The Medical Tests Every Woman Must Have in your 30s, 40s, 50s

Sure, your to-do list is probably longer than the Great Wall of China, so you may be tempted to let your annual mammogram or cholesterol test slip. But don’t let that happen: Stud­ies show that regular checkups and screenings can help keep you out of the doctor’s office the rest of the year. Here, we lay out the essential med­ical tests you need in your 30s, 40s, 50s, and up, according to top women’s-health experts. In most cases, these should be covered by insurance—but be sure to ask first.

 
In your 30s and up, get a …

Full gynecological check

Your gyno will perform manual pelvic and breast exams, plus a Pap smear (during which cervical cells are collected with a swab). You may also receive an HPV (human papilloma­virus) test to detect strains of the HPV virus that are responsible for most cervical cancer cases.

Why you need it: A pelvic exam checks for abnormalities such as growths. A breast exam will identify any suspicious lumps, dimpling, rashes, and nipple discharge. And the Pap smear and HPV test are important screenings for cervical cancer.

How often you need it: All women 30 and older need annual pelvic exams (a breast exam is typically included). The exception: You may be able to skip a year or two if three consecutive, annual Pap tests come back normal or if you have both the Pap and HPV tests and both are regularly normal.

Tip: For the most accurate Pap results, avoid having sex or using vaginal medications (such as anti-yeast creams) one to two days before your appointment, says Mary Marnach, MD, an assistant professor of obstetrics and gynecology at the Mayo Clinic in Rochester, Minnesota. And at home, many experts say, it’s smart to perform monthly breast self-exams (manual checks for lumps), despite debate about whether these exams help prevent breast cancer deaths. Do them about a week after you start your period, when breasts tend to be less swollen and tender, Marnach says.

Heart-health check

Your doc will check your blood pressure and administer a lipid profile, a blood test that checks for LDL (bad) and HDL (good) cholesterol, triglycerides, and total cholesterol levels. If you have a family history of heart disease or other risk factors, she may recommend a high-sensitivity CRP test (hs-CRP), which measures inflammation, an indicator of heart health. If you have a history of depression, you may have increased levels of inflammation.

Why you need it: These tests help determine your level of risk for heart disease (the number-one killer of women) and stroke.

How often you need it: If your blood pressure is normal—120 over 80, or less—get rechecked every two years. Have your cholesterol checked every five years. (After age 45, you’ll need both tests annually, as your risk rises with age.) Talk to your doctor about how often to retake the hs-CRP test, if this applies to you.

Tip: A lipid profile is best done after fasting for 9 to 12 hours, so book a morning appointment and skip breakfast. If your blood pressure reading seems unusually high, try again a few minutes later or at the end of the visit.

Skin check

Your dermatologist looks head to toe for any suspicious moles or growths.

Why you need it: Melanoma, the deadliest form of skin cancer, often begins as a mole. And the disease is on the rise, especially in women.

How often you need it: Once or twice a year.

Tip: You should also perform your own monthly skin checks in front of a mirror—and don’t skimp on your lower half: melanoma can crop up anywhere on the body but is more commonly found on women’s legs. Talk to your derm if you spot any suspicious or changing moles, and always apply a broad-spectrum sunscreen (it blocks both UVA and UVB rays) 20 to 30 minutes before any outdoor activity.

Eye exam

This series of tests, performed by an ophthalmologist or optometrist, checks vision and looks for signs of eye disease.

Why you need it: The exam can catch signs of glaucoma, age-related macular degeneration, and cataracts, as well as diabetes and high blood pressure.

How often you need it: Every three years (every two after age 40), or more frequently if there’s a family history of eye disease or you have diabetes, high blood pressure, or are a contact lens wearer, according to Andrea Thau, doctor of optometry, of the American Optometric Association.

Tip: Wear sunglasses, even on cloudy days, to protect your eyes from damaging ultraviolet light. Choose a pair that blocks 99 to 100 percent of both UVA and UVB radiation; ask the salesperson for help or check the label. 

In your 40s, add a …

Diabetes test

This test determines your blood-glucose level to diagnose prediabetes and diabetes.

Why you need it: Diabetes affects more than 23 million Americans, ups risks of heart disease and stroke, and can lead to kidney disease and blindness.

How often you need it: Every three years after age 45. Talk to your doctor about testing earlier if you’re overweight and have any other risk factors, such as high blood pressure or high cholesterol, or if you smoke or have a family history of diabetes. If you have prediabetes (your blood-glucose level is slightly elevated), you should be checked every one to two years.

Tip: Don’t eat or drink for eight hours before the test. To lower your risk for diabetes by nearly 60 percent, exercise 30 minutes a day and maintain a healthy weight.

Mammogram

This X-ray of the breasts screens for cancer. There are film (traditional) and digital mammograms. Both are effective for spotting tumors, but research shows that digital mammography is significantly better for women who are younger than age 50 or have very dense breasts, according to the National Cancer Institute.

Why you need it: Thanks to this critical tool, on average, women are being diagnosed with smaller tumors now than in past decades. (Small tumors are more likely to be at a more treatable stage.)

How often you need it: Every year, starting at age 40. If your mother or sister was diagnosed with breast cancer, especially if she was younger than 40, get tested 5 to 10 years earlier than the age your relative was diagnosed.

Tip: “Schedule mammos about two weeks after your period, when breasts are less tender,” says Nieca Goldberg, MD, director of the New York University Langone Medical Center Women’s Heart Program and author of Nieca Goldberg’s Complete Guide to Women’s Health. Skip deodorant, perfume, or powder that day because the residue can interfere with the X-rays.

Vitamin D Test

The blood test checks your level of this important nutrient.

Why you need it: Vitamin D helps protect your bones. It may also defend against diabetes, heart disease, and some cancers, and hike your body’s ability to fight off infections. You typically get the nutrient from sun exposure and fortified dairy products. But now that women are more cautious about the sun’s harmful rays (rightly so), some may not be getting enough D. Supplementation can help.

How often you need it: Ask your doctor. Aging ups your risk of vitamin D deficiency (your body becomes less efficient at synthesizing the nutrient).

Tip: Get more vitamin D from foods like salmon, egg yolks, and fortified milk, or from a calcium-and–vitamin D supplement.

In your 50s, add a …

Colonoscopy

The doc will insert a long, flexible tube with a small camera on the end through your rectum to check for polyps (small growths that can become cancerous over time) while you’re sedated. Any suspicious growths are immediately removed for testing.

Why you need it: The risk of colon cancer—the fourth most common cancer in women and men—increases with age. It’s often curable if detected early.

How often you need it: Every 5 to 10 years, unless your doctor recommends otherwise. Start testing earlier if you have a family history of the disease.

Tip: If you’re nervous, bring your iPod. Research shows that listening to your favorite music can help you tune out anxiety and require less sedation.

Thyroid Test

This blood test checks your level of thyroid-stimulating hormone (TSH).

Why you need it: High TSH levels can mean hypothyroidism (under-active thyroid), which can cause unexplained weight gain, fatigue, dry skin, and brittle nails. And low levels indicate hyperthyroidism (overactive thyroid), which is marked by a fast pulse, insomnia, and weight loss that can’t be attributed to diet or activity changes. Thyroid problems are more common in older people.

How often you need it: Every five years. But if you start to notice symptoms earlier, don’t wait to get checked. The American Thyroid Association is pushing for screening to start at age 35.

Tip: A thyroid problem can be temporary. Up to 10 percent of women develop one after giving birth, but 90 percent will return to normal in six to nine months. “A thyroid problem is often mistaken for postpartum blues,” says Mark Wiesen, MD, chief of endocrinology at Hackensack University Medical Center. If you’re pregnant, talk to your doc about getting tested after delivering your baby. 

Bone-density (DEXA) scan

This X-ray measures bone mass (the amount of calcium and minerals in bones), a key indicator of bone strength.

Why you need it: Your estrogen level plummets as you age, upping your risk for osteopenia, or low bone mass, which can lead to osteoporosis if not treated. (Medication may be prescribed if you have osteopenia.) Women who are Caucasian or of Southeast Asian descent are at higher risk, as are those with small frames or family histories of the condition.

How often you need it: Ask your doc.

Tip: To help bones stay strong, do 30 minutes of weight-bearing exercise (like tennis or aerobics) several times a week; regularly eat dairy foods (low-fat milk, cheese, and yogurt) and fortified foods like cereal and orange juice; and take a calcium-and–vitamin D supplement like Citracal Plus. But don’t take a supplement for 24 hours before the scan, as it could skew the results.

A test you don’t need

During a Whole-Body CT Scan, your body is scanned using special X-rays to look for signs of abnormalities and disease. But there’s no solid proof that it helps detect any particular disease early enough for the condition to be treated or cured, according to the Food and Drug Administration.

Most health organizations don’t recommend it. What’s more, the scan may needlessly expose you to radiation and can lead to further, unnecessary testing or biopsies when the problem may be benign or go away on its own.