9 Medical Tests Every Woman Over 40 Should Have
Feb 09 2018
By Barbara Brody
There's a lot that's pretty great about turning 40. With a few decades of experience under your belt, you're more knowledgeable about what you want out of life and how to get it. Maybe you're finally hitting your stride in your career, getting the hang of parenting, or eagerly tackling new adventures that you would have shied away from when you were younger. If you've been prioritizing fitness and good nutrition, you might even feel—and look—healthier than ever. But does that mean you are actually healthier? (Here's how to be your healthiest you at 40, 50, 60, 70, and beyond.)
Whether you seem to be in peak physical condition or admit that you've put on a few pounds and have slowed down over the years, 40 is the ideal time to take your relationship with your primary care physician to the next level.
"As you get older, there is an increased incidence in many diseases, including heart disease, cancer, and arthritis. Starting to see your doctor a little more regularly can help prevent, predict, and treat diseases before they become significant problems," says Mia Finkelston, MD, a board certified family physician who treats patients virtually via the telehealth app LiveHealth Online. Step one: Schedule a physical, and plan to do it again annually unless your doc gives you other instructions.
A physical you get in your 40s should be similar to ones you had when you were younger, but don't be surprised if your doctor orders a few additional tests or refers you to some specialists in an effort to keep you as healthy as possible. Here's a look at the medical tests you should plan on having in this decade.
This shouldn't be brand new to you, since the American Heart Association recommends getting your blood pressure tested at least every year or two starting at age 20. (You can lower your blood pressure naturally with these 13 tips.) But once you enter midlife, it's extra important to stay on top of it. High blood pressure is a major risk factor for heart disease and stroke, which rarely has any symptoms. Normal blood pressure is less than 120/80 mm Hg.
As with blood pressure, you should have been getting blood tests that check your LDL ("bad" cholesterol), HDL ("good" cholesterol), and triglycerides every year or two since you were 20. If you haven't done this in a while, don't delay: "Heart disease is still the leading killer of women. It accounts for about 22% of deaths in women, which is more than all cancers combined," says Wendy Day, MD, an internal medicine physician with UCHealth Family Medicine Clinic-Castle Rock. (You can lower your cholesterol naturally with food. Here's how.)
If you have risk factors like obesity or a family history of diabetes, then your doctor might have been monitoring your blood sugar for years. If not, the American Diabetes Association recommends starting annual screening at age 45. Your doctor can choose to screen you with a fasting blood glucose test or an A1C test (a blood test that provides an average of your sugar levels over the past 3 months).
This one's a bit controversial, since some guidelines suggest that women at average risk wait until age 50 and others say to start at 40. The American Cancer Society splits the difference, saying that women in their early to mid-40s "should have the choice to start breast cancer screening with mammograms," women 45-54 should get them annually, and women 55 and older and can opt to get them every 2 years. (Psst! Here are 9 things you can expect at your first mammogram.)
If you're confused, you're not alone, but your doctor can help you make the best decision for you, says Day. Some factors to discuss include your family history and how you personally weigh the pros and cons of starting screening now versus waiting a few years. (You might catch cancer earlier... or you might end up with unnecessary treatment.)
5. Eye exam
Even if your eyesight used to be 20/20, don't be surprised if you suddenly have a hard time reading restaurant menus and text messages. While developing presbyopia (trouble reading up close) isn't dangerous and a pair of reading glasses from the drugstore might suffice, consider your struggle a reminder that you should see an optometrist or ophthalmologist for a checkup.
The American Optometric Association recommends getting an eye exam at least every two years starting at age 18, yet once you're in your 40s it becomes even more important, says Adam Splaver, MD, a cardiologist with Nanohealth Associates in South Florida. Starting at 40 you should be tested every 1-3 years for glaucoma; your eye doc should also check for retinal disease, especially if you have diabetes.
You might not be seeing your ob-gyn as regularly as you used to if you're done having kids and have long settled into a monogamous relationship, but women ages 30-65 should have a Pap test plus an HPV test at least every 5 years (or a Pap test alone every 3 years). While you're there for your appointment, don't hesitate to spill some intimate details about your sex life. If you're in a new relationship, have multiple partners, or suspect that your partner has other partners then you need to be screened for STDs (in addition to HPV, the virus that causes cervical cancer), says Shilpi Agarwal, MD, a Washington, DC-based family medicine doctor and author of The 10-Day Total Body Transformation, which will be published in March.
As with mammograms, this one's a bit tricky because different groups offer different recommendations. (The United States Preventive Services Task Force, for instance, says there isn't enough evidence to urge everyone to get routine professional skin checks.) That said, most dermatologists and many internists suggest seeing a dermatologist at least once a year for a skin exam. Whether or not you go annually is up to you, but at the very least you should be checking your own skin regularly and seeing a doctor if you notice any changes. (Make sure you know these 7 skin cancer symptoms you can't see.)
About 13% of women ages 35-65 have hypothyroidism (an underactive thyroid), so starting at age 35 it's a good idea to get your thyroid checked out at least every 5 years. (It's usually part of a standard blood work-up.) After you turn 50 your doctor may suggest keeping ever closer tabs on your thyroid, since some thyroid disorders are more prevalent after menopause.
Your primary care doctor should be doing this at a checkup, no matter your age. But there are some times in a woman's life when you may be especially vulnerable. "Sometimes moods change in your 40s as you approach menopause," says Agarwal. Hormonal shifts may play a role, but whatever the cause, statistics show that women 40-59 have higher rates of depression compared to teenage girls. Many women in their 40s also experience excessive anxiety, adds Agarwal. (Here are 9 surprising depression symptoms you should know.)
Your doctor should screen you for these issues by asking some simple questions. "They shouldn't just say, 'Are you depressed,'" says Agarwal. "I usually ask 'How's your mood?' and then ask if they've noticed feeling down, hopeless, or disinterested in activities they used to enjoy during the past two weeks," she explains. If those few questions point to possible depression, she'll follow up with a longer list of more detailed questions designed to diagnose depression.
Whether your doctor brings it up or not, be sure to raise any concerns you may have about your mood, or seek out a mental health expert near you.