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Health maintenance for women of reproductive age (generally defined as 15 to 44 years of age) comprises counseling and screening tests, with the goal of prevention and early detection of common diseases such as cancer, infections, and mental health issues. A systematic review found no evidence that general preventive visits (outside of condition-based screening recommendations) reduce overall mortality or deaths from conditions such as cancer or heart disease1; however, it is still important for family physicians to continue evidence-based preventive services, whether part of a routine physical examination or separately.2 This article focuses on screening and counseling for conditions that are more prevalent in women of this age or that have a unique impact on women. In most cases, recommendations from the American Academy of Family Physicians (AAFP) are aligned with those from the U.S. Preventive Services Task Force (USPSTF); this article states when recommendations differ. A full list of USPSTF recommendations is published on their website.3 Grade A and B recommendations (
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Clinical recommendation | Evidence rating | Comments |
---|---|---|
Screening pelvic examinations are not recommended for asymptomatic women.16,17 | C | Systematic review of cohort studies and one RCT showed no benefit of screening pelvic examinations, and low-quality cohort studies demonstrated harms (e.g., pain, embarrassment, false-positive results) |
Screen for obesity in adolescents and adults; refer adults with a body mass index of 30 kg per m2 or more to intensive behavioral interventions focused on healthy diet and exercise.20,23 | B | Systematic review of RCTs demonstrated increased weight loss in intensive behavioral intervention groups compared with control groups |
Screen for depression in adolescents and women when systems are in place for diagnosis, follow-up, and treatment.27,28 | B | Systematic review of RCTs demonstrated reduced prevalence of depression following screening in primary care settings when treatment supports are in place |
Screen for intimate partner violence in women of reproductive age.29 |