breasts. With the tips of their fingers, they check for any lumps and other signs of breast cancer or other breast problems. They also check your nipples and armpits.
🔑 A mammogram, on the other hand, uses low-energy X-rays to detect tumors doctors can’t feel through a clinical breast exam, as well as tiny deposits of calcium that signify breast cancer.
Annual gynecological check-ups usually include breast exams, so you don’t have to wait to have one. In fact, if you’re 25 to 39, experts recommend you get an exam every one to three years. After 40, get a breast exam annually and a mammogram every one to two years.
The exception is if any family members have or had a diagnosis of breast or ovarian cancer. It’s important to tell your doctor, because they may recommend screenings sooner to rule out any chance of breast cancer. Plus, your family health history gives your doctor a good baseline to work from if they notice changes year-over-year.
Now, back to self-breast exams: What do your breasts look like? What do they feel like? Some might find this kind of self-exploration uncomfortable, but you have to have a sense of what “normal” is for your body to be able to detect changes that might require more testing.
At the beginning or end of each month, make it a habit to check your breasts for abnormalities.
💡 It could save your life. If you feel any lumps, call your health provider immediately. And try not to feel too alarmed — lumps don’t always mean you have cancer; but the earlier you and your doctors detect anything, the easier it is to treat.
3. Screenings for HIV, STDs and STIs
I can’t stress enough how important it is to have regular screenings for HIV, and STDs (i.e., chlamydia and gonorrhea).
The Centers for Disease Control and Prevention (CDC) recommends women under 25 who are sexually active test for gonorrhea and chlamydia every year. Women 25 and up who have new or multiple sex partners, or a sex partner who has an STD, should also test for gonorrhea and chlamydia every year.
If you have unprotected sex with multiple partners or share injection equipment with others, I also recommend an HIV test and STD screening every six months.
It’s a good rule of thumb to get tested after any risky sexual behavior, or even if you’ve recently become active. When we leave chlamydia and gonorrhea untreated, for example, they can spread to your pelvis and infect the uterus, fallopian tubes and ovaries, which can lead to infertility — and that’s just one outcome.
There’s no shame in an adventurous sex life, so my advice isn’t that you shouldn’t seek pleasure in ways that fulfill you.
🔑 The key is safety. Use a new condom for every act of vaginal, anal and oral sex throughout the entire sex act, but never go from anal to vaginal sex with the same condom, or you’ll increase the risk of infections. Also, have honest conversations with your health provider about your sexual activity so they can provide you the best options.
If you’re not comfortable talking with your doctor about these topics, there are tons of clinics that can help you and keep your information confidential. If you’re in the Denver Metropolitan Area, try mine: STRIDE Community Health Center!
Meet Dr. Savita Ginde
Dr. Savita Ginde is an advocate and thought leader for reproductive health and served as Chief Medical Officer of Planned Parenthood of the Rocky Mountains for over 13 years. And, until very recently, she served as the Chief Healthcare Officer for STRIDE Community Health Center where she oversaw all of STRIDE’s healthcare services and led their COVID-19 vaccination efforts.