A Lifetime of

Good Health

Your Guide to Staying Healthy

800-994-9662 • TDD: 888-220-5446
Office on Women's Health, http://www.womenshealth.gov 1

A Lifetime of 

Good Health

Your Guide to Staying Healthy

About Us..........................................................................................2

Understanding Risk Factors......................................................4

Preventive Screening Tests and Immunizations................6

Medicare-Covered Preventive Services.............................16

Heart Disease and Stroke Prevention ................................18

Heart Attack and Stroke Warning Signs ...........................20

Diabetes........................................................................................22

Coping with Many Chronic Health Conditions...............24

Physical Activity for Health ....................................................26

Healthy Eating............................................................................28

Fighting the Flu..........................................................................31

Cervical Health ...........................................................................32

Reproductive Health................................................................34

Preconception Health..............................................................35

Pregnancy .................................................................................... 36

Breastfeeding .............................................................................. 39

Menopause .................................................................................. 41

Finding Breast Cancer Early ................................................... 44

Urinary Tract Health .................................................................. 46

Colorectal Health ....................................................................... 48

Healthy Eyes and Ears .............................................................. 49

Healthy Bones ............................................................................. 51

Quitting Smoking ...................................................................... 53

Oral Health ................................................................................... 55

Healthy Skin ................................................................................ 57

Stress .............................................................................................. 59

Mental Health ............................................................................. 61

Dealing with Violence .............................................................. 64

Talking with Your Doctor or Nurse ...................................... 65

Checklist of Questions to Ask Your 

Doctor or Nurse .......................................................................... 66
2 Call for free health publications: 800-994-9662 TDD: 888-220-5446

About Us

What is the U.S. Department of Health and Human 

Services?

The U.S. Department of Health and Human 

Services (HHS) is the federal agency responsible for protecting the health of all Americans. 

Its headquarters are based in Washington, 

DC. HHS is the publisher of A Lifetime of Good 

Health: Your Guide to Staying Healthy.

What is the Office on Women’s Health?

Established in 1991, the Office on Women’s Health (OWH) is part 

of the Office of the Assistant Secretary of Health within HHS. 

OWH wrote and produced this guide. Our mission is to improve 

the health and well-being of all U.S. women and girls. We lead 

and coordinate the efforts of all the HHS agencies and offices 

involved in women’s health. We create and sponsor innovative 

programs that focus on the health of women and girls. We educate health professionals, such as physicians, dentists, researchers, therapists, and nurses. Our publications, websites, and 

special events reach out to you, the public. We work to educate 

and motivate people to live healthier lives by giving them trustworthy, accurate health information.

How can I get more information?

We offer two award-winning comprehensive websites, http://

www.womenshealth.gov and http://www.girlshealth.gov. These 

two websites provide reliable, accurate, commercial-free information on the health of women and girls. They 

cover more than 800 topics on issues ranging from adolescent health to reproductive 

health to healthy aging. We also offer free 

assistance by phone through our information referral center. Call 800-994-9662, 

toll free, and our trained Information 

Specialists can answer your calls in either 

English or Spanish. For individuals who 

are hearing impaired and use TDD, 

call 888-220-5446.

Whichever way you use our 

services, you’ll get:

• Clear answers to frequently asked questions

• Links to thousands of 

health publications

• Statistics on women’s health
Office on Women's Health, http://www.womenshealth.gov 3

• An online glossary of health terms 

• Daily news on women’s health

• A National Breastfeeding Helpline with trained peer 

counselors

• Health information in Spanish

How are womenshealth.gov and girlshealth.gov different from other websites on women’s and girl’s 

health?

Womenshealth.gov and girlshealth.gov are sponsored by the 

federal government with your tax dollars. We don’t represent 

any special commercial interests. We don’t allow advertisements on our sites. We don’t try to sell you products, magazines, or anything else. We screen all health information for 

accuracy before it ever appears on our websites or in our publications. Our Information Specialists are trained to help you, 

whether it’s referring you to the right organization, mailing 

you free information, or even coaching new moms on how to 

breastfeed their infants.

Womenshealth.gov and girlshealth.gov exist to help you and 

your loved ones get the reliable and accurate health information you need to get, or stay, healthy.

What is Healthy People 2020?

Healthy People 2020 provides science-based, 10-year goals 

from the U.S. government for improving health and stopping disease. Learn more at http://www.healthypeople.

gov/hp2020.

What is the Affordable Care Act?

The Affordable Care Act, also called “health care reform,” is a 

new law that is helping keep Americans healthy. It helps by 

making health insurance available to more people, by offering screenings and tests at no out-of-pocket cost to you, and 

more! Learn all about it at http://www.healthcare.gov.

What can I do if I don’t have health 

insurance?

If you need health insurance, visit http://www.healthcare.

gov to learn what options you have under the new health 

reform law.
4 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Understanding Risk Factors

Part of learning how to take charge of your health requires 

understanding your risk factors for different diseases. Risk factors are things in your life that increase your chances of getting 

a certain disease. Some risk factors are beyond your control. 

You may be born with them or exposed to them through no 

fault of your own. Some risk factors that you have little or no 

control over include your:

• Family history of a disease 

• Sex/gender — male or female 

• Ancestry

• Age

• Health — having one health problem may raise your risk of 

having another (for instance, having diabetes increases your 

chances of getting heart disease) 

Some risk factors you can control include:

• What you eat 

• How much physical activity you get 

• Whether you use tobacco 

• How much alcohol you drink 

• Whether you use illegal drugs 

• Whether you use your seat belt

In fact, it has been estimated that almost 35 percent of all U.S. 

early deaths in 2000 could have been avoided by changing just 

three behaviors: 

• Stopping smoking 

• Eating a healthy diet (for example, eating more fruits and 

vegetables and less red meat)

• Getting more physical activity 

Having more than one risk factor

You can have one risk factor for a disease or you can have 

many. The more risk factors you have, the more likely you are 

to get the disease. For example, if you eat healthy, exercise on a 

regular basis, and control your blood pressure, your chances of 

getting heart disease are less than if you are diabetic, a smoker, 

and inactive. To lower your risks, take small steps toward engaging in a healthy lifestyle, and you’ll see big rewards.

Inheriting risk — your family health history

Rarely, you can inherit a mutated gene that alone causes you to 

get a disease. Genes control chemical reactions in our bodies. 

If you inherit a faulty gene, your body may not be able to carry 

out an important chemical reaction. For instance, a faulty gene 
Office on Women's Health, http://www.womenshealth.gov 5

may make your blood unable to clot. This problem is at the root 

of a rare bleeding disorder. More often, you can inherit genes 

from one or both of your parents that put you at higher risk of 

certain diseases. But having a gene for a certain disease does 

not always mean you will get it. There are many unknown factors that may raise or lower your chances of getting the disease. 

How do I find out my disease risks?

It is important to talk to your doctor or nurse about your individual health risks, even if you have to bring it up yourself. 

And it’s important for your doctor to know not just about your 

health, but your family health history as well. Come to health 

care visits armed with information about you, your children, 

siblings, parents, grandparents, aunts and uncles, and nieces 

and nephews, including:

• Major medical conditions and causes of death 

• Age of disease onset and age at death 

• Ethnic background 

• General lifestyle information like heavy drinking and 

smoking 

What if I have a family history of a 

disease?

People with a family health history of chronic disease may have the most to gain from making lifestyle 

changes. You can’t change your genes, but you can 

change behaviors that affect your health, such as smoking, 

inactivity, and poor eating habits. In many cases, making 

these changes can reduce your risk of disease even if the 

disease runs in your family. Another change you can make 

is to have screening tests, such as mammograms and colorectal cancer screening. These screening tests help detect 

disease early. People who have a family health history of a 

chronic disease may benefit the most from screening tests 

that look for risk factors or early signs of disease. Finding 

disease early, before symptoms appear, can mean better 

health in the long run.
6 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Preventive Screening Tests and Immunizations

Prevention is important to living long and living well. Getting 

preventive screenings and immunizations are among the most 

important things you can do for yourself. Take time to review 

these guidelines for screening tests and immunizations. Use the 

General Screenings and Immunizations for Women

charts on the next few pages to remind yourself of when you 

need to see your doctor, based on your personal health profile. 

Make an appointment today!

Screening tests Ages 19–39 Ages 40–49 Ages 50–64 Ages 65 and older

General health: Discuss with your doctor or Discuss with your doctor or Discuss with your doctor or Discuss with your doctor or 

Full checkup, including nurse. nurse. nurse. nurse.

weight and height. Ask 

your doctor or nurse about 

health topics such as:

Overweight and obesity

Tobacco use

Alcohol use

Depression 

Thyroid (TSH) testing

Skin and mole exam

•

•

•

•

•

•

HIV test At least once to find out your At least once to find out your At least once to find out your Discuss with your doctor or 

HIV status. Ask your doctor or HIV status. Ask your doctor or HIV status. Ask your doctor or nurse.

nurse if and when you need nurse if and when you need nurse if and when you need 

the test again. the test again. the test again. 

Heart health: At least every 2 years At least every 2 years At least every 2 years At least every 2 years

Blood pressure test

Cholesterol test Start at age 20, discuss with Discuss with your doctor or Discuss with your doctor or Discuss with your doctor or 

your doctor or nurse. nurse. nurse. nurse.

Please note: These charts are guidelines only. Your doctor or nurse will personalize the timing of each test and immunization to meet your health care needs. Check 

with your insurance plan to find out which tests are covered. These charts are current as of February 2011.
Office on Women's Health, http://www.womenshealth.gov 7

General Screenings and Immunizations for Women

Screening tests Ages 19–39 Ages 40–49 Ages 50–64 Ages 65 and older

Bone health:

Bone mineral density test

Discuss with your doctor or 

nurse.

At least once. Talk to your 

doctor or nurse about repeat 

testing.

Diabetes:

Blood glucose or A1c test

Discuss with your doctor or 

nurse.

Start at age 45, then every 3 

years.

Every 3 years Every 3 years

Breast health:

Mammogram (x-ray of 

breast)

Every 1–2 years. Discuss with 

your doctor or nurse.

Every 1–2 years. Discuss with 

your doctor or nurse.

Every 1–2 years. Discuss with 

your doctor or nurse.

Clinical breast exam Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Reproductive health:

Pap test

Every 2 years starting at age 

21. Women 30 and older, every 

3 years.

Every 3 years Every 3 years Discuss with your doctor or 

nurse.

Pelvic exam Yearly beginning at age 21. 

Younger than 21 and sexually 

active, discuss with your doctor or nurse.

Yearly Yearly Yearly

Chlamydia test Yearly until age 24 if sexually 

active. Age 25 and older, get 

this test if you have new or 

multiple partners.

Get this test if you have new or 

multiple partners. 

Get this test if you have new or 

multiple partners.

Get this test if you have new or 

multiple partners.

Sexually transmitted infection (STI) testsDiscuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Colorectal health:

Many tests can screen for 

colorectal cancer.

Talk to your doctor or nurse 

about which test is best for 

you and how often you need 

it.

Talk to your doctor or nurse 

about which test is best for 

you and how often you need 

it.
8 Call for free health publications: 800-994-9662 TDD: 888-220-5446

General Screenings and Immunizations for Women

Screening tests Ages 19–39 Ages 40–49 Ages 50–64 Ages 65 and older

Eye and ear health:

Comprehensive eye exam

Discuss with your doctor. Get a baseline exam at age 40, 

then every 2–4 years or as your 

doctor advises.

Every 2–4 years until age 55, 

then every 1–3 years until age 

65, or as your doctor advises

Every 1–2 years

Hearing screening Every 10 years Every 10 years Every 3 years Every 3 years

Oral health:

Dental and oral cancer 

exam

Routinely; discuss with your 

dentist.

Routinely; discuss with your 

dentist.

Routinely; discuss with your 

dentist.

Routinely; discuss with your 

dentist.

Immunizations Ages 19–39 Ages 40–49 Ages 50–64 Ages 65 and older

Influenza vaccine Every fall (or winter) Every fall (or winter) Every fall (or winter) Every fall (or winter)

Pneumococcal vaccine If you smoke or have a chronic 

health problem, ask your doctor or nurse if you need this 

vaccine.

If you smoke or have a chronic 

health problem, ask your doctor or nurse if you need this 

vaccine.

If you smoke or have a chronic 

health problem, ask your doctor or nurse if you need this 

vaccine.

You need 1 dose at 65 (or older) 

if you have never been vaccinated. You may also need a 

second dose.

Tetanus, diphtheria, 

pertussis (Td,Tdap) 

vaccine

Get a Td booster every 10 years. 

Ask if you need 1 dose of Tdap 

instead of Td booster to prevent 

whooping cough. 

Get a Td booster every 10 years. 

Ask if you need 1 dose of Tdap 

instead of Td booster to prevent 

whooping cough. 

Get a Td booster every 10 years. 

Ask if you need 1 dose of Tdap 

instead of Td booster to prevent 

whooping cough. 

Get a Td booster every 10 years. 

Ask if you need 1 dose of Tdap 

instead of Td booster to prevent 

whooping cough.

Hepatitis B vaccine Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Hepatitis A vaccine Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Discuss with your doctor or 

nurse.

Human papillomavirus 

(HPV) vaccine

You need this vaccine if you are 

26 or younger and have not 

already completed the vaccine 

series.
Office on Women's Health, http://www.womenshealth.gov 9

General Screenings and Immunizations for Women

Immunizations Ages 19–39 Ages 40–49 Ages 50–64 Ages 65 and older

Measles, mumps, 

rubella (MMR) vaccine

If you have not had at least 1 

dose of MMR, ask your doctor or 

nurse if you need this vaccine.

If you have not had at least 1 

dose of MMR, ask your doctor or 

nurse if you need this vaccine.

If you were born in 1957 or later 

and have not had at least 1 

dose of MMR, ask your doctor or 

nurse if you need this vaccine.

Varicella (chickenpox) 

vaccine

If you have never had chickenpox or you have been vaccinated but only got 1 dose, ask 

your doctor or nurse if you need 

this vaccine.

If you have never had chickenpox or you have been vaccinated but only got 1 dose, ask 

your doctor or nurse if you need 

this vaccine.

If you have never had chickenpox or you have been vaccinated but only got 1 dose, ask 

your doctor or nurse if you need 

this vaccine.

If you have never had chickenpox or you have been vaccinated but only got 1 dose, ask 

your doctor or nurse if you need 

this vaccine.

Meningococcal 

vaccine

You need this vaccine if you are 

a young adult planning to live 

at college or if you have certain 

medical conditions. Discuss with 

your doctor or nurse.

You may need this vaccine if 

you have certain medical conditions. Discuss with your doctor 

or nurse.

You may need this vaccine if 

you have certain medical conditions. Discuss with your doctor 

or nurse.

You may need this vaccine if 

you have certain medical conditions. Discuss with your doctor 

or nurse.

Zoster (shingles) 

vaccine

Starting at age 60, you need a 

single dose of this vaccine.

Starting at age 60, you need a 

single dose of this vaccine.

What is the Affordable Care Act?

The Affordable Care Act, also called 

“health care reform,” makes sure that you 

can get the tests, vaccines, and other 

services that may help keep you from 

getting sick. And, it does this without any 

additional out-of-pocket cost to you!

For example, depending on your age, you 

may have free access to things like:

• Blood pressure, diabetes, and 

cholesterol tests

• Mammograms and colonoscopies

• Counseling on quitting smoking, 

losing weight, eating well, treating 

depression, and reducing alcohol use

• Routine vaccinations against diseases 

such as measles, polio, or meningitis

• Flu and pneumonia vaccines

• Counseling, screening, and vaccines to 

ensure healthy pregnancies

• Regular well-baby and well-child 

visits, from birth to age 21

Learn more at http://www.healthcare.gov. 
10 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Recommended Screenings, Tests, and Immunizations for Women with High-Risk Factors

This chart lists screenings, tests, or exams you might need more often or earlier because of having high-risk factors or things in your 

life that increase your chances of developing a condition or disease.



if it 

applies

Does your family 

history include?

Then ask your doctor or 

nurse if you need the following screenings, tests, 

exams, or vaccines more 

often or at a younger age:

High blood pressure Blood pressure test

High cholesterol Cholesterol test

Heart disease or heart 

attack 

Blood pressure test, cholesterol 

test 

Diabetes Diabetes test

Breast cancer (in female 

or male relatives) 

Mammogram, clinical breast 

exam, genetic counseling 

Colorectal cancer or 

colon polyps 

Colonoscopy or other screening 

tests, genetic counseling 

Ovarian cancer Genetic counseling 

Broken hip in either your 

mother or father 

Bone mineral density test



if it 

applies

Does your family 

history include?

Then ask your doctor or 

nurse if you need the following screenings, tests, 

exams, or vaccines more 

often or at a younger age:

Thyroid disease or thyroid cancer Thyroid test, genetic counseling 

Gum (periodontal) disease Oral exam

Hearing problems or 

deafness

Hearing screening

Vision problems, eye disease, or blindness Eye exam

Cancer, heart disease, 

diabetes, or any health 

problem at an unusually young age (10 to 

20 years before most 

people get the health 

problem) 

Genetic counseling, screening 

tests

Please note: These charts are guidelines only. Your doctor or nurse will personalize the timing of each test and immunization to meet your health care needs. Check 

with your insurance plan to find out which tests are covered. These charts are current as of February 2011.
Office on Women's Health, http://www.womenshealth.gov 11

Recommended Screenings, Tests, and Immunizations for Women with High-Risk Factors



if it 

applies

Does your family 

history include?

Then ask your doctor or 

nurse if you need the following screenings, tests, 

exams, or vaccines more 

often or at a younger age:

Rare types of cancer, two 

or more relatives with 

the same type of cancer 

or with certain combinations of cancers, such as: 

• Breast and ovarian 

cancers

• Colorectal and endometrial cancers

Genetic counseling, screening 

tests

Birth defects or genetic 

disorder (you or your 

partner) 

Genetic counseling, screening 

tests 

What is a risk factor?

Risk factors are things in your life that increase your chances of developing a condition or disease. They can include 

things like family history, exposures to things in the environment, being a certain age or sex, being from a certain 

ethnic group, or already having a health condition. If you 

do have risk factors, your doctor or nurse will most likely 

want you to be screened or immunized at a younger age 

or more often than what is recommended. Check with your 

doctor or nurse to find out if you need to have specific 

health screenings and how often you will need them. (See 

the section on Understanding Risk Factors on page 4 for 

more information.)
12 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Recommended Screenings, Tests, and Immunizations for Women with High-Risk Factors



if it 

applies

Are you? Then ask your doctor or 

nurse if you need the following screenings, tests, 

exams, or vaccines more 

often or at a younger age:

 African-American Eye exam, screening for sickle 

cell trait

 American Indian or Alaska 

Native 

Flu vaccine

 Ashkenazi Jewish descent Genetic counseling for certain 

disorders that are passed down 

in families, such as Tay-Sachs 

disease, if you want to become 

pregnant; genetic counseling 

for BRCA1/2 mutation if you 

have a family history of breast 

or ovarian cancer

 Age 65 or older Flu vaccine, pneumococcal 

vaccine

 Pregnant Flu vaccine, depression screening, prenatal tests

 A smoker Blood pressure test, cholesterol 

test, bone mineral density test, 

oral exam, pneumococcal vaccine



if it 

applies

Are you? Then ask your doctor or 

nurse if you need the following screenings, tests, 

exams, or vaccines more 

often or at a younger age:

 Overweight Body mass index, blood pressure test, cholesterol test, diabetes test

Thin, weighing less than Bone mineral density test

127 pounds

 A college student living in Meningococcal vaccine and 

a dormitory other vaccines 

 Living in long-term care TB test, flu vaccine, pneumococcal vaccine and other tests 

or vaccines

 A health care worker TB test, flu vaccine, MMR vaccine, Td/Tdap vaccine, varicella 

vaccine, hepatitis B vaccine and 

other tests or vaccines

 A member or former Depression screening

member of the military 
Office on Women's Health, http://www.womenshealth.gov 13

Recommended Screenings, Tests, and Immunizations for Women with High-Risk Factors



if it 

applies

Do you have or 

have you had? Then ask your doctor or nurse if you need the follow- ing screenings, tests, exams, 

or vaccines more often or at 

a younger age:

 High blood pressure Blood pressure test, cholesterol 

test, diabetes test, eye exam

 High cholesterol Blood pressure test, cholesterol 

test, diabetes test

 Heart disease Blood pressure test, cholesterol 

test, diabetes test, other tests or 

exams, flu vaccine, pneumococcal 

vaccine

 Diabetes Blood pressure test, cholesterol 

test, blood glucose and A1c tests, 

eye exam, urine test, other tests 

or exams, flu vaccine, pneumococcal vaccine

 Breast cancer Mammogram, clinical breast 

exam, breast self-exam, pelvic 

exam, other imaging or lab tests, 

genetic counseling

 Dense breasts Digital mammogram

 Cervical, endometrial 

(uterine), or vaginal 

cancer 

Pap test, pelvic exam, other imaging or lab tests, genetic counseling 



if it 

applies

Do you have or 

have you had? Then ask your doctor or nurse if you need the follow- ing screenings, tests, exams, 

or vaccines more often or at 

a younger age:

 Ovarian cancer Pelvic exam, other lab or imaging 

tests, genetic counseling

 An abnormal Pap test Pap test, HPV test, HPV vaccine

Menopause before 

age 45

Bone mineral density test

 Colon polyps, colon cancer, inflammatory bowel 

disease 

Colonoscopy or other screening 

tests, genetic counseling

 An autoimmune disease (such as lupus, 

rheumatoid arthritis, 

scleroderma, multiple 

sclerosis, psoriasis, type 

1 diabetes, inflammatory bowel disease, 

thyroid disease) 

Flu vaccine, pneumococcal vaccine, bone mineral density test, 

thyroid test, TB test, eye exam, 

other vaccines or tests

Steroid (glucocorticoid) 

treatment, such as 

prednisone, for more 

than 3 months

Bone mineral density test
14 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Recommended Screenings, Tests, and Immunizations for Women with High-Risk Factors



if it 

applies

Do you have or 

have you had? Then ask your doctor or nurse if you need the follow- ing screenings, tests, exams, 

or vaccines more often or at 

a younger age:

 Chronic lung disease 

(such as chronic 

obstructive pulmonary 

disease or asthma) 

Flu vaccine, pneumococcal vaccine

 Chronic liver disease Hepatitis A and B vaccines, flu 

vaccine, pneumococcal vaccine, 

bone mineral density test

 Thyroid nodule Thyroid funtion or imaging tests

 Gum disease (periodontitis) Oral exam

 Intellectual disability Vision and hearing screening, oral 

exam, thyroid test, TB test, hepatitis B vaccine, flu vaccine, other 

vaccines, tests, or exams 

 Eye injury or disease Eye exam

 Ear injury or prolonged 

exposure to loud noise 

Hearing screening



if it 

applies

Do you have or 

have you had? Then ask your doctor or nurse if you need the follow- ing screenings, tests, exams, 

or vaccines more often or at 

a younger age:

A broken bone as an 

adult

Bone mineral density test

 HIV/AIDS CD4 count, viral load, drug-resistance screening, hepatitis screening, TB test, STI tests, flu vaccine, 

pneumococcal vaccine, hepatitis 

A and B vaccines, varicella vaccine, eye exam, Pap test, blood 

pressure test, cholesterol test, diabetes test, depression screening, 

exam to discuss family planning, 

other vaccines, tests, or exams
Office on Women's Health, http://www.womenshealth.gov 15



if it 

applies

Do you have or 

have you had? Then ask your doctor or nurse if you need the follow- ing screenings, tests, exams, 

or vaccines more often or at 

a younger age:

 Risk factors for hepatitis 

C, including having 

ever:

• Had signs of liver 

disease

• Injected illegal drugs

• Received blood or 

organ transplant 

before 1992

• Received clotting 

factors made before 

1987

• Needed long-term 

dialysis

Hepatitis C test

 Multiple sex partners 

(or a partner who has 

or had multiple sex 

partners) or history of 

not using condoms 

STI tests, HIV test, hepatitits B vaccine, HPV vaccine



if it 

applies

Do you have or 

have you had? Then ask your doctor or nurse if you need the follow- ing screenings, tests, exams, 

or vaccines more often or at 

a younger age:

 Eating disorder Blood pressure test, bone mineral 

density test, dental exam, mental 

health screening, full physical 

exam

 Alcohol abuse or Flu vaccine, pneumococcal vacdependence cine, mental health screening, liver 

tests, bone mineral density test

 Injection drug use or Hepatitis A and B vaccines, hepadrug addiction titis C test, STI tests, HIV test, TB 

test, mental health screening

 Sexually transmitted STI tests, HIV test, Pap test, pelvic 

infection exam, hepatitis B vaccine, HPV 

vaccine

 Lived or worked with TB test

someone with active 

tuberculosis 

 A deep or dirty wound Td/Tdap vaccine

 A baby within the last Postpartum depression screening

year
16 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Medicare-Covered Preventive Services

Check this chart to see what screenings and immunizations are 

covered under Medicare for individuals who are entitled to and 

enrolled in Medicare Part B coverage. Costs for these screenings 

and immunizations may only be partially covered. For some of 

these services, you might have to pay a deductible, coinsurance, and/or copayment. These amounts vary, depending on 

the type of services you need and the kind of Medicare health 

plan you have. For more information, call 800-MEDICARE or visit 

http://www.medicare.gov.

Did you know that Medicare covers...?

Bone Mass Measurements Medicare covers these measurements once 

These measurements help to every 24 months (more often if medically 

see if you are at risk for broken necessary) for people with Medicare at risk 

bones. for osteoporosis.

Cardiovascular Screenings Medicare covers tests for cholesterol, lipid, 

Doctors test your cholesterol, and triglyceride levels every 5 years.

lipid, and triglyceride levels so 

they can help you prevent a 

heart attack or stroke.

Colorectal Cancer Screenings If you are a person with Medicare who is age 50 

These tests help find colorectal or older, or is at high risk for colorectal cancer, 

cancer early, when treatment one or more of the following tests are covered 

works best. by Medicare:

• Fecal occult blood test

• Screening colonoscopy

• Flexible sigmoidoscopy

• Barium enema

How often Medicare pays for these tests is 

different, depending on the test. You and 

your doctor decide which is best for you, 

based on your level of risk for this cancer.

Diabetes Screenings Medicare covers tests to check for diabetes 

Diabetes means that your or pre-diabetes. These tests are available if 

blood glucose (sugar) is too you have any of the following risk factors:

high. Your blood always has 

some glucose in it because the 

body uses glucose for energy. 

It's the fuel that keeps you 

going. Too much glucose in 

the blood is not good for your 

• High blood pressure 

• History of abnormal cholesterol and triglyceride levels (dyslipidemia)

• Obesity 

• A history of high blood glucose

health. Tests are also covered if you have two or more 

of the following characteristics:

• Age 65 or older

• Overweight

• Family history of diabetes (parents, brothers, sisters)

• A history of gestational diabetes (diabetes 

during pregnancy) or delivery of a baby 

weighing more than 9 pounds 
Office on Women's Health, http://www.womenshealth.gov 17

Diabetes Screenings (continued from page 16)Based on the results of these tests, you may 

be eligible for up to two screenings every 

year. Talk to your doctor for more information.

Flu Vaccines

These shots help prevent influenza or flu virus.

Medicare covers these vaccines once a flu 

season in the fall or winter for all people with 

Medicare. You need a new flu vaccine each 

new flu season.

Glaucoma Tests

These tests help find the eye 

disease glaucoma.

Medicare covers these tests once every 12 

months for people with Medicare who are at 

high risk for glaucoma.

Hepatitis B Vaccines

This vaccine (given in 3 doses) 

helps protect people from getting hepatits B.

Medicare covers these vaccines for people 

with Medicare at high or medium risk for 

hepatitis B.

Medical Nutrition Therapy 

Services

Nutrition therapy helps you 

choose the right foods to eat 

for your health condition.

Medicare may cover medical nutrition therapy if you have diabetes or kidney disease, 

and your doctor refers you for the service. 

Talk to your doctor for more information.

Pap Test and Pelvic Exam 

(includes clinical breast 

exam)

These exams check for cervical 

and vaginal cancers. As part 

of the pelvic exam, Medicare 

covers a clinical breast exam to 

check for breast cancer.

Medicare covers these exams every 24 

months for all women with Medicare, or once 

every 12 months for women with Medicare 

at high risk.

Physical Exam (one-time Medicare covers a one-time review of your 

“Welcome to Medicare” health and for education and counseling 

physical exam) about preventive services, including certain 

All adults should visit their screenings, vaccines, and referrals for other 

health care provider from care if needed. Medicare will cover this exam 

time to time, even if they are only within the first 12 months you have 

healthy. The purpose of these Medicare Part B coverage.

visits is to:

• Screen for diseases 

• Assess risk of future medical problems 

• Encourage a healthy lifestyle 

• Update vaccinations 

• Maintain a relationship with 

a doctor in case of an illness 

Pneumococcal Vaccine Medicare covers this vaccine for all people 

This vaccine helps prevent with Medicare Part B. Most people only need 

pneumococcal infections (like this vaccine once in their lifetime. Talk with 

certain types of pneumonia). your doctor.

Screening Mammograms Medicare covers mammograms once every 

A mammogram is a type of 12 months for all women with Medicare age 

x-ray to check for breast 40 and older.

cancer.

Smoking Cessation (counsel- Medicare will cover up to eight face-to-face 

ing to quit smoking) visits during a 12-month period. These visits 

Counseling is available for peo- must be ordered by your doctor and providple with Medicare who smoke ed by a qualified doctor or other Medicareand who are diagnosed with a recognized practitioner.

smoking-related illness or are 

taking medicines that may be 

affected by tobacco.
18 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Heart Disease and Stroke Prevention

Many women may not be aware that heart disease and stroke 

are major threats to their health. But heart disease is the most 

common cause of death among women in the United States, 

and stroke is the third most common cause of death. Heart disease and stroke also are major causes of long-term disability.

The most common form of heart disease is coronary artery disease (CAD). In CAD, plaque builds up on the walls of the arteries 

that carry blood to the heart. Over time, this buildup causes the 

arteries to narrow and harden. This keeps the heart from getting all the blood it needs. Blood clots may develop.

If a clot mostly or completely blocks blood flow to the heart, it 

causes a heart attack.

If a clot mostly or completely blocks blood flow to the brain, 

it causes a stroke. Stroke happens when the brain doesn’t get 

enough blood. Without enough blood, brain cells start to die.

The good news is that you can take steps to lower your chances 

of having a heart attack or stroke, or other heart problems. Here 

are some things you can do:

• Don’t smoke. Smoking hurts your heart and increases your 

risk of stroke. If you smoke, try to quit.
Office on Women's Health, http://www.womenshealth.gov 19

• Get more exercise. Try to do at least 2 hours and 30 minutes 

of aerobic exercise each week, and muscle-strengthening 

exercises on at least 2 days each week.

• Eat heart-healthy foods. Focus on eating fruits and vegetables, whole grains, fat-free or low-fat dairy products, fish, 

beans, peas, nuts, and lean meats.

• Eat less salt. Use spices, herbs, lemon, and lime instead of 

salt to flavor your food.

• If you drink alcohol, don’t have more than one drink each 

day. Too much alcohol raises your blood pressure and can 

raise your risk of stroke and other illnesses. 

• Get a blood pressure test. If it is high, talk to your doctor 

about how to lower it. 

• Get your cholesterol tested. If it is high, talk to your doctor 

or nurse about losing weight (if you’re overweight), getting 

more exercise, eating foods low in cholesterol and saturated 

fat, and possibly taking medicine to help.

• Get tested for diabetes. If you have diabetes, keep an eye 

on your blood glucose levels. High blood glucose levels can 

play a role in cardiovascular disease (see box). 

• Take your medicine. If your doctor has prescribed medicine 

to help you, take it exactly as you have been told to.

Understanding heart disease

Cardiovascular disease includes high blood pressure, stroke, 

heart failure, and coronary artery disease (CAD). CAD is 

caused by a narrowing of the arteries near the heart due to 

fatty buildups of plaque. It's likely to produce angina (chest 

pain), heart attack, or both.
20 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Heart Attack and Stroke Warning Signs

Heart Attack

A heart attack happens when the heart does not get enough 

blood flow. During a heart attack, heart muscle can be permanently damaged. Many people think a heart attack is sudden, like 

a “movie” heart attack, where someone clutches her chest and 

falls over. But the truth is that many heart attacks start slowly as 

mild pain or discomfort. These feelings may even come and go. 

For both women and men, the most common sign of a heart 

attack is pain or discomfort in the center of the chest. The pain 

or discomfort can be mild or strong. The discomfort may be constant or it may come and go over several minutes.

For women, though, chest pain may not be the first sign that 

your heart is in trouble. Before a heart attack, women have 

reported unusual tiredness, trouble sleeping, heartburn, a 

cough, heart flutters, or loss of appetite.

These are symptoms that could mean a heart attack is happening: 

• Chest discomfort. Most heart attacks involve discomfort in 

the center of the chest that lasts more than a few minutes, 

or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. 

Get help right away

If you have signs of a heart attack or stroke, call 911. Call 

right away — in 5 minutes or less. Learn more about heart 

attack symptoms in women at http://www.womenshealth.

gov/heartattack.

• Discomfort in other areas of the upper body. Symptoms 

can include pain or discomfort in one or both arms, the 

back, neck, jaw, or stomach.

• Shortness of breath. This may occur with or without chest 

discomfort.

• Other signs. These may include breaking out in a cold 

sweat, nausea, or lightheadedness.

Stroke

A stroke happens when part of the brain doesn’t get the blood 

it needs. Brain cells can die during a stroke. There are two kinds 

of stroke:

• An ischemic (iss-KEE-mik) stroke happens when blood is 

blocked from getting to the brain.
Office on Women's Health, http://www.womenshealth.gov 21 • A hemorrhagic (heh-muh-RA-jik) stroke happens when a 

blood vessel in the brain bursts, and blood leaks into the 

brain. 

A person might also have a “mini-stroke,” or a transient ischemic 

attack (TIA). This happens when, for a short time, less blood 

than normal gets to the brain. You may have some signs of a full 

stroke, or you may not notice any signs at all. A TIA can last a few 

minutes or up to 24 hours. Then you’re back to normal. 

TIAs are important warning signs to reduce your risk because 

they are a sign that a stroke will likely occur in the future. TIAs 

can occur days, weeks, or even months before a major stroke. In 

about half the cases, the stroke happens within 1 year of the TIA.

The signs of a stroke come on all of a sudden and are different 

from the signs of a heart attack. Signs include sudden: • Numbness or weakness of the face, arm, or leg, especially on 

one side of the body 

• Confusion, trouble speaking or understanding • Trouble seeing in one or both eyes • Trouble walking, dizziness, loss of balance or coordination • Severe headache with no known cause 
22 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Diabetes

Diabetes means that your blood glucose (sugar) is too high. 

Your blood always has some glucose in it because the body 

uses glucose for energy. It’s the fuel that keeps you going. But 

too much glucose in the blood is not good for your health.

When you take steps to prevent diabetes, you also lower your 

risk of heart disease, stroke, kidney disease, blindness, and amputation. Small changes in your lifestyle can make a difference.

Steps you can take:

• Get moving. Although health benefits can be gained from 

any increase in your physical activity, the most significant 

health benefits may be gained by doing the following each 

week: 

• 2 hours and 30 minutes of moderate-intensity aerobic 

physical activity

 or 

• 1 hour and 15 minutes of vigorous-intensity aerobic physical activity

 or 

• A combination of moderate- and vigorous-intensity 

aerobic physical activity 

 and 

• Muscle-strengthening 

activities on 2 days

• Stay at a healthy weight.

Being overweight raises 

your risk of diabetes. If 

you're overweight, start 

making small changes 

to your eating habits by 

adding more whole-grain 

foods, fruits, and vegetables. Start exercising more, 

even if taking a short walk 

is all you can do for now. 

If you're not sure where 

to start, talk to your doctor. Even a small amount 

of weight loss — 10 to 

15 pounds — has been 

proven to delay or even 

prevent the onset of type 2 

diabetes.
Office on Women's Health, http://www.womenshealth.gov 23

You can prevent the health problems caused by 

diabetes!

• Eye disease and blindness. Control your blood glucose and 

blood pressure and get a dilated eye exam once a year. 

• Heart health. To protect your heart and blood vessels, eat right, 

increase your activity, don’t smoke, and keep healthy blood glucose, blood pressure, and cholesterol levels. Eat a healthy diet 

that is low in salt and high in non-starchy vegetables. Work with 

a dietitian to plan healthy meals. If you’re overweight, talk about 

how to safely lose weight. Ask about a physical activity (or exercise) program. Quit smoking if you currently do. Get a hemoglobin A1C test at least twice a year to determine what your 

average blood glucose level was for the past 2 to 3 months. Get 

your blood pressure checked at every doctor’s visit (or at least 

once a year). Get your cholesterol checked at least once a year. 

Take medications if prescribed by your doctor.

• Kidney disease. Control blood glucose and blood pressure. See 

your doctor if your urine is cloudy or bloody, if you feel like you 

have to urinate often, if you have pain or burning when you urinate, or if you have back pain, chills, and fever. Have a urine test 

once a year. 

• Foot problems. Check your feet every day for cuts, sores, 

bumps, blisters, or red spots. Wash your feet daily and dry them 

carefully. Ask your doctor to check your feet at every office visit. 

Have a complete foot exam four times a year. 

• Mouth problems. Twice a year, have a dentist clean your teeth 

and check your gums. Use dental floss at least once a day. Brush 

your teeth with a soft toothbrush after every meal. 

• Nerve damage. You can help keep your nervous system 

healthy by keeping your blood glucose as close to normal as 

possible, getting regular physical activity, not smoking, taking 

good care of your feet each day, having your doctor or nurse 

examine your feet at least four times a year, and getting your 

feet tested for nerve damage at least once a year. 

• Flu and pneumonia. Get a flu vaccine every year. Ask your doctor about getting a vaccine to protect you from pneumonia. 

Being sick can raise your blood glucose. Moreover, illness can 

stop you from eating properly, which further affects blood glucose. Watch your blood glucose carefully if you are sick with the 

flu or a cold.
24 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Coping with Many Chronic Health Conditions

What are chronic diseases?

Chronic diseases are illnesses that you can’t catch and that last a 

long time, do not get better suddenly, and are rarely cured completely. Examples of chronic diseases include heart disease, cancer, stroke, diabetes, and arthritis. Although chronic diseases are 

more common among older adults, they affect people of all ages.

Many chronic diseases share the same risk factors. (See 

Understanding Risk Factors on page 4 for more information). 

For example, smoking can contribute to heart disease, diabetes, and stroke. If you can get rid of a risk factor — by quitting 

smoking, for example — then you can generally lower your 

chances of developing many chronic diseases. 

Dealing with more than one chronic disease

Having more than one chronic disease at a time is called having 

“multiple chronic conditions,” or MCC. If you have MCC, you may 

be stressed just keeping up with your doctor visits. You likely 

need to see different specialists for your many issues. You may 

get confused by the different instructions and medications you 

get from each doctor. Also, it can cost a lot of money to have 

MCC, because you may need to take several prescription medications. Costs can add up quickly.

Steps you can take:

• Take notes when you visit each doctor, so you remember 

important instructions

• Ask your doctor’s office to send a letter after each visit to 

your other doctor(s), so everyone is up to date on your 

health care

• Use an organizer to sort your medication so you take the 

right medicines each day 
Office on Women's Health, http://www.womenshealth.gov 25

Preventing chronic diseases

Chronic diseases are the most common and cost the most 

of all health problems, but they are also the most prevent-

able. Much of the illness, disability, and early death related 

to chronic diseases are caused by one of four things: • Tobacco use • Lack of physical activity • Poor eating habits • Too much alcohol use

By making some changes in your lifestyle — like quitting 

smoking, getting more exercise, eating better, and drinking 

less alcohol — you can prevent many chronic conditions. 

If you already have more than one chronic condition, mak-

ing these changes may help you to feel better and prevent 

more health problems.
26 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Physical Activity for Health

You have probably heard by now that physical activity is good 

for you. Well, the news in favor of regular physical activity keeps 

coming in! An active lifestyle can lower your risk of early death 

from a lot of causes. There is strong evidence that regular physical activity can also lower your risk of:

• Heart disease

• Stroke

• High blood pressure

What is metabolic syndrome?

Metabolic syndrome is a group of conditions that put you 

at risk for heart disease and diabetes. These conditions are 

• High blood pressure 

• High blood glucose levels 

• High levels of triglycerides, a type of fat, in your blood 

• Low levels of HDL, the good cholesterol, in your blood 

• Too much fat around your waist

• Unhealthy cholesterol levels

• Type 2 diabetes

• Metabolic syndrome 

(see box)

• Colon cancer

• Breast cancer 

• Falls 

• Depression

Regular activity can help you reach and stay at a healthy weight. 

It can also improve your cardiorespiratory (heart, lungs, and 

blood vessels) and muscular fitness. For older adults, activity can 

improve mental function.

It’s never too late to begin physical activity. If you haven’t been 

active for a while, though, check with your doctor before starting an exercise program. 

Physical activity may also help: 

• Improve functional health for older adults (your healthrelated quality of life)

• Reduce waistline size

• Lower risk of hip fracture 
Office on Women's Health, http://www.womenshealth.gov 27

• Lower risk of lung cancer 

• Lower risk of endometrial cancer 

• Keep a healthy weight

• Increase bone density, which can lower your risk of 

bone loss 

• Improve sleep quality

So what do you need to do to be active? Health benefits 

are gained by doing the following each week:

• 2 hours and 30 minutes of moderate-intensity aerobic 

physical activity 

 or

• 1 hour and 15 minutes of vigorous-intensity aerobic 

physical activity 

 or

• A combination of moderate- and vigorous-intensity 

aerobic physical activity 

 and

• Muscle-strengthening activities on 2 or more days 

(like working out with hand weights)

You can gain even more benefits by boosting activity to 5 

hours of moderate-intensity or 2 hours and 30 minutes of 

vigorous-intensity aerobic physical activity each week.

Examples of moderate and vigorous physical activities

Moderate activities Vigorous activities

Leisure 

activities

Walking at a brisk pace, 

ballroom dancing, leisurely bicycling, roller skating, 

canoeing 

Jogging, running, 

bicycling fast or uphill, 

jumping rope, swimming continuous laps 

Sports Golfing, softball, badminton, downhill skiing, 

Frisbee playing 

Singles tennis, beach 

volleyball on sand, basketball game, soccer, 

cross-country skiing 

Activities at 

home

Pushing a power lawn 

mower, gardening, raking leaves, shoveling light 

snow, moderate housework, hand washing/waxing a car, actively playing 

with children, riding a stationary bike 

Pushing a hand mower, 

heavy or rapid shoveling (more than 10 

pounds per minute), 

carrying items weighing 25 pounds or more 

up a flight of stairs 

Activities at 

work

Maid service, waiting 

tables, feeding or grooming farm animals, manually milking cows, picking fruits or vegetables, 

walking while carrying a 

mailbag 

Teaching an aerobic 

dance class, heavy 

farm work 
28 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Healthy Eating

Eating a healthy diet full of nutrients can help you stay at a 

healthy weight and may help protect you from certain diseases. 

A nutrient is anything in food that:

• Provides energy

• Helps your body “burn” another nutrient to provide energy

• Helps build or repair tissue

Making healthy choices can sometimes be hard, but there are 

easy changes you can make to eat better. To help prevent heart 

disease, stroke, and perhaps other diseases, you should eat 

mainly:

• Fruits and vegetables

• Grains (at least half of your grains should be whole grains, 

such as whole wheat, oatmeal, and brown rice)

• Fat-free or low-fat versions of milk, cheese, yogurt, and other 

milk products

• Fish, skinless poultry, lean red meats, beans, eggs, and nuts

• Polyunsaturated and monounsaturated fats (some foods 

that have these “good” fats include salmon, avocados, olives, 

walnuts, and olive oil)

An unhealthy diet and not exercising help make someone 

overweight or obese. Being overweight raises the risk of having some health problems like heart disease, type 2 diabetes, 

high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, osteoarthritis, and some cancers.

You can avoid unhealthy foods by limiting:

• Saturated fat (Saturated fat is the main dietary cause of high 

blood cholesterol. It is found mostly in foods from animals 

and some plants.)
Office on Women's Health, http://www.womenshealth.gov 29

• Trans fat (The amount of trans fat content in foods is printed on the Nutrition Facts label. Keep trans fat intake to less 

than 1 percent of total calories. For example, if you need 

2,000 calories a day, you should consume less than 2 grams 

of trans fat.)

• Cholesterol

• Sodium

• Added sugars

To stay at a healthy weight, you need to balance the calories you 

eat with the calories you use up (burn). To lose weight, you need 

to burn more calories than you eat. A healthy diet and physical 

activity can help you control your weight.

Steps you can take:

• Focus on fruits. For a 2,000-calorie diet, you will need 11⁄2 

to 2 cups of fruit each day (like one small banana, one large 

orange, and 1⁄4 cup of dried apricots or peaches).

• Vary your veggies. Eat more dark green veggies (such as 

broccoli, kale, spinach, and other dark leafy greens); orange 

veggies (like sweet potatoes or carrots); and beans and peas. 

For a 2,000-calorie diet, you will need 2 to 21⁄2 cups of vegetables each day (like 12 baby carrots and 1 cup of cooked 

spinach). 

• Get your calcium-rich foods. Get 3 cups of low-fat or fatfree milk (or the same amount of low-fat yogurt and/or lowfat cheese) every day. One cup of milk equals 11⁄2 ounces of 

hard cheese or one regular container (8 ounces) of yogurt. 

Lactose-free milk products and/or other calcium-fortified 

foods and drinks (like orange juice, salmon, spinach, and 

cereals) can give you calcium if you don’t drink regular milk.

• Make half your grains whole. Eat at least 3 ounces of wholegrain cereals, breads, crackers, rice, or pasta every day. One 

ounce is about one slice of bread, 1 cup of breakfast cereal, or 

1⁄2 cup of cooked rice or pasta. Eat whole-wheat bread instead 

of white bread or brown rice instead of white rice. 

• Eat fish. Broil, bake, steam, or grill your fish instead of frying it. Fish and shellfish contain a type of fat called omega-3 

fatty acids — it’s good for you! Research suggests that eating 

omega-3 fatty acids lowers your chances of dying from heart 

disease. Fish that naturally contain more oil (such as salmon, 

trout, herring, mackerel, anchovies, and sardines) have more 

omega-3 fatty acids than lean fish (such as cod, haddock, 

and catfish). You can also get omega-3 fatty acids from plant 

sources, such as:

• Canola oil 

• Soybean oil 

• Walnuts 

• Ground flaxseed (linseed) and flaxseed oil 

• Go lean with protein. Choose lean meat, poultry, and fish. 

Bake it, broil it, or steam it. Mix up your protein sources with 

more beans, peas, nuts, and seeds.
30 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Limit saturated fats and trans fats. Get less than 10 percent 

of calories from saturated fats. Most of the fats you eat should 

come from foods such as fish, nuts, and vegetable oils. When 

cooking meat, poultry, and fish, choose lean cuts. When having 

milk products, choose low-fat or fat-free kinds. Avoid trans fats, 

which are found in some processed foods (such as packaged 

cakes and cookies). Saturated fats, trans fats, and cholesterol 

tend to raise “bad” (LDL) cholesterol levels in the blood, which 

in turn increases the risk of heart disease. To lower risk of heart 

disease, cut back on foods containing saturated fats, trans fats, 

and cholesterol.

• Limit salt. Eat less than 2,300 mg of sodium (about 1 teaspoon of salt) each day. If you are older than age 51, or if 

you are African-American (at any age), or if you have hypertension, diabetes, or chronic kidney disease, you should eat 

less than 1,500 mg of sodium each day. Most of the salt we 

eat each day actually comes from processed foods rather 

than salt that we add to foods that we cook. Cut back on 

frozen dinners, pizza, packaged mixes, canned soups or 

broths, and salad dressings — these often have a lot of 

sodium. Make sure to check the sodium content on the 

Nutrition Facts label when buying food.

• Limit added sugars. Since sugars contribute calories with few, 

if any, nutrients, look for foods and beverages low in added 

sugars. Read the ingredient list and make sure that added 

sugars are not one of the first few ingredients. Some names 

for added sugars include sucrose, glucose, high fructose corn 

syrup, corn syrup, maple syrup, and fructose.

• Watch your portion sizes. Eating too many calories, even 

if they come from healthy foods, can lead to weight gain. If 

you are eating in a restaurant, split your meal with a friend if 

it’s large. At home, use small plates for your meals. 

• Balance your calories. Remember that the calories that 

come in should be burned. Too many calories will lead to 

weight gain if they are not burned by exercise.

How many calories should I eat? 

Use the Interactive Tools at My Pyramid.gov at http://www.

mypyramid.gov. They will show you the number of calories 

you need to eat each day to keep your current weight. If 

you are overweight, eat fewer calories than you burn to 

lose weight.
Office on Women's Health, http://www.womenshealth.gov 31

Fighting the Flu

“Flu” refers to sickness caused by a number of different influenza 

viruses. Most healthy people recover from the flu without problems, but certain people are at high risk for serious complications. Some people may even die from the flu. Pregnant women 

are especially at risk for serious complications from the flu.

Flu symptoms may include:

• Fever

• Coughing

• Sore throat

• Runny or stuffy nose

• Headaches

• Body aches

• Chills

• Fatigue

 In H1N1 flu infection, vomiting and diarrhea may also occur.

Annual outbreaks of the seasonal flu usually occur during the 

late fall through early spring. Flu is contagious — that means 

it can be spread from person to person. Because flu viruses 

change from year to year, people may not have natural immunity (protection); therefore, a seasonal flu vaccine is available. 

Vaccination is the best protection against getting the flu. Flu 

vaccines are safe and recommended for all individuals 6 months 

of age and older. Flu vaccines are also safe during pregnancy 

and can be received during the first, second, or third trimester of 

pregnancy.

Steps you can take:

• Cover your nose and mouth with a tissue when you cough or 

sneeze. Throw the tissue in the trash after you use it.

• Wash your hands often with soap and water, especially after 

you cough or sneeze. You can also use alcohol-based hand 

cleaners.

• Avoid touching your eyes, 

nose, or mouth. Germs 

spread this way.

• Try to avoid close contact 

with sick people.

• Stay home if you are sick 

until at least 24 hours after you no longer have a fever (100°F 

or 37.8°C) or signs of a fever (without the use of a feverreducing medicine, such as Tylenol). Ask your doctor about 

how long to stay away from others.

For current 

information on the flu, 

visit www.flu.gov.
32 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Cervical Health

Cervical cancer happens when normal cells in the cervix 

change into cancer cells. Before the cells turn into cancer, 

abnormal cells develop on the cervix that can be found by a 

Pap test. Treating the cervix before the abnormal cells become 

cancerous can prevent cancer. 

Most cases of cervical cancer are caused by the human papillomavirus (HPV). HPV is a virus that is passed from person 

to person through genital contact, most often during vaginal and anal sex. You are more likely to get HPV if you have 

more than one partner. However, any woman who has ever 

had genital contact with another person can get HPV. Most 

women infected with HPV will not get cervical cancer. Pap 

tests look for changes in the cervical cells that could become 

cancerous if not treated.

Steps you can take:

• Get a Pap test. The best time to get a Pap test is between 

10 and 20 days after the first day of your last period. Do 

not have the test done when you have your period, and 

don’t use douches, vaginal medicines (unless your doctor 

tells you to), spermicide foams, creams, or jellies 2 days 

before your Pap test. Talk to your doctor about how often 

to get Pap tests.
Office on Women's Health, http://www.womenshealth.gov 33

• If you have sex, stay with one partner who only has sex 

with you. HPV is a group of viruses that can be passed 

through sexual contact. HPV can cause changes on the cervix that can lead to cervical cancer. Using condoms every 

time you have sex may reduce your chances of getting HPV. 

HPV can also be passed by skin-to-skin contact with sores or 

infected genital skin that looks normal.

• Ask your doctor about an HPV test. In combination with 

a Pap test, an HPV test helps detect the types of HPV that 

cause cervical cancer. 

• Depending on your age, get the HPV vaccine. Scientists 

have made two vaccines (shots) that help stop certain types 

of HPV. The vaccines help protect against the types of HPV 

that most often cause cervical cancer. The HPV vaccines 

(called Gardasil and Cervarix) are recommended for females 

ages 9 to 26. One of these two vaccines is given in three 

doses (shots) over a 6-month period. It is very important to 

get all three doses. Women who are pregnant should not get 

the HPV vaccine until after the baby is born. 

• Don’t smoke.

How common is HPV?

Genital HPV is the most common sexually transmitted infection (STI) in the United States. About 20 million Americans 

ages 15 to 49 currently have HPV. And at least half of all sexually active men and women get genital HPV at some time 

in their lives. You are more likely to develop cervical cancer 

if you smoke, have HIV or reduced immunity, or don’t get 

regular Pap tests.
34 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Reproductive Health

Did you know that your reproductive system is one of the most 

fragile systems of your body? It can easily get infected or injured, 

and, if it does, you might have long-term health problems, 

including difficulty getting pregnant or carrying a pregnancy.

Taking simple steps to prevent getting or spreading HIV/AIDS 

and other sexually transmitted infections (STIs) will pay off 

both for you and for those you love. Taking control and getting 

treatment is very important. It’s not only important because it 

will keep you from spreading the infection, but getting treatment may also stop serious problems, including infertility and 

even death.

Steps you can take:

• Know that many methods of birth control, like birth 

control pills, shots, implants, or diaphragms, will not 

protect you from HIV or other STIs. If you use one of these 

methods, be sure to also use a latex condom or dental dam 

(used for oral sex) correctly with each sex act. 

• Don’t share needles or IV drug equipment for illegal 

drugs like heroin and cocaine, or for legal drugs like insulin. If you get a tattoo or body piercing, make sure you do so 

at a place that properly sterilizes the equipment and needles.

• Talk frankly with your doctor or nurse and your sex 

partner(s) about any STIs you or your partner have now 

or have had. Talk about any sores or discharge in the genital area. If you are living with HIV, be sure to tell your partner and your doctor.

• Have regular pelvic exams. Talk with your doctor about 

how often you need them. Ask your doctor to test you for 

STIs.

• If you are pregnant, get tested for chlamydia, gonorrhea, hepatitis B and C, HIV, and syphilis. Get tested as 

soon as you think you may be pregnant. If you have HIV and 

are pregnant, you can greatly lower the chances of giving HIV 

to your baby by taking medicine. Talk to your doctor.

For more information, call: 

CDC National STD & AIDS Hotlines

• 800-CDC-INFO or 800-232-4636 — English Service (24 

hours a day, 7 days a week)

• 800-CDC-INFO or 800-232-4636 — Spanish Service (24 

hours a day, 7 days a week)

• 888-232-6348 — TTY Service (24 hours a day, 7 days a 

week)
Office on Women's Health, http://www.womenshealth.gov 35

Preconception Health

Preconception health is a woman's health before she becomes 

pregnant. It includes knowing how health conditions and 

risk factors could affect a woman or her unborn baby if she 

becomes pregnant. For example, some foods, habits, herbs, 

and medicines can harm your baby — even before he or she is 

conceived. Some health problems, such as diabetes, also can 

affect pregnancy.

Every woman should be thinking about her health whether or 

not she is planning pregnancy. One reason is that about half of 

all pregnancies are not planned. Unplanned pregnancies have 

a greater risk of preterm birth and low-birth-weight babies. 

Another reason is that, despite important advances in medicine 

and prenatal care, about 1 in 8 babies is born too early. By taking action on health issues and risks before pregnancy, you can 

prevent problems that might affect you or your baby later.

Steps you can take:

• Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 

mg) of folic acid every day if you are planning or capable 

of pregnancy. This will lower your child’s risk of some birth 

defects of the brain and spine, including spina bifida. All 

women need folic acid every day. Talk to your doctor about 

your folic acid needs. Some doctors prescribe prenatal vitamins that contain higher amounts of folic acid. 

• Stop smoking and drinking alcohol.

• If you have a medical condition, be sure it is under 

control. Some conditions that can affect pregnancy or be 

affected by it include asthma, diabetes, lupus, oral health, 

obesity, thyroid disease, blood clotting disorders, or epilepsy. 

• Talk to your doctor about any over-the-counter and prescription medicines you are using. These include dietary 

or herbal supplements. Be sure your vaccinations are up to 

date.

• Avoid contact with toxic substances or materials that 

could cause infection at work and at home. Stay away 

from chemicals and cat or rodent feces. 

• Take care of your teeth and gums. Infections in your teeth 

and gums can be dangerous during pregnancy.
36 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Pregnancy

If you know you are pregnant, or think you might be, call your 

doctor as soon as possible and set up a visit. You will need to 

visit your doctor many times during your pregnancy. Follow 

your doctor’s schedule for visits and don’t miss them! 

You will notice your body is changing in many ways. These 

changes may be strange at first, but they are all normal. Try to 

stay as healthy as you can — for you and your new baby! 

Steps you can take:

• Stop smoking, drinking alcohol, and doing drugs. These 

can cause long-term damage to your baby. Ask your doctor 

for help. 

• Eat healthy foods. This includes lots of fruits, vegetables, 

whole grains, and calcium-rich foods. You need 1000 milligrams (mg) of calcium per day. (If you are a teen, you need 

at least 1300 mg of calcium each day.) Avoid eating a lot of 

fatty foods such as butter and fatty meats. Choose foods 

lower in fat, like chicken and turkey (without the skin) and 

fish. Check with your doctor to find out how much weight 

gain during pregnancy is healthy for you.

• Don’t eat uncooked or undercooked meats or fish. Do 

not eat any shark, swordfish, king mackerel, and tilefish (also 

called golden or white snapper) because these fish have high 

levels of mercury. Do not eat more than 6 ounces of "white" 

or "albacore" tuna or tuna steak each week.

• Limit caffeine from coffee, tea, sodas, medicines, and chocolate.

• Drink water. Water helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Aim for 8 cups of fluids each day. If you drink enough 

fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 

cups) or more of colorless or slightly yellow urine a day, your 

fluid intake is probably good.

• Take at least 400 micrograms of folic acid daily. This will 

help prevent certain types of birth defects. Your doctor may 

prescribe a daily vitamin that has it, or you can buy folic acid 

pills. Eat foods high in folic acid like orange juice, leafy green 

vegetables, beans, peanuts, peas, and whole-grain products.

• Tell your doctor about all of the medicines you take. This 

includes prescriptions, over-the-counter medicines you buy 

without prescriptions, and herbals. Ask if they are safe to 

take while you are pregnant. Most of the time, the medicine 

a pregnant woman is taking does not affect her baby. But 

sometimes it can, causing damage or birth defects. Talk with 

your doctor about which drugs and supplements are safe.
Office on Women's Health, http://www.womenshealth.gov 37 • Stay active. Being physically active during pregnancy 

helps you in many ways. It prevents a lot of extra weight 

gain. It helps you have good posture, which will help you 

feel better later in your pregnancy. It can help you sleep 

better and have a shorter, easier labor. If you were physi-

cally active before getting pregnant, you can keep doing 

mild-to-moderate activity, like low-impact aerobic dance, 

swimming, or walking. If you were not physically active 

before getting pregnant, you still can become active, but 

start slowly. Try walking at first, then build up to more. 

Mild stretching, easy yoga poses, and weight training on 

exercise machines is okay. Talk to your doctor about which 

activities are good for you.

• Take care of your teeth and gums. If you are pregnant 

and have not had regular checkups, have a complete oral 

exam early in your pregnancy. Because you are pregnant, 

you might not receive routine x-rays. But if you must have 

x-rays for a dental problem needing treatment, the health 

risk to your unborn baby is small. Pregnant women may have 

changes in taste and develop red, swollen gums that bleed 

easily. This condition is called pregnancy gingivitis (jin-juhVYT-uhss). It can be caused by both poor oral hygiene and 

higher hormone levels during pregnancy. So remember to 

brush and floss regularly!

• Avoid toxic chemicals. These include paint, paint thinners, 

cleaning products, and those used to kill bugs or that con-
38 Call for free health publications: 800-994-9662 TDD: 888-220-5446

tain lead or mercury. Read the product label to see if it has a 

pregnancy warning.

• Avoid hot tubs, saunas, and unnecessary x-rays. Be sure 

to tell your doctor that you are pregnant if you need an x-ray. 

The doctor or nurse will recommend whether the x-ray is necessary.

• Avoid changing cat litter. It can carry and cause an infection that can cause birth defects. Wear gloves when gardening in areas cats may visit.

• Clean, handle, cook, and chill food properly to prevent 

food-borne illness.

• Get enough sleep. Try to get 7 to 9 hours of sleep every 

night.

• Control the stress in your life. Don’t be afraid to say no to 

requests for your time and energy.

• Buckle up. Wearing a seat belt during car and air travel is 

safe while pregnant. The lap strap should go under your 

belly and across your hips. The shoulder strap should go 

between your breasts and to the side of your belly. Make 

sure it fits snugly.

• Learn all you can. Read books, watch videos, go to a childbirth class, and talk with other moms.
Office on Women's Health, http://www.womenshealth.gov 39

Breastfeeding

Breastfeeding is more than a lifestyle choice — it's an important 

health choice. Breastfeeding lowers the risk of certain health 

problems in both babies and mothers. It is also a joyful bonding 

experience.

Why breastfeed?

• Breastfed babies are more able to fight off infection and 

disease, such as diarrhea, ear infections, and respiratory illnesses such as pneumonia. They are sick less often and have 

fewer visits to the doctor. 

• Breast milk has the perfect amount of fat, sugar, water, and 

protein to help your baby grow just right.

• Most babies find breast milk easier to digest than formula.

• A mother can satisfy her baby's hunger right away with 

breastfeeding.

• Breastfeeding encourages a mother to take some quiet 

relaxed time for herself and her baby, helping them bond. 

Physical contact is important to newborns and can help 

them feel more secure, warm, and comforted. Breastfeeding 

mothers may have increased self-confidence and feelings of 

closeness and bonding with their infants.

• Breastfeeding helps the uterus to get back to its original size 

and lessens any bleeding a woman may have after giving birth. 

For detailed information on breastfeeding please visit 

http://www.womenshealth.gov/breastfeeding.

• When you breastfeed, there are no bottles and nipples to 

sterilize. 

• Breast milk is free.

Steps you can take:

• Put your baby to the breast to nurse as soon as possible after 

birth. Frequent breastfeeding helps your body make even 

more milk for the baby. 

• Give your baby only breast milk for the first 6 months of life. 

It is even better for your baby to breastfeed for 12 months or 

longer. 

• You can give solid foods when your baby is 6 months old, 

while you keep breastfeeding. 

• Be patient with yourself! What works for one mom might 

not work for you. Relax and try to find a routine and 

positions that work for you and your baby. It will get 

easier with time.
40 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Did you know? 

The Affordable Care Act (also called “health care reform”) 

requires companies to provide reasonable, unpaid break 

time and a private, non-bathroom space for breastfeeding 

mothers to express milk for the first year of a child’s life. 

Learn more at http://www.healthcare.gov. 

Breastfeeding is linked to a lower risk of these health 

problems:

In infants: • 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

Ear infections

Stomach viruses

Diarrhea

Respiratory infections

Atopic dermatitis, also known as eczema or 

very itchy, dry skin

Asthma

Obesity

Type 1 and type 2 diabetes

Childhood leukemia

Sudden infant death syndrome or SIDS

Necrotizing enterocolitis, a disease that 

affects the gastrointestinal tract in preterm 

infants

In moms: • 

• 

• 

• 

Type 2 diabetes

Breast cancer

Ovarian cancer

Postpartum depression 
Office on Women's Health, http://www.womenshealth.gov 41

Menopause

Menopause is a normal change in your life when your periods 

stop. During menopause, your body slowly makes less of the 

hormones estrogen and progesterone. As you near menopause, 

you may have symptoms from the hormone changes in your 

body. Many women wonder if these changes are normal, and 

many are confused about how to treat their symptoms. You can 

feel better by learning all you can about menopause and by 

talking with your doctor about your health and your symptoms.

Steps you can take:

• Hot flashes. Avoid hot environments, eating or drinking hot 

or spicy foods, alcohol, caffeine, and stress, all of which can 

bring on hot flashes. Dress in layers, and keep a fan in your 

home or workplace. Regular exercise might also bring relief. 

Ask your doctor about taking an antidepressant medicine. 

These medicines can be helpful for some women. 

• Vaginal dryness. Use an over-the-counter vaginal lubricant. 

There are also prescription estrogen replacement creams 

that your doctor might give you. If you have spotting or 

bleeding from estrogen creams, see your doctor. 

• Problems sleeping. Avoid alcohol, caffeine, large meals, and 

working right before bedtime. Try to keep your bedroom at 

a comfortable temperature. Avoid napping during the day, 

• Memory problems. Ask your doctor about mental exercises 

you can do to improve your memory. Try to get enough 

sleep and to be physically active.

and try to go to bed and get up at the same times every day. 

Exercise can also help. But avoid exercise close to bedtime. 
42 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Mood swings. Try to get enough sleep and to be physically 

active. Ask your doctor about relaxation exercises you can 

do. Ask your doctor about taking an antidepressant medicine, which could help.

There are a lot of ways to stay healthy during this time in your 

life:

• Be active and get more exercise. Try to get at least 2 hours 

and 30 minutes of moderate exercise each week and 2 days 

of muscle-strengthening exercise. Try weight-bearing exercises, like walking, running, or dancing. (See the section on 

Physical Activity for Health on page 26 for more details.) All 

older adults should avoid inactivity. Some physical activity 

is better than none, and older adults who participate in any 

amount of physical activity gain some health benefits.

• If you smoke, quit. Ask your doctor for help. (See page 53 

for more ideas on Quitting Smoking.)

• Eat healthy. Eat lots of whole-grain products, vegetables, 

and fruits. Choose foods low in fat and cholesterol. 

• Get enough calcium to keep your bones strong. Before age 

50, you need about 1,000 mg of calcium per day. After age 50, 

you need 1,200 mg per day. 

• If you drink alcohol, 

drink moderately. Limit 

it to no more than one 

drink per day.

• Control your weight.

Ask your doctor what a 

healthy weight is for you.

• Talk to your doctor 

about bone health. Ask 

if you’re getting enough 

calcium and vitamin D. 

Get a bone density test if 

you’re older than 65, or if 

your doctor says you have 

a high chance of getting 

osteoporosis. Ask about 

taking medicine to help 

preserve bone and slow 

down bone loss.

• Get preventive screenings. Have your blood 

pressure, cholesterol, and 

blood glucose checked. 
Office on Women's Health, http://www.womenshealth.gov 43

Have regular clinical breast exams and mammograms (a 

breast x-ray).

To help control the symptoms of menopause, some women can 

take hormones, called menopausal hormone therapy (MHT). Once 

a woman reaches menopause, MHT currently is recommended 

only as a short-term treatment of moderate to severe symptoms 

such as hot flashes or night sweats. Women who have problems 

with vaginal dryness can try lower dose estrogen products, such 

as vaginal creams, rings, and tablets. Long-term use of MHT is 

no longer advised, and doctors very rarely prescribe MHT to prevent certain chronic diseases, like osteoporosis. Postmenopausal 

women should not take MHT as they grow older to prevent problems like heart disease. In fact, combination hormone therapy 

can increase the risk of heart disease in healthy postmenopausal 

women. A woman should talk about the benefits and risks of 

using MHT with her doctor to decide if MHT is right for her.

When using menopausal hormone therapy (MHT)

• Use at the lowest dose that helps 

• Use for the shortest time needed

Who should NOT use MHT for menopause:

Women who:

• Think they are pregnant 

• Have problems with vaginal bleeding 

• Have had certain kinds of cancers (such as breast and uterine 

cancer) 

• Have had a stroke or heart attack 

• Have had blood clots 

• Have liver disease 
44 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Finding Breast Cancer Early

Breast cancer is the second most common type of cancer in 

women (the first is skin cancer). The older a woman is, the greater 

her risk. Most women who develop breast cancer have no special 

risk factors for the disease, so it is critical that you talk with your 

doctor and work out a plan that meets your needs.

Reasons to call your doctor include:

• A lump in or near your breast or under your arm

• Thick or firm tissue in or near your breast or under your arm 

• A change in the size or shape of your breast 

• Nipple discharge (fluid that is not breast milk) 

• Nipple changes, such as a nipple that points or faces inward 

(inverted) into the breast

• Changes to your breast skin, areola, or nipple, such as itching, redness, scaling, dimples, or puckers

• Wanting to talk to your doctor about breast cancer screening

Keep in mind that most breast changes are not cancer. For 

instance, nipple discharge can be caused by birth control pills, 

some medicines, and infections. Or, a breast lump could be a 

cyst, which is a fluid-filled lump that is not cancer. Early breast 

cancer usually does not cause pain. Still, any breast changes or 

pain should be checked out by a doctor. If you notice a change 

in your breast, call your doctor and schedule a visit. Don’t wait 

until your "next checkup."

Steps you can take:

• Get a mammogram. It is the best way to find out if you 

have breast cancer. A mammogram is an x-ray picture 

of the breast. It can find breast cancer that is too small 

for you or your doctor to feel. Starting at age 40, women 

should talk with their doctor and make a decision about 

whether to have screening mammograms and how often 

to have them. Recommendations vary, but they should be 

at least every 2 years. Depending on factors such as family 

history and your general health, your doctor may recommend a mammogram more frequently. Discuss how often 

you need a mammogram with your doctor. If your mother 

or sister had breast cancer, insist that you have a mammogram. Have the mammogram done right after your period 

because it might be less painful and more accurate than 

during your period. 

• Get a clinical breast exam (CBE) if you have concerns 

about anything you find in your breast. This is a breast 

exam done by your doctor or nurse. He or she will check 
Office on Women's Health, http://www.womenshealth.gov 45

your breasts and underarms for any lumps, nipple 

discharge, or other changes. Ask your doctor if you 

need a CBE.

• Get to know your 

breasts. Some women 

check their own breasts 

for changes. If you find a 

change, it’s important to 

call your doctor or nurse 

for a visit. Make sure to 

watch the change you 

found until you see your 

doctor or nurse. Although 

research data do not support an official recommendation that all women do 

breast self-exams, knowing your body is key to 

pointing out any concerns 

to your doctor.

Signs of Breast Cancer

Change in how the nipple 

looks, like pulling in of the 

nipple

Clear or bloody 

fluid that leaks out of 

the nipple

Lump Skin dimpling Change in skin color 

or texture
46 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Urinary Tract Health

Proper functioning of the urinary system is a natural part of 

your day. It is something that you probably don’t think about 

until you have a problem. The urinary tract makes and stores 

urine. There are three main parts of the urinary tract – the urethra (which directs the urine from the bladder out of the body, 

the bladder (which collects and holds urine until you are ready 

to urinate), and the kidneys (which clear wastes from the body). 

Bacteria (germs that get into your urinary tract) can cause a 

urinary tract infection, or UTI. Most of the germs come from the 

anal area. They can enter through the urethra, go into the bladder, and even go up into the kidneys and cause infection. A UTI 

can involve any of the parts of your urinary tract — the kidneys, 

the bladder, and the urethra.

There are steps you can take to try to prevent a UTI. Following 

these steps can decrease your chances of getting a UTI. These 

steps may not always be enough, so if you have symptoms of a 

UTI such as pain, bleeding, or frequent urination, call your 

doctor.

Steps you can take:

• Urinate when you need to. Don’t hold it. Holding urine 

allows bacteria to grow and cause problems. 

• Urinate before and after sex. If you use a diaphragm for 

contraception make sure to empty your bladder after sex 

and after removal of the diaphragm, too. 

• Drink water every day.

Drinking six to eight 

glasses of water each day 

can help keep your bladder 

healthy. You can also drink 

cranberry juice, which may 

fight infection. However, 

don’t drink cranberry juice 

if you’re taking the bloodthinning medication warfarin. Possible interactions 

between cranberry juice 

and warfarin may lead to 

bleeding.

• Clean your anus and the outer lips of your vagina each 

day. The anus is the place where a bowel movement leaves 

your body, located between the buttocks. Make sure to 

wash from front to back and rinse well with water.
Office on Women's Health, http://www.womenshealth.gov 47

• Wipe from front to back. Doing so after urinating and after 

a bowel movement helps prevent bacteria in the anal region 

from spreading to the vagina and urethra.

• Don’t use douches or feminine hygiene sprays. These can 

contain perfumes and chemicals that irritate the area and 

may increase the chance of infection.

• If you get a lot of UTIs and use spermicides or creams 

that kill sperm, talk to your doctor about using other 

forms of birth control.

• Wear underwear with a cotton crotch. Keep the area dry as 

much as possible.

• Take showers instead of tub baths. Bubble bath detergents can irritate the urinary tract and increase the chance of 

infection.

The Urinary Tract

Kidney

Bladder

Ureter

Urethra
48 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Colorectal Health

Colorectal refers to the colon and rectum. Colorectal cancer is 

often called a "silent" disease because symptoms don’t always 

develop until it is difficult to cure. The good news is that colorectal 

cancer is preventable and mostly curable when detected early 

through regular screening tests.

Screening tests help your doctor find polyps, before you have 

symptoms. Polyps are growths that may turn into cancer. 

Finding and removing polyps may prevent colorectal cancer. 

Also, treatment for colorectal cancer is more likely to be effective when the disease is found early.

To find polyps or early colorectal cancer:

• People in their 50s and older should be screened.

• People who are at higher-than-average risk of colorectal cancer 

should talk with their doctor about whether to have screening 

tests before age 50, what tests to have, the benefits and risks of 

each test, and how often to schedule appointments.

Steps you can take:

• Adopt a diet low in fat and high in vegetables and fruit.

Diets high in vegetables and fruits have been linked with 

lower risk of colon cancer. Diets high in processed and/or 

red meats have been linked with a higher risk.

• Consider taking calcium pills. Higher intakes of calcium have 

been linked to reduced risks of colorectal cancer. Talk to your 

doctor or nurse about whether this is a good idea for you.

• Try to stay at a healthy weight. Ask your doctor about a 

healthy weight range for you.

• Limit alcohol. For women, drink no more than one alcoholic 

drink per day.

• If you smoke, quit. Ask your doctor or nurse for help.

• Get regular physical activity. See page 26 for more information. 

• When you turn 50, start getting regular colorectal 

screening exams. These include yearly rectal exams and 

stool blood tests, as well as sigmoidoscopy every 5 years 

and colonoscopy every 10 years. If your family members 

developed cancer at a young age, talk with your doctor or 

nurse about testing before age 50.

• Consider genetic counseling and testing. People with a 

strong family history of colorectal polyps or cancer should 

consider genetic counseling to determine whether genetic 

testing may be right for them. If needed, this kind of testing 

can help you decide about getting tested and treated at an 

early age.
Office on Women's Health, http://www.womenshealth.gov 49

Healthy Eyes and Ears

Vision and hearing losses can happen as you age. Other problems with your eyes and ears can happen as you work and play. 

Prevention, early detection, and proper treatment for injury or 

disease to your eyes and ears will help you enjoy independence 

and a better quality of life.

Steps you can take:

• Get your eyes examined according to this schedule:

• If you are between the ages of 18 and 39, discuss with 

your doctor when you should have a comprehensive 

dilated eye exam. 

• Get a baseline exam at age 40, then every 2 to 4 years (or 

as your doctor advises) until age 49. 

• Have an exam every 2 to 4 years until age 55, then every 

1 to 3 years until age 65, or as your doctor advises.

• At ages 65 and older, get an exam every 1 to 2 years.

People at higher risk for eye diseases need to be examined more 

often. For example, adults with diabetes should have a dilated eye 

exam at least once a year. African-Americans over age 40, people 

with a family history, and everyone over age 60 are at higher 

risk for glaucoma and should have a dilated eye exam every 1 to 

2 years. Eye diseases often have no warning signs in their early 

stage and can only be detected by an eye care professional. 

• Have regular dilated eye exams. This is the best thing you 

can do to make sure your eyes are healthy and you are seeing your best. Your eye care professional will tell you how 

often you need to have one.

• Wear sunglasses to protect your eyes from harmful ultraviolet (UV) rays when outdoors. Choose sunglasses with 99 to 

100 percent UVA and UVB protection, to block both forms of 

ultraviolet rays.
50 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Wear protective eyewear, such as polycarbonate safety 

glasses, safety goggles, or face shields, when working outdoors or with materials that can harm eyes and when playing sports. 

• Eating a diet rich in fruits and vegetables, particularly dark 

leafy greens such as spinach, kale, or collard greens is important to keep your eyes healthy. 

• Reduce eyestrain by adjusting your computer monitor 

appropriately, taking rest breaks when working on a computer, and sitting upright with your feet flat on the floor 

when working on a computer. 

• Prevent hearing loss from noise. Pay attention to 

sounds around you that are at or above 85 decibels, such 

as concerts, fireworks, or lawn mowers. If you are around 

loud sounds for too long, wear earplugs or move away 

from the sound. 

• Get a hearing exam every 10 years between the ages of 18 

and 49 and every 3 years after that.

• Prevent ear infections. You can help prevent upper respiratory infections — and a resulting ear infection — by washing your hands often. Also, get a flu vaccine every year to 

help prevent flu-related ear infections.

• Ask your doctor if your medicines may hurt your ears.

Some medicine (like certain antibiotics) can damage hearing.

• Be careful when listening to music through headphones.

Many devices that people use today have noise levels much 

higher than 85 decibels. For example, an MP3 player at 

maximum level is roughly 105 decibels. Scientists recommend no more than 15 minutes of unprotected exposure to 

sounds that are 100 decibels. In addition, regular exposure 

to sounds at 110 decibels for more than 1 minute risks permanent hearing loss.
Office on Women's Health, http://www.womenshealth.gov 51

Healthy Bones

Women of all ages need to take steps to keep their bones strong. 

Unfortunately, millions of women already have or are at risk for 

osteoporosis (oss-tee-oh-puh-RO-sis). Osteoporosis means that 

your bones get weak, and you’re more likely to break a bone. 

Because there are no symptoms, you might not know your bones 

are getting weaker until you break a bone! There are steps you can 

take to stop your bones from becoming weak and brittle.

Steps you can take:

• Get enough calcium each day. You can easily get it through 

many foods, including dairy products like milk, cheese, and 

yogurt, fortified cereals, oatmeal, spinach, and white beans. 

If you don't eat enough of these foods, you can get extra 

calcium from calcium pills. Talk with your doctor to see 

if you need a calcium pill, and which kind is best for you. 

Remember: 

• Adults under age 51 need 1,000 mg of calcium daily. 

• Adults 51 and over need 1,200 mg of calcium daily.

• Get enough vitamin D each day. You can get vitamin D 

through sunlight and foods like salmon, low-fat or fat-free 

milk, and some yogurt with added vitamin D. Check food 

labels to see how much vitamin D you are getting. Talk to 

your doctor before taking vitamin D pills. Remember:

• Adults ages 19 to 70 need 600 IU of vitamin D daily. 

• Adults ages 71 and older need 800 IU of vitamin D daily.

• Get moving. Being active helps your bones by slowing bone 

loss, improving muscle strength, and helping your balance. 

Weight-bearing exercises, like walking, dancing, jogging, 

stair-climbing, racquet sports, and hiking, can help prevent 

osteoporosis.

• Eat a healthy diet. You can get the nutrients you need by eating foods like lean meats, fish, low-fat or fat-free milk, green 

leafy vegetables, and oranges.
52 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Don’t smoke. Smoking damages your bones.

• Limit alcohol. If you drink, do not drink more than one 

alcoholic drink per day.

• Make your home safe. Reduce your chances of falling: use 

a rubber bathmat in the shower or tub, remove throw rugs, 

and install grab bars in the bath or shower.

• Get your bones tested. If you are age 65 and older, get a 

bone density test. If you are between ages 60 and 64, weigh 

less than 154 pounds, and don’t take estrogen, get a bone 

density test. Your doctor may recommend a bone density 

test if you are younger than 60 and have one or more risk 

factors for osteoporosis.

• Talk to your doctor about medicine. Some medicines can 

prevent or treat bone loss.

• Teach your daughter early. Making good choices 

for healthy bones should start in childhood and 

become habits that last. For more information, visit 

http://bestbonesforever.gov.
Office on Women's Health, http://www.womenshealth.gov 53

Quitting Smoking

Smoking is the number one cause of preventable illness and 

death in the United States. If you're a long-time smoker, you 

may think it's too late. But it's never too late to benefit from 

quitting. If you quit smoking, you are likely to add years to your 

life. You may also breathe more easily, have more energy, and 

save more money.

Other benefits include:

• Reduced cancer, heart attack, and lung disease risk 

• Better blood circulation 

• No smoke odor in your clothes and hair 

• A better sense of taste 

• A more sensitive sense of smell 

• No more second-hand smoke for your family members

Steps you can take: 

Research has shown that these five steps will help you to quit 

for good.

• Pick a date to stop smoking. Before that day, get rid of all 

cigarettes, ashtrays, and lighters everywhere you smoke. Do 

not allow anyone to smoke in your home. Write down why 

you want to quit, and keep this list as a reminder.

• Get support from your family, friends, and coworkers.

Studies have shown you will be more likely to quit if you 

have help. Let the people important to you know the date 

you will be quitting, and ask them for their support. Ask 

them not to smoke around you or leave cigarettes out.

• Find substitutes for smoking and vary your routine.

When you get the urge to smoke, do something to take your 

mind off smoking. Talk to a friend, go for a walk, or go to the 

movies. Reduce stress with exercise, meditation, hot baths, 

or reading. Try sugar-free gum or candy to help handle your 

cravings. Drink lots of water and juices. You might want 

to try changing your daily routine as well. Try drinking tea 

instead of coffee, eating your breakfast in a different place, 

or taking a different route to work.

• Talk to your doctor or nurse about medicines to help you 

quit. Some people have withdrawal symptoms when they 

quit smoking. These symptoms can include depression, trouble sleeping, feeling irritable or restless, and trouble thinking 

clearly. There are medicines to help relieve these symptoms. 

Most medicines help you quit smoking by giving you small, 

steady doses of nicotine, the drug in cigarettes that causes 

addiction. Talk to your doctor or nurse to see if one of these 

medicines may be right for you:
54 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Nicotine patch: worn on the skin and supplies a steady 

amount of nicotine to the body through the skin 

• Nicotine gum or lozenge: releases nicotine into the 

bloodstream through the lining in your mouth 

• Nicotine nasal spray: inhaled through your nose and 

passes into your bloodstream 

• Nicotine inhaler: inhaled through the mouth and 

absorbed in the mouth and throat 

• Bupropion (byou-PRO-pee-on): an antidepressant 

medicine that reduces nicotine withdrawal symptoms 

and the urge to smoke 

• Varenicline (var-e-NI-kleen): a medicine that reduces 

nicotine withdrawal symptoms and the pleasurable 

effects of smoking

• Be prepared for relapse. Most people relapse, or start 

smoking again, within the first 3 months after quitting. 

Don't get discouraged if you relapse. Remember, many 

people try to quit several times before quitting for good. 

Think of what helped and didn't help the last time you tried 

to quit. Figuring these out before you try to quit again will 

increase your chances for success. Certain situations can 

increase your chances of smoking. These include drinking 

alcohol, being around other smokers, gaining weight, stress, 

or becoming depressed. Talk to your doctor or nurse for 

ways to cope with these situations.

• Get more help if you need it. Join a quit-smoking program 

or support group to help you quit. These programs can help 

you handle withdrawal and stress and teach you skills to 

resist the urge to smoke. Contact your local hospital, health 

center, or health department for information about quitsmoking programs and support groups in your area.

Hotlines and websites to help you quit 

• Call the National Cancer Institute at 877-44U-QUIT to 

talk to a counselor.

• Call 800-QUIT-NOW (800-784-8669) to be connected 

to the hotline for your state. You can talk to a counselor and, in some cases, get free nicotine replacement 

therapy.

• Smokefree.gov (http://women.smokefree.gov) provides 

free information and professional help to women who 

are trying to quit smoking.
Office on Women's Health, http://www.womenshealth.gov 55

Oral Health

Good oral health does not just mean you have pretty teeth. 

Your whole mouth needs care to be in good health. The word 

“oral” refers to the mouth, which includes your teeth, gums, 

jawbone, and supporting tissues. Oral health can affect the 

health of your whole body.

The health of your mouth can be a sign of your body’s 

health. Mouth problems are not just cavities, toothaches, and 

crooked or stained teeth. Many diseases, such as diabetes, 

HIV, cancer, and some eating disorders, can cause oral health 

problems. For instance, people with diabetes can develop 

tooth and gum problems if their blood glucose stays high. 

Regular dental exams help you maintain good oral health 

and avoid related health problems.

Steps you can take: • Get regular checkups. Have an oral exam once or twice 

a year. Your dentist may recommend more or fewer visits, 

depending on your oral health. At most routine visits, the 

dentist and a dental hygienist will treat you. During regular 

checkups, dentists look for signs of diseases, infections, prob-

lems, injuries, and oral cancer.

• Brush your teeth. Brush at least twice each day with fluo-

ride toothpaste. Aim for first thing in the morning and before 

going to bed. 
56 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Floss every day. Once a day, use floss to clean food your 

toothbrush missed. 

• Drink water that contains added fluoride if you can.

Fluoride protects against dental decay. Most public water 

systems in the United States have added fluoride. Check 

with your community’s water or health department to find 

out if there is fluoride in your water. You also may want to 

use a fluoride mouth rinse, along with brushing and flossing, to help prevent tooth decay. 

• Change your toothbrush. Use a new toothbrush every 3 

months, or earlier if the toothbrush looks worn or the bristles spread out. A new toothbrush removes more plaque. 

• Clean your dentures. If you wear dentures, be sure to 

remove them at night and clean them before putting them 

back in the next morning. 

• Eat healthy meals. Cut down on tooth decay by brushing after meals. Avoid snacking on sugary or starchy foods 

between meals. 

• Don’t smoke. It raises your risk of gum disease, oral and 

throat cancers, and oral fungal infections. It also affects the 

color of your teeth and the smell of your breath.

• Limit alcohol use to one drink per day for women. Heavy 

alcohol use raises your risk of oral and throat cancers. Using 

alcohol and tobacco together raises your risk of oral cancers 

more than using one alone. 

• Limit how much soda you drink. Even diet soda contains 

acids that can erode tooth enamel.

• If you have another health problem, think about how it 

may affect your oral health. For instance, if you take medicines that give you a dry mouth, ask your doctor or nurse if 

there are other drugs you can use. Have an oral exam before 

starting cancer treatment. And if you have diabetes, practice 

good oral hygiene to prevent gum disease.
Office on Women's Health, http://www.womenshealth.gov 57

Healthy Skin

The skin, your body’s largest organ, protects you against heat, 

light, injury, and infection. Tanned skin is not a sign of good 

health. It means that your skin has been hurt by the sun’s ultraviolet (UV) rays. Too much sun without protection can cause skin 

damage, eye problems, and more serious health problems such 

as skin cancer and lip cancer. The good news is that you can take 

steps to protect your natural beauty and your health.

Steps you can take:

• Avoid the rays. Stay inside or in the shade when the sun’s 

rays are the strongest. This is between 10 a.m. and 4 p.m. UV 

rays can also reach you on cloudy days and during any season. 

• Apply lots of sunscreen. Use sunscreen on all exposed skin 

that has a sun protection factor (SPF) of at least 15. Your 

sunscreen should protect you from both ultraviolet A (UVA) 

and ultraviolet B (UVB) rays. Reapply every 2 hours, even on 

cloudy days, and after swimming or sweating. Do not forget 

to apply sunscreen to your lips, ears, feet, hands, bald spots 

or a part in your hair, and the back of the neck. Also, apply it 

under bathing suit straps, necklaces, bracelets, and sunglasses. You should put on 1 ounce of sunscreen every 2 hours. 

Use more if you are swimming or sweating. A small tube 

containing 3 to 5 ounces 

of sunscreen might only be 

enough for one person during a day at the beach.

• Accessorize. Wear protective clothing, such as a 

wide-brimmed hat, longsleeved shirt, and long 

pants. If you can’t wear 

long shirts and pants, try 

to stay in the shade and 

wear sunscreen. Keep your 

eyes safe with wraparound 

sunglasses with 100 percent UV ray protection.

• Avoid sun tanning and tanning beds. UV light from tanning beds and the sun cause skin cancer and make your 

skin look wrinkled. If you want to look like you’ve been in 

the sun, think about using a self-tanning lotion. Remember 

that you still need to use sunscreen, even if you use a selftanning lotion!

• Check your skin often. Look for changes in size, texture, or 

color of moles or birthmarks or patches on the skin that look 
58 Call for free health publications: 800-994-9662 TDD: 888-220-5446

dry, scaly, reddish, and 

slightly raised. See your 

doctor right away if you 

find anything unusual.

• Get vitamin D safely.

Vitamin D is an important 

vitamin that your body 

produces when you are 

out in the sun. But there 

are other ways to get vitamin D that don’t require 

you to be in the sun’s rays. 

You can get vitamin D 

through fortified milk and 

orange juice, cheese, butter, cereals, and fish. You 

can also get vitamin D 

through vitamin supplements. Talk to your doctor 

or nurse if you have questions about vitamin D.

Did you know that too much sun exposure can cause:

Melanoma 

Melanoma (mell-ah-NOH-ma) is the most 

serious form of skin cancer. Be aware of any 

unusual skin rashes or of any change in the 

color or size of a mole, and talk to your doctor or nurse about it. Finding a melanoma 

early can save your life! Check your skin each 

month for new or changing moles. 

Nonmelanoma skin cancers 

Nonmelanoma (non-mell-ah-NOH-ma) skin 

cancers are not as serious as melanoma. 

However, they can still cause health problems and need to be treated by a doctor. 

There are two kinds:

Basal cell carcinomas — these are small 

tumors on the skin that look like small fleshy 

bumps 

Squamous cell carcinomas — these are small 

tumors on the skin that might appear as red, 

scaly patches 

Actinic keratoses 

Actinic keratoses (ack-TIN-ick ker-ah-TOEsees) are growths on the skin caused by 

the sun. They are usually found on the face, 

hands, forearms, and the “V” of the neck. 

They are usually rough and scaly. See a doctor right away if you notice these growths.

Early aging of the skin 

Being in the sun — or laying in a tanning 

bed — without proper protection causes the 

skin to become thick, wrinkled, and leathery. 

Read “Steps you can take” on page 57 for ideas 

on how to protect your skin from the sun!
Office on Women's Health, http://www.womenshealth.gov 59

Stress

Women today have busy, demanding lives! You may feel pulled 

in different directions and experience stress from dealing with 

work, family, and other matters, leaving little time for yourself. 

Learning to balance your life with time for yourself will give you 

big rewards.

Caregiver stress

Caregivers usually take care of the medical needs of their loved 

ones. You may be taking care of a child with medical needs, or you 

may be caring for your aging parents. Maybe you’ve already raised 

your own child and now you’re raising your grandchild. You might 

be taking care of your spouse, or a sibling. Whomever you care for, 

your health can be affected by the stress of taking care of someone else. The stress that caregivers are under may lead to missed 

work or lost free time, strained relationships with people who may 

not understand the situation, and physical and mental exhaustion.

Stress from caregiving can make it hard to cope with a loved 

one's medical problems. It is important that people caring for 

those with medical disorders also take care of themselves.

Steps you can take:

• Relax. Try deep breathing, yoga, meditation, or massage 

therapy. 

• Make time for yourself. Set aside at least 15 minutes each 

day to do something for yourself, like taking a walk or calling 

a friend.

• Sleep. Sleeping helps both your body and mind. Try to get 7 

to 9 hours of sleep every night.

• Eat healthy. Try to fuel up with fruits, vegetables, and 

whole-grain foods, such as whole-grain crackers and 

breads.
60 Call for free health publications: 800-994-9662 TDD: 888-220-5446

• Get moving. Believe it or not, getting physical activity 

not only helps relieve your tense muscles but helps your 

mood too!

• Talk to friends. This can help you work through your stress.

• Get help from a professional if you need it. Don’t let 

stress lead to more serious problems. 

• Compromise. Sometimes, it’s not always worth the stress 

to argue. Give in once in awhile.

• Write down your thoughts. Keeping a journal can be a 

great way to get things off your chest and work through 

issues.

• Help others. Helping someone else can help you. Help 

your neighbor, or volunteer in your community. 

• Get a hobby. Give yourself time to explore your interests.

• Set limits. Set limits with yourself and others. Don’t be 

afraid to say no to requests for your time and energy.
Office on Women's Health, http://www.womenshealth.gov 61

Mental Health

Good mental health is an important part of a woman’s overall health. All women feel worried, anxious, or sad from time 

to time. But a true mental health disorder makes it hard for 

a woman to function normally. It’s important to remember 

that mental health disorders are real medical illnesses that 

can't be willed or wished away! They affect both the mind 

and the body; it’s not just “all in your head.” In fact, most mental 

health disorders do not have a precise cause. They come from 

a combination of life events, brain chemicals, genes, hormones, 

and illness.

Anxiety Disorders

Anxiety is a normal reaction to stress. It can help you cope with 

a hard situation. When anxiety becomes an extreme, irrational 

fear of everyday situations, it can be disabling. Anxiety disorders 

include:

• Obsessive compulsive disorder

• Panic disorder 

• Generalized anxiety disorder 

• Social phobia (or social anxiety disorder) 

• Specific phobias 

Like depression, these conditions can be helped with all the 

“Steps you can take” described on page 63. All of these disorders 

can improve with treatment.

Post-Traumatic Stress Disorder (PTSD)

PTSD is a real illness. You can get PTSD after living through or 

seeing a dangerous event, such as war, a hurricane, a bad accident, or violence and abuse. PTSD makes you feel stressed and 

afraid even after the danger is over. PTSD can be treated.

Anorexia, Bulimia, and Binge Eating Disorder

A woman with an eating disorder eats too much, too little, or 

causes herself to throw up food. Eating disorders can include:

• Anorexia nervosa 

• Bulimia 

• Binge eating disorder 

Because eating disorders can be physically dangerous, it is 

important to talk with your doctor or nurse if you (or someone 

you know) may have an eating disorder. Eating disorders can be 

treated.
62 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Depression

When a person has a depressive disorder, it hurts their daily 

life, and normal functioning and causes pain for both the person with the disorder and those who care about him or her. 

Depression is a common but serious illness, and most women 

who have it need treatment to get better.

Symptoms of depression include:

• Sad, anxious, or "empty" feelings that won’t go away

• Feelings of hopelessness and/or pessimism 

• Feelings of guilt, worthlessness, and/or helplessness 

• Irritability, restlessness 

• Loss of interest in activities or hobbies once pleasurable, 

including sex 

• Fatigue and decreased energy 

• Difficulty concentrating, remembering details, and making 

decisions 

• Insomnia, early-morning wakefulness, or excessive sleeping 

• Overeating, or appetite loss 

• Thoughts of suicide, suicide attempts 

• Aches or pains, headaches, cramps or digestive 

problems that do not get 

better, even with treatment

Depression, even the most 

severe cases, can be treated. 

The sooner treatment begins, 

the more effective it is. The 

first step to getting treatment for depression is to 

visit a doctor.

Postpartum Depression

Postpartum depression is 

when a new mother has a 

major depressive episode 

within 1 month after delivery. 

Ten to 15 percent of women 

have postpartum depression 

after giving birth. It can make 

you feel restless, anxious, 
Office on Women's Health, http://www.womenshealth.gov 63

very tired, and worthless. Some new moms worry they will hurt 

themselves or their babies. Researchers think that changes in 

your hormone levels during and after pregnancy may lead to 

postpartum depression. If you think you have it, tell your doctor. 

Medicine and talk therapy can help you get well.

Steps you can take:

If you are depressed, you may feel exhausted, helpless, and 

hopeless. It may be very hard to do anything to help yourself. 

But it is important to realize that these feelings are part of the 

depression and do not reflect real life.

After you see a doctor and begin treatment, negative thinking 

will fade. In the meantime:

• Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. 

Participate in religious, social, or other activities. 

• Set realistic goals for yourself.

• Break up large tasks into small ones. Set priorities and do 

what you can as you can. 

• Try to spend time with other people and confide in a 

trusted friend or relative. Try not to isolate yourself, and let 

others help you. 

• Expect your mood to improve gradually, not immediately. Do not expect to suddenly “snap out of” your depression. 

Often during treatment for depression, sleep and appetite 

will begin to improve before your depressed mood lifts. 

• Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better.

Discuss decisions with others who know you well and have a 

more objective view of your situation. 

• Be confident that positive thinking will replace negative 

thoughts as your depression responds to treatment.

Are you thinking about suicide?

If you are thinking about hurting or killing yourself, please 

ask for help! You can call: 

• 911

• 800-273-TALK (8255)

• 800-SUICIDE

You can also check your local phone book or look online for 

the number of a suicide crisis center.
64 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Dealing with Violence

Women of all ages and backgrounds are at risk for many different types of violence. It doesn’t matter what race or culture 

you come from, how much money you have, or if you have a 

disability. It is most common among women between ages 15 

and 54, but it can happen at any age. If you are being abused 

or have a loved one who is abused, or think there is abuse, get 

help as soon as you can.

In fact, millions of women in this country have experienced violence. Violence greatly affects the lives and health of women: the 

effect can last for years — even a lifetime. But there are places to 

turn for help, ways to protect yourself, and hope for healing and 

a better future. It’s important to talk to a service provider about 

how to protect your safety. The hotlines listed on this page can 

connect you to local resources.

Steps you can take:

• Don’t keep it to yourself. Get help. Talk with someone: a 

family member, friend, colleague, or faith counselor.

• If you’ve been hurt, get medical attention and call the 

police. Abuse is a crime and you have rights. 

• Set aside some money and choose a place to go. If you 

decide to leave, you’ll be prepared. Put important papers — 

marriage license, birth certificates, checkbook, and other papers 

and items — in a place where you can get them quickly.

• Contact your family court or domestic violence court.

Get information about a civil protection order.

• If you're in an abusive relationship, be careful when using 

the Internet. Your computer use can be tracked. It is impossible to fully erase the websites you have visited. If you think 

someone is tracking your computer use, please use a safer 

computer. You may be able to use a friend's computer or a 

computer at your local library.

• If someone touches, grabs, or makes sexual comments 

to you at work, speak up. Tell your employer or human 

resources department. If this is not possible, call the police.

To get immediate help and support: 

National Domestic Violence Hotline

Web address: http://www.thehotline.org 

800-799-SAFE (7233) or TTY 800-787-3224

National Sexual Assault Hotline 

Web address: http://www.rainn.org 

800-656-HOPE (4673)

National Sexual Assault Online Hotline 

Web address: https://ohl.rainn.org/online
Office on Women's Health, http://www.womenshealth.gov 65

Talking with Your Doctor or Nurse

Knowing how to talk to your doctor or nurse will help you get the 

information you need to make better health care decisions. Here are 

some tips:

• Make a list of health concerns and questions to take with 

you to your visit. Share the list with your doctor or nurse. 

• Describe symptoms clearly and briefly. Say what the symptoms are, when they began, how they make you feel, what 

triggers them, what (if anything) makes them stop, and 

what you’ve done to help them. This helps your doctor decide 

the best course of treatment, along with any tests you may need. 

• Tell your doctor or nurse what prescription and over-thecounter medicines, vitamins, herbal products, and other 

supplements you’re taking. Be honest about your diet, physical 

activity, smoking, alcohol or drug use, and sexual history. Discuss 

allergies to drugs, foods, or other things. Tell your doctor or nurse 

if you are being treated by another doctor or nurse, including a 

mental health professional. 

• Don’t be afraid to ask questions and don’t feel embarrassed 

about discussing sensitive topics. Your doctor or nurse is used 

to talking to people about personal concerns.

• Don’t leave something out because you’re worried about 

taking up too much time.

• Be sure you understand everything before you leave. This 

includes treatment recommendations and any follow-up tests 

or referrals. If you don’t understand something, ask to have it 

explained again. 

• Bring a family member or friend with you to take notes and 

offer moral support. An extra pair of eyes and ears can help 

you remember your questions as well as the answers.

• Make sure you can see and hear as well as possible. Many 

older people use glasses or need aids for hearing. Remember to 

take your eyeglasses to the doctor’s visit. If you have a hearing 

aid, make sure that it is working well and wear it. Tell the doctor 

and staff if you have a hard time seeing or hearing. For example, 

you may want to say: “My hearing makes it hard to understand 

everything you’re saying. It helps a lot when you speak slowly.”

• Find an interpreter if you know you’ll need one. If the doctor 

you selected or were referred to doesn’t speak your language, 

consider bringing an interpreter with you.
66 Call for free health publications: 800-994-9662 TDD: 888-220-5446

Checklist of Questions to Ask Your Doctor or Nurse

General Health and Wellness Questions

❑ How often do I need a physical exam, breast exam, pelvic 

exam, and Pap test?

❑ Do I need a flu vaccine or other immunizations?

❑ Will changing my lifestyle (diet, exercise, smoking, drinking) 

help me avoid certain diseases?

❑	 What can I do to be healthier? Is there any reading material 

or videotapes on these topics? Are there support groups or 

community services that can help?

Medical Test Questions

❑ What will we know after the test is done?

❑ How do I find out the results? How long will it take to get 

the results?

❑ What does the test involve? What do I do to get ready for it?

❑ Are there any dangers or side effects with the test?

Symptoms and Diagnosis Questions

❑ Could my symptoms be caused by or related to something 

other than my current condition?

❑ What may have caused my current condition? 
Office on Women's Health, http://www.womenshealth.gov 67

Checklist of Questions to Ask Your Doctor or Nurse

Treatment Questions

❑ How is this condition treated or managed? What long-term 

effects (if any) will it have on my life?

❑ How soon should treatment start? How long will it last?

❑ Are there other treatments available?

❑ How much will the treatment cost? Is it covered by insurance?

❑ What are the treatment’s risks and side effects?

Medication Questions (you can also ask your 

pharmacist)

❑ What are the side effects? 

❑ What should I do if I miss a dose?

❑ Are there foods, drugs, or activities I should avoid while taking this medicine?

❑ Is there a generic brand available at a lower price?
Notes
U.S. Department of Health and Human Services

Office on Women’s Health

200 Independence Ave, SW

Room 712E

Washington, DC 20201

800-994-9662 • TDD: 888-220-5446

Scan this code with your smartphone to 

go directly to womenshealth.gov