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Health screening - women - age 40 - 64

Definition

All adults should visit their health care provider from time to time, even if they are healthy. The purpose of these visits is to:

  • Screen for diseases
  • Assess risk of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Maintain a relationship with a health care provider in case of an illness

Alternative Names

Health maintenance visit - women - age 40 - 64; Physical exam - women - age 40 - 64; Yearly exam - women - age 40 - 64; Checkup - women - age 40 - 64; Women’s health - age 40 - 64

Information

Even if you feel fine, it is still important to see your health care provider regularly to check for potential problems. For example, most people who have high blood pressure don't even know it. The only way to find out is to have your blood pressure checked regularly. Likewise, high blood sugar and high cholesterol levels often do not produce any symptoms until the disease becomes advanced.

There are specific times when you should see your health care provider. Age-specific guidelines are as follows:

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked every 2 years unless it is 120-139/80-89 Hg or higher. Then have it checked every year.
  • Watch for blood pressure screenings in your area. Ask your health care provider if you can stop in to have your blood pressure checked. Check your blood pressure using the automated machines at local grocery stores and pharmacies.
  • If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your health care provider's office.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.

CHOLESTEROL SCREENING

  • Women over age 44 should be checked every 5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.

DIABETES SCREENING

  • If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.

COLON CANCER SCREENING

People between the ages of 50 and 75 should be screened for colorectal cancer. This may involve:

  • A stool test done every year.
  • Flexible sigmoidoscopy every 5 years, including a stool guaiac test.
  • Colonoscopy every 10 years.
  • Double-contrast barium enema every 5 years.
  • Computed tomographic colonography (virtual colonoscopy) every 5 years.
  • People with risk factors for colon cancer such as ulcerative colitis, a personal or family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often.

DENTAL EXAM

  • Go to the dentist every year for an exam and cleaning.

EYE EXAM

  • Have an eye exam every 2 years.
  • Once you turn 45, make sure that your health care provider checks for glaucoma.

IMMUNIZATIONS

  • You should receive a flu vaccine every year.
  • Ask your health care provider if you should get a vaccine to reduce your risk of pneumonia.
  • You should have a tetanus-diphtheria and acellular pertussis (TdAP) vaccine once as part of your tetanus-diphtheria vaccines. You should have a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccination once after age 60.

PHYSICAL EXAM

  • Have a physical exam every 1 to 5 years.
  • Your height, weight, and body mass index (BMI) should be checked at each exam.
  • Routine diagnostic tests are not recommended.

BREAST EXAM

  • Women should do a monthly breast self-exam.
  • Women should contact their health care provider immediately if they notice a change in their breasts, whether or not they do self exams.
  • A health care provider should do a complete breast exam every year.

MAMMOGRAM

  • Women over age 40 should have a mammogram done every 1 to 2 years, depending on their risk factors, to check for breast cancer.

OSTEOPOROSIS SCREENING

  • All postmenopausal women with fractures should have a bone density test (DEXA scan).
  • Women under age 65 who have risk factors for osteoporosis should be screened.

PELVIC EXAM AND PAP SMEAR

  • Pap smears should be done once every 2 to 3 years.
  • Pelvic exams may be done more often to check for other disorders.
  • If your Pap smears have been normal three times in a row, your health care provider may tell you that you only need a Pap smear once every 3 years.
  • Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears.
  • Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.
  • Your health care provider will discuss how to prevent sexually transmitted infections (STIs) with you if you are sexually active.
  • Your health care provider will ask you questions about alcohol and tobacco, and may ask you about depression.

References

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 14.

U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services, 2012. Agency for Healthcare Research and Quality, Rockville, MD. Last update 2011. Available at http://http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/index.html. Accessed April 14, 2013.

American College of Obstetricians and Gynecologists. Cervical cytology screening. ACOG Practice Bulletin No. 109. Obstet Gynecol. 2009; 114:1409-1420.

Smith, R. A., Brooks, D., Cokkinides, V., Saslow, D. and Brawley, O. W. (2013), Cancer screening in the United States, 2013. CA Cancer J Clin. 2013;63:87–105. doi: 10.3322/caac.21174

Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ,Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women - 2011 update: A guideline from the American Heart Association. Circulation. 2011;123(11):1243-1262.

Advisory Committee on Immunization Practices. Recommended Immunization Schedules for Persons Aged 0 Through 18 Years and Adults Age 19 Years and Older - United States, 2013. MMWR. 2013;62(Suppl 1):1-19.


Review Date: 4/14/2013
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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