Ultimate 40s & 50s Female Health Checklist

You're a busy woman in your 40s or 50s and your to-do isn't getting shorter. 

Even if you're up to your neck in work, household duties, family commitments, side projects and so forth, don't deprioritize your wellness.

Make sure to stay on top of your preventative health, no matter how much of a hassle it may seem.

I put together this ANNUAL HEALTH CHECKLIST FOR WOMEN IN THEIR 40s and 50s to simplify the process a bit for you. When it's time for your physical, make sure to talk to your doctor about the following tests:

• Heart Disease Screening 
  • Fasting lipid/cholesterol panel
  • Blood pressure check
  • Fasting Blood Glucose (as part of your comprehensive metabolic panel)
  • Weight and BMI (body mass index)
  • Tobacco use (if you are a smoker, be sure to discuss tobacco cessation with your doctor as this elevates your heart disease risk)
  • if your above results indicate that you have elevated cardiovascular disease risk (i.e. your 10 year cardiovascular disease risk is over 5%) you may need further testing and follow-up with your primary care doctor to discuss    
• Mammogram: for women with average risk (no personal history of breast cancer, no strong family history of breast cancer or genetic mutation known to increase risk of breast cancer like BRCA gene, no chest radiation therapy before the age of 30), these are the guidelines as per the American Cancer Society
  • Women between 40 and 44 have the option to start screening with a mammogram every year.
  • Women 45 to 54 should get mammograms every year.
  • Note: While the ACS no longer recommends a clinical breast exam (CBE) as a screening method for women in the U.S and breast self-exam is also no longer recommended as an option for women of any age, I still recommend a clinical breast exam for women starting at age 20, to be done annually for women 40 and over  
• Colonoscopy: the American Cancer Society recommends that people with average risk of colorectal cancer start regular screening at age 45. This can be done with either a stool-based test or with an exam that looks at the colon and rectum. Those with average risk have none of the following: a personal history of colorectal cancer or certain types of polyps, a family history of colorectal cancer, a personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease), a confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC), a personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer. I will caveat that colonoscopy is by far the best test (i.e. gold standard) for detection of pre-cancerous polyps and what I recommend to my patients. 
  • Stool-based tests
    • Highly sensitive fecal immunochemical test (FIT) every year
    • Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
    • Multi-targeted stool DNA test with fecal immunochemical testing (MT-sDNA or sDNA-FIT or FIT-DNA)) every 3 years (Cologuard)
  • Visual exams of the colon and rectum
    • Colonoscopy every 10 years
    • CT colonography (virtual colonoscopy) every 5 years
    • Sigmoidoscopy every 5 years 
• Cervical Cancer Screening (ages 30-65): as per the CDC these are the guidelines. Speak to your doctor about which is the right option for you.
  • An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
  • An HPV test along with a Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
  • A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.    
• Lung Cancer Screening: (for adults aged 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years)
  • annual screening for lung cancer with low-dose computed tomography (LDCT)

• Skin Cancer Screening: make sure to see your dermatologist and they will determine the frequency of follow-up based on your risk
• Eye Exam
• Dental Exam
• Bloodwork
  • Comprehensive metabolic panel looking at your fasting blood glucose, electrolytes, and liver function tests
  • Vitamin D and B12 levels
  • Thyroid function test
  • If you're plant-leaning, vegan/vegetarian or have a history of heavy periods or iron deficiency anemia, ask to have your complete blood count, iron panel and ferritin (iron stores) checked
  • Hepatitis B and C screening for all adults (one-time screening) 

• Sexually Transmitted Disease Screening
  • If you are sexually active and have a higher risk for STDs, get yearly tests for chlamydia, gonorrhea and syphilis. Take an HIV test at least once, more frequently if you are at risk.     
• Last but not least, make sure all of your vaccines are up-to-date