Women’s Health by the Decade

A decade-by-decade checklist of screenings, actions, questions to ask your doctor, and more to support healthy living for women of all ages

Women juggle many priorities throughout their lives — but it’s always important to prioritize health. From childhood to childbearing and beyond, there’s always something new when it comes to women’s health. Hello Alpha has put together a decade-by-decade checklist of screenings, actions, questions to ask, and more to support healthy living for women of all ages.

20s:

“In your 20s, it can be easy to assume you’ll be young and healthy forever, but taking control of your health early on is the key to setting up healthy habits for the rest of your life,” says Dr. Mary Jacobson, Chief Medical Officer at Hello Alpha. At this age, preventive care is typically the top focus. Setting a foundation for your health by establishing a relationship with a dedicated primary care provider (PCP) is a smart first step. Then, you can rely on your provider as a partner in your health for decades to come.

Key screenings:

• Blood pressure. If your blood pressure is in the healthy range (under 120/80), get in-office blood pressure measurements at least once every two years. If you’re at Hypertension Stage 1, when blood pressure consistently ranges from 130–139 systolic (the top number) or 80–89 mm Hg diastolic (the bottom number), providers are likely to prescribe lifestyle changes. They may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) for heart attack or stroke. Obtain blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. If blood pressure readings measure consistently above Hypertension Stage, providers are likely to prescribe a combination of blood pressure medications and lifestyle changes.
• Depression. The US Preventive Services Task Force (USPSTF) recommends annual screening for depression in the general adult population, including pregnant and postpartum people. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
• Anxiety. The USPSTF recommends annual screening for anxiety in adults, including pregnant and postpartum persons.
• Cervical cancer. Detecting cervical cancer early gives you a greater chance at successful treatment. Women ages 21 to 29 should get a Pap smear every three years.
• Sexually transmitted infections (STIs). Females at birth 24 years or younger and 25 years or older who are sexually active should get screened for chlamydia and gonorrhea annually or whenever you change sexual partners. Females with multiple sexual partners should also be screened for trichomonas and Hepatitis B. All women should be tested for HIV at least once in their lifetime. Women at increased risk (history of incarceration or transactional sex work, geography, race/ethnicity) for syphilis infection should be screened. All pregnant women should be tested for syphilis, HIV, and hepatitis B starting early in pregnancy. At-risk pregnant women should also be tested for chlamydia and gonorrhea starting early in pregnancy. Testing should be repeated as needed to protect the health of mothers and their infants.
• Fertility. If you’ve been trying to become pregnant in your 20s for more than 12 months without success, talk to your provider about fertility screenings.
• Cholesterol. According to the CDC, people should have their cholesterol checked at least once between ages 17 and 21. Most healthy adults should get their cholesterol checked every four to six years. Some people, such as those with heart disease, diabetes, or a family history of high cholesterol, should get their cholesterol checked more often, according to their provider’s recommendations.
• Colorectal cancer. Only those with a family history of familial adenomatous polyposis or 8 years after the start of pancolitis should get screened for colon cancer at this stage of life.
• Hepatitis C. The CDC recommends screening at least once in a lifetime for all adults aged 18 years and older. All pregnant people should get Hepatitis C screening during each pregnancy.

Actions:

• Folic acid. The United States Preventive Services Task Force recommends folic acid supplementation regularly for all people trying or capable of becoming pregnant. Consult with your provider about this.
• Quit tobacco. If you use tobacco in any form, consider methods to quit for good. There are medical treatments to support tobacco cessation if you need extra support.
• Learn about preventive health. Education is key to helping you stay healthy and detecting health problems early, before they cause other issues or become more difficult to treat. Take advantage of this now and reap the benefits later.
• Healthy diet and exercise. Regular physical activity and a balanced, nutritious diet are two of the most important things you can do for your health. Being physically active and eating smart can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities.

Key discussion topics:

• Preconception planning or finding the right birth control option for you
• Weight, diet and physical activity level
• Efforts to continue building bone mass
• Use of tobacco, alcohol or drugs
• Any exposure to violence
• Depression, anxiety or any other mental health concerns
• An in-depth family health history, especially regarding cancer, heart disease or diabetes
• Sun protection and the hazards of tanning

30s:

“Your 30s are busy!” says Dr Jacobson. “You may have a marriage and a career, and perhaps you have kids or are starting to think about family planning. How you maintain your health and well-being during your 30s can largely determine your health for the rest of your life. If you can maintain a healthy weight, eat right, de-stress, and exercise, you could be looking at more than half a century of disease-free living.”

Key screenings:

• Blood pressure. If your blood pressure is in the healthy range (under 120/80), get in-office blood pressure measurements at least once every two years. If you’re at Hypertension Stage 1, when blood pressure consistently ranges from 130–139 systolic (the top number) or 80–89 mm Hg diastolic (the bottom number), providers are likely to prescribe lifestyle changes. They may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) for heart attack or stroke. Obtain blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. If blood pressure readings measure consistently above Hypertension Stage, providers are likely to prescribe a combination of blood pressure medications and lifestyle changes.
• Depression. The US Preventive Services Task Force (USPSTF) recommends annual screening for depression in the general adult population, including pregnant and postpartum people. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
• Anxiety. The USPSTF recommends annual screening for anxiety in adults, including pregnant and postpartum persons.
• Cervical cancer. Detecting cervical cancer early gives you a greater chance at successful treatment. Women should get a Pap smear every three years or a Pap smear with HPV testing every 5 years or more frequently if a result is abnormal.
• Fertility. If you’re under 35 and have been trying to become pregnant for more than 12 months without success, or you’re over 35 and have been trying without success for six months, talk to your provider about fertility screenings.
• Sexually transmitted infections (STIs). Talk to your provider about your risk and need for screenings for STIs. If your provider determines you’re at increased risk, they will recommend testing for syphilis or HIV infection. For pregnant women, a Hepatitis B test is recommended, as well as syphilis and Rh(D) incompatibility screenings.
• Cholesterol. According to the CDC, most healthy adults should get their cholesterol checked every four to six years. Some people, such as those with heart disease, diabetes, or a family history of high cholesterol, should get their cholesterol checked more often, according to their provider’s recommendations.
• Prediabetes and diabetes. According to the USPSTF, women that are overweight or obese should be screened for prediabetes and type 2 diabetes beginning at age 35.
• Colorectal cancer. Only those with a family history of familial adenomatous polyposis or 8 years after the start of pancolitis should get screened in their 30s for colon cancer.
• Hepatitis C. The CDC recommends screening at least once in a lifetime for all adults aged 18 years and older. All pregnant people should get Hepatitis C screening during each pregnancy.

Actions:

• Folic acid. The United States Preventive Services Task Force recommends folic acid supplementation regularly for all women trying or capable of becoming pregnant. Consult with your provider about this.
• Quit tobacco. If you use tobacco in any form, consider methods to quit for good. There are medical treatments to support tobacco cessation if you need extra support.
• Learn to manage stress. If you haven’t learned stress-relief strategies that work for you, stress can lead to serious health issues. Stress and anxiety can impact anything from digestion concerns to an inability to lose weight, so learning effective coping skills can be a key component of your health in your 30s and beyond.
• Healthy diet and exercise. Regular physical activity and a balanced, nutritious diet are two of the most important things you can do for your health. Being physically active and eating smart can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities.

Key discussion topics:

• Preconception planning or finding the right birth control option for you
• Weight, diet and physical activity level
• Bone and muscle mass maintenance
• Use of tobacco, alcohol or drugs
• Any exposure to violence
• Depression, anxiety or any other mental health concerns
• An in-depth family health history, especially regarding cancer, heart disease or diabetes

40s:

Age 40 is a milestone when the risk of many health conditions increases. From the menopause transition to breast health, there are many changes in a woman’s body. But, because many women have demanding jobs, aging parents, growing children or all of the above, it can be easy to disregard your own health priorities. “As you enter your 40s, you may find yourself dealing with some changes in your body,” says Dr. Jacobson. “It’s a good time to take a deep breath and refocus on yourself. Knowing what’s in store can help you stay healthy and happy for decades into the future.”

Key screenings:

• Blood pressure. If your blood pressure is in the healthy range (under 120/80), get in-office blood pressure measurements at least once every two years. If you’re at Hypertension Stage 1, when blood pressure consistently ranges from 130–139 systolic (the top number) or 80–89 mm Hg diastolic (the bottom number), providers are likely to prescribe lifestyle changes. They may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) for heart attack or stroke. Obtain blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. If blood pressure readings measure consistently above Hypertension Stage, providers are likely to prescribe a combination of blood pressure medications and lifestyle changes.
• Depression. The US Preventive Services Task Force (USPSTF) recommends annual screening for depression in the general adult population, including pregnant and postpartum people. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
• Anxiety. The USPSTF recommends annual screening for anxiety in adults, including pregnant and postpartum persons.
• Cervical cancer. Detecting cervical cancer early gives you a greater chance at successful treatment. Women should get a Pap smear every three years or a Pap smear with HPV testing every 5 years or more frequently if a result is abnormal.
• Fertility. If you have been trying to become pregnant without success for three months, talk to your provider about fertility screenings since more immediate treatment may be warranted.
• Sexually transmitted infections (STIs). Talk to your provider about your risk and need for screenings for STIs. If your provider determines you’re at increased risk, they will recommend testing for syphilis or HIV infection. For pregnant women, a Hepatitis B test is recommended, as well as syphilis and Rh(D) incompatibility screenings.
• Cholesterol. According to the CDC, most healthy adults should get their cholesterol checked every four to six years. Some people, such as those with heart disease, diabetes, or a family history of high cholesterol, should get their cholesterol checked more often, according to their provider’s recommendations.
• Prediabetes and diabetes. According to the USPSTF, women that are overweight or obese should be screened annually for prediabetes and type 2 diabetes.
• Colon cancer screening. The United States Preventive Services Task Force recommends offering colorectal cancer screening starting at age 45 years. Although the absolute risk of developing colorectal cancer is much lower in adults younger than 50 years, recent research indicates a trend of increasing risk of colorectal cancer in younger ages.
• Hepatitis C. The CDC recommends screening at least once in a lifetime for all adults aged 18 years and older. All pregnant people should get Hepatitis C screening during each pregnancy.
• Breast cancer screening. Women who are 40 to 49 years old should talk to their doctor or other health care provider about when to start and how often to get a mammogram. Women should weigh the benefits and risks of screening tests when deciding whether to begin getting mammograms before age 50.

Actions:

• Folic acid. The United States Preventive Services Task Force recommends folic acid supplementation regularly for all women trying or capable of becoming pregnant. Consult with your provider about this.
• Quit tobacco. If you use tobacco in any form, consider methods to quit for good. There are medical treatments to support tobacco cessation if you need extra support.
• Learn about menopause. The average age of menopause is 51, with most individuals experiencing menopause between ages 40 and 58, and perimenopause lasting for four to eight years. Menopausal symptoms include hot flashes, sleep disruption and impacted cognitive function. This is a significant physical change for women, and it’s important to learn what to expect.
• Healthy diet and exercise. Regular physical activity and a balanced, nutritious diet are two of the most important things you can do for your health. Being physically active and eating smart can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities.

Key discussion topics:

• For premenopausal women: preconception planning or finding the right birth control option for you
• Menopause transition
• Weight, diet and physical activity level
• Bone and muscle mass maintenance
• Use of tobacco, alcohol or drugs
• Any exposure to violence
• Depression, anxiety or any other mental health concerns
• An in-depth family health history, especially regarding cancer, heart disease or diabetes

50s:

With so many changes and advancements in medicine, turning 50 is still considered relatively young. Getting older may also bring a greater sense of acceptance and self-knowledge that we should eagerly embrace and celebrate. “As you celebrate aging in a society that idealizes the young and thin, regular body changes seen during aging may be unwelcome,” says Dr. Jacobson. “But you can adjust your approach to your health routine to keep your body and mind in excellent working order for many, many years.”

Key screenings:

• Blood pressure. If your blood pressure is in the healthy range (under 120/80), get in-office blood pressure measurements at least once every two years. If you’re at Hypertension Stage 1, when blood pressure consistently ranges from 130–139 systolic (the top number) or 80–89 mm Hg diastolic (the bottom number), providers are likely to prescribe lifestyle changes. They may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) for heart attack or stroke. Obtain blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. If blood pressure readings measure consistently above Hypertension Stage, providers are likely to prescribe a combination of blood pressure medications and lifestyle changes.
• Depression. The US Preventive Services Task Force (USPSTF) recommends annual screening for depression in the general adult population, including pregnant and postpartum people. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
• Anxiety. The USPSTF recommends annual screening for anxiety in adults, including pregnant and postpartum persons.
• Cervical cancer. Detecting cervical cancer early gives you a greater chance at successful treatment. Women should get a Pap smear every three years or a Pap smear with HPV testing every 5 years or more frequently if a result is abnormal.
• Cholesterol. According to the CDC, most healthy adults should get their cholesterol checked every four to six years. Some people, such as those with heart disease, diabetes, or a family history of high cholesterol, should get their cholesterol checked more often, according to their provider’s recommendations.
• Prediabetes and diabetes. According to the USPSTF, women that are overweight or obese should be screened annually for prediabetes and type 2 diabetes.
• Colon cancer screening. The United States Preventive Services Task Force recommends screening for everyone between 50 and 75. There are different types of tests that will then impact your follow-up frequency.
• Breast cancer screening. The USPSTF recommends that women who are at average risk for breast cancer get a mammogram every two years beginning at age 50.
• Osteoporosis screening. The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool.
• Hepatitis C. The CDC recommends screening at least once in a lifetime for all adults aged 18 years and older. All pregnant people should get Hepatitis C screening during each pregnancy.

Actions:

• Understand how to support your skin health. After 50, the collagen fibers in the deeper layer of your skin may become coarser and less orderly in arrangement, causing your thinning skin to be less elastic and making wrinkles more apparent. Your provider may recommend switching from hot to warm showers, exfoliating and applying a retinol night cream, although the most important step is to use sun protection.
• Weight management. During your 50s is often when you can’t help but notice changes in body shape and metabolism. It is important to maintain a healthy weight because having a waist measurement of greater than 35 inches significantly increases your risk for developing diabetes and heart disease.
• Keeping your brain and memory strong. Research from the British Medical Journal shows that from your mid-40s to late 50s, reasoning skills, verbal fluency and sharpness in memory decline. However, the ability to regulate emotions, make moral decisions, and read social situations actually improves with age. Talk to your provider about how to keep your mind sharp.
• Bone and muscle health. After age 50, women are at risk for weaker bones and reduced muscle mass; this is due to a number of factors but menopause is one of the main culprits. Strength training and building muscle can help manage these newfound health risks and give you a sense of stability, strength, and independence. Building and maintaining muscle mass is especially important as you get older and can lead to physical and mental benefits.

Key discussion topics:

• Menopause symptoms
• Weight, diet and physical activity level
• Bone and muscle mass maintenance
• Use of tobacco, alcohol or drugs
• Any exposure to violence
• Depression, anxiety or any other mental health concerns
• An in-depth family health history, especially regarding cancer, heart disease or diabetes

60s+:

Your 60s and beyond can be an astounding stage of life. By the time you reach this age, chances are you have walked a path of exciting experiences, navigated a career or two, and possibly raised a family. This stage can be strict “you time” and is meant to be filled with hobbies, dreams, and fun. “In order to jump on whatever life brings, you need to feel vibrant and healthy,” says Dr. Jacobson. “Fitting these screenings and actions into your lifestyle will help you live your best life, because you deserve it.”

Key screenings:

• Blood pressure. If your blood pressure is in the healthy range (under 120/80), get in-office blood pressure measurements at least once every two years. If you’re at Hypertension Stage 1, when blood pressure consistently ranges from 130–139 systolic (the top number) or 80–89 mm Hg diastolic (the bottom number), providers are likely to prescribe lifestyle changes. They may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) for heart attack or stroke. Obtain blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. If blood pressure readings measure consistently above Hypertension Stage, providers are likely to prescribe a combination of blood pressure medications and lifestyle changes.
• Depression. The US Preventive Services Task Force (USPSTF) recommends annual screening for depression in the general adult population, including pregnant and postpartum people. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
• Anxiety. The USPSTF recommends annual screening for anxiety in adults, including pregnant and postpartum persons.
• Cervical cancer. Detecting cervical cancer early gives you a greater chance at successful treatment. Women should get a Pap smear every three years or a Pap smear with HPV testing every 5 years or more frequently if a result is abnormal. You can discontinue Pap and HPV testing at age 65 if you have had adequate negative prior screening test results and no history of CIN 2 (moderate dysplasia) or higher.
• Cholesterol. According to the CDC, most healthy adults should get their cholesterol checked every four to six years. Some people, such as those with heart disease, diabetes, or a family history of high cholesterol, should get their cholesterol checked more often, according to their provider’s recommendations.
• Prediabetes and diabetes. According to the USPSTF, people at an unhealthy weight, specifically overweight or obese should get screened for prediabetes and type 2 diabetes.
• Colon cancer screening. The United States Preventive Services Task Force recommends screening for everyone between 50 and 75. There are different types of tests that will then impact your followup frequency.
• Breast cancer screening. The USPSTF recommends that women who are at average risk for breast cancer get a mammogram every two years.
• Bone density screening. The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures beginning at age 65 and in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool.
• Hepatitis C. The CDC recommends screening at least once in a lifetime for all adults aged 18 years and older. All pregnant people should get Hepatitis C screening during each pregnancy.

Actions:

• Mobility and flexibility. One of the keys to feeling young and maintaining mobility for years to come is doing what you can to move your body. As you get older, your joints can get stiffer, and it can also become harder to keep your balance. A helpful way to prevent this is by doing static stretches and balance exercises every day. One easy idea to maintain flexibility is by standing on just one foot for a few moments, a few times each day.
• Fall prevention. More than one in four people age 65 years or older fall each year, however, many falls can be prevented. For older women, a fall can be the start of more serious health problems and many falls can be prevented by exercising, managing your medications, having your vision checked, and making your home safer. The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls.
• Find community. Older adults with a fulfilling social life tend to avoid many of the physical, cognitive and emotional difficulties that those who are isolated. Socialization can reduce stress and depression, increase self-esteem and even help increase longevity.
• Medicare. Don’t forget to sign up for Medicare health coverage around your 65th birthday.

Key discussion topics:

• Weight, diet and physical activity level
• Use of tobacco, alcohol or drugs
• Bone and muscle mass maintenance
• Any exposure to violence
• Fall prevention
• Depression, anxiety or any other mental health concerns
• Who will make health care decisions for you if you are unable to

PLEASE NOTE: THIS BLOG DOES NOT PROVIDE MEDICAL ADVICE.
The information, including but not limited to, test, graphics, imagines and other material contained on this website are for informational/educational purposes only. No material on this site is intended to substitute for professional medical advice, diagnosis or treatment. A patient-client relationship will only be formed after you enter into a written agreement with an Alpha provider. Always consult a professional in the area for your particular needs before undertaking any new healthcare regimen.

Sources:

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

https://www.womenshealth.gov/healthy-living-age

https://www.health.harvard.edu/topics/screening-tests-for-women