Internal Medicine Over 40 years female check up

Last updated date: 13-Mar-2023

Originally Written in English

Internal Medicine Over 40 years female Check up


Routine check-ups should be part of your healthcare regimen, no matter how busy you are or how healthy you feel.

When you reach the age of 40, valuing your health becomes more important. Let's face it: aging is unavoidable, and whether you like it or not, it brings a slew of changes to your body and brain. As your metabolism slows around the age of 40, it is more crucial than ever to take care of yourself. Aside from eating well, getting adequate exercise, and managing stress, it is also important that you get regular health tests.

Annual physical exams can aid in the early detection of issues, even before they occur. Depending on your age, family medical history, and risk factors, your doctor may prescribe a range of tests and screenings during your physical exam. This involves examining your lifestyle patterns and ensuring that your vaccines are up to date.


When Should I Go For Screening?

After the age of 40, the current Health Promotion Board guidelines urge getting frequent health tests.

As the risk of developing chronic illnesses and cancer grows with age, frequent health screening is an effective approach of discovering health problems early.

If you have risk factors such as a family history of chronic illnesses or cancer, as well as lifestyle hazards such as smoking or substantial alcohol intake, earlier screening may be suggested. Even if no risk factors exist, please visit a doctor if you observe any unusual symptoms.


Check–up Tests For Over 40 Years Old Women

Even if you feel good, you should see your provider on a regular basis for checks. These checkups might help you avoid future difficulties. For example, the only way to determine whether you have high blood pressure is to get it examined on a regular basis. In the early stages, high blood sugar and high cholesterol levels may not cause any symptoms. These problems can be detected with a simple blood test.

You should see your provider at certain times of the year. Screening recommendations for women aged 40 to 64 are provided below.

1. Body mass index (BMI)/obesity screening:

Body mass index

Your BMI is calculated by measuring your weight and height. Overweight is defined as having a BMI of 25 to 30%. Obesity is defined as a percentage more than 30%. The higher your BMI, the greater your risk of having heart disease, hypertension, type 2 diabetes, some malignancies, and other disorders. Losing 5 to 10% of your body weight can help minimize your chance of getting obesity-related disorders.


2. Blood Pressure Screening:

Blood Pressure Screening

Have your blood pressure checked at least once every two years? If the top number (systolic number) is between 120 and 139 mm Hg, or the bottom number (diastolic number) is between 80 and 89 mm Hg, you should have it tested once a year.

If the top number is 130 or higher, or the bottom number is 80 or higher, make an appointment with your practitioner to discover how you may lower your blood pressure.

If you have diabetes, heart disease, renal issues, or other diseases, your blood pressure should be tested more frequently, but at least once a year.

Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.


3. Breast Cancer Screening:

Breast Cancer Screening

Women should perform a monthly breast self-exam. However, doctors disagree on whether breast self-exams help detect breast cancer or save lives. Discuss your options with your provider.

As part of your preventative visit, your provider may do a clinical breast exam.

Mammograms are recommended every 1 to 2 years for women aged 40 to 49. However, not all specialists agree on the advantages of obtaining mammography when a woman is in her forties. Discuss your options with your provider.

Women between the ages of 50 and 75 should undergo a mammogram every 1 to 2 years, depending on their risk factors, to screen for breast cancer.

Women who have a mother or sibling who had breast cancer when they were younger may consider getting a mammogram every year. They should start sooner than their youngest family member was diagnosed.

If you have additional risk factors for breast cancer, your doctor may advise you to get mammography, breast ultrasound, or an MRI scan.


4. Cervical Cancer Screening:

Cervical Cancer Screening

Cervical cancer screening should start at age 21. After the first test:

  • Women aged 30 to 65 should have a Pap test every three years or an HPV test every five years.
  • If you or your sexual partner has new partners, you should have a Pap test every three years.
  • Women aged 65 to 70 can cease receiving Pap tests if they have had three normal tests in the previous ten years.
  • Women who have been treated for precancer (cervical dysplasia) should continue to receive Pap tests for the next 20 years or until they reach the age of 65, whichever comes first.
  • You do not require Pap screenings if you have had your uterus and cervix removed (total hysterectomy) and have not been diagnosed with cervical cancer.


5. Cholesterol Screening:

Cholesterol Screening

Current guidelines recommend that cholesterol testing occur every three to five years in women and men over the age of 20. the breakdown of total cholesterol is more important than the total cholesterol number itself. This includes:

  • Triglycerides, a blood fat often related to obesity or diabetes. Ideal triglycerides levels are below 250 for those without diabetes or below 150 for those with diabetes.
  • HDL (“good”) cholesterol. With this type of cholesterol, the higher the number, the better. If a patient’s HDL level is below 50, many doctors say they should watch their diet and increase the amount of fish that they eat to raise this number.
  • LDL (“bad”) cholesterol. This number is the most important to look at because a high level is closely related to heart disease, stroke, kidney disease and overall cardiovascular death. LDL levels should be below 160 in a healthy, pre-menopausal woman. Those with obesity, hypertension or diabetes need that number to be even lower, such as 130. In these high-risk cases, medication is often needed to achieve low numbers.


6. Colorectal Cancer Screening:

Colorectal Cancer

Talk to your provider about being tested if you are under the age of 45. If you have a significant family history of colon cancer or polyps, you should be tested. If you have risk factors such as a history of inflammatory bowel disease or polyps, screening may be recommend

Colorectal cancer screening is recommended for those aged 45 to 75. Several screening tests are available:

  • A stool-based fecal occult blood (gFOBT) or fecal immunochemical test (FIT) every year
  • A stool sDNA-FIT test every 1 to 3 years
  • Flexible sigmoidoscopy every 5 years or every 10 years with stool testing with FIT done every year
  • CT colonography (virtual colonoscopy) every 5 years
  • Colonoscopy every 10 years

You may need a colonoscopy more often if you have risk factors for colorectal cancer, such as:

  • Ulcerative colitis.
  • A personal or family history of colorectal cancer.
  • A history of growths in the colon called adenomatous polyps.


7. Dental Exam:

Dental Exam

Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.


8. Diabetes Screening:

Diabetes Screening

If you are over the age of 44, you should have a screening every three years.

A BMI of more over 25 indicates that you are overweight. If you are overweight, you should get a screening at the age of 35. If an Asian American's BMI is more than 23, they should be examined.

If your blood pressure is higher than 130/80 mm Hg, or if you have additional diabetes risk factors, your physician may test your blood sugar level for diabetes.


9. Eye exam:

Eye exam

Have an eye checkup every 2 to 4 years between the ages of 40 and 54, and every 1 to 3 years between the ages of 55 and 64. If you have vision difficulties or are at risk of glaucoma or cataract, your physician may advise you to get more frequent eye exams.

If you have diabetes, you should undergo an eye checkup at least once a year.


10. Thyroid Test: 

Thyroid Test

Weight gain, hair loss, brittle nails, and weariness are just a few of the usual concerns of women over 40. Hypothyroidism, or underactive thyroid, is a prevalent cause of this. This gland secretes the hormones T3, T4, and TSH, which are crucial for managing the body's metabolism. Any modifications might have a major impact on the body. Women are particularly vulnerable to this because of the significant hormonal changes that occur during pregnancy, delivery, nursing, and menopause. After the age of 40, women should have this test done every three years.


11. Human immunodeficiency virus (HIV) screening:

HIV test

Regardless of sexual behavior or lifestyle, everyone should be tested for HIV (through a blood test). HIV may be transferred by blood and other body fluids, sperm, and breast milk, as well as through the sharing of needles and blood transfusions.

There are three main types of HIV tests:

  • Antibody Test. This test examines your blood or saliva for HIV antibodies. When you are exposed to germs or viruses, such as HIV, your immune system produces antibodies. From 3–12 weeks after infection, an HIV antibody test can identify if you have HIV. This is because it might take several weeks or more for your immune system to produce antibodies against HIV. You may be able to do an HIV antibody test in the comfort of your own home. Inquire with your doctor about at-home HIV testing kits.
  • HIV Antibody/Antigen Test. This blood test tests for HIV antibodies and antigens. An antigen is a component of a virus that stimulates an immunological response. If you've been exposed to HIV, antigens will appear in your bloodstream before HIV antibodies. Within 2–6 weeks of infection, this test can generally detect HIV. One of the most popular forms of HIV testing is the HIV antibody/antigen test.
  • HIV Viral Load. This test detects the presence of the HIV virus in the blood. It can detect HIV more quickly than antibody or antibody/antigen testing, but it is quite costly. It is largely used to track HIV infections.


12. Immunization:


Every year, you should obtain a flu vaccination.

Ask your doctor whether you should get a pneumococcal vaccination to lower your chance of infection (causes a type of pneumonia).

If you did not have it as an adolescent, you should receive a tetanus-diphtheria-acellular pertussis (Tdap) vaccination as part of your tetanus-diphtheria vaccines. Every ten years, you should have a tetanus-diphtheria health boost.

After the age of 50, you may be able to acquire a shingles or herpes zoster vaccine.

If you are at high risk for certain conditions, your clinician may prescribe additional vaccines.


13. Infectious Disease Screening:

Infectious Disease

The US Preventive Services Task Force promotes hepatitis C screening. You may need to get tested for diseases such as syphilis, chlamydia, and HIV, as well as others, depending on your lifestyle and medical history.


14. Lung Cancer Screening:

Lung Cancer Screening

You should have an annual screening for lung cancer with low-dose computed tomography (LDCT) if all of the following are present:

  • You are age 50 to 80 years AND
  • You have a 20-pack-year smoking history AND
  • You currently smoke or have quit within the past 15 years


15. Osteoporosis Screening:


The NOF recommends measurement of BMD for osteoporosis (DXA of the hip and spine) in:

  • Women age 65 years and older and men age 70 years and older, regardless of clinical risk factors.
  • Younger postmenopausal women, women in the menopausal transition, and men age 50 to 69 years with clinical risk factors for fracture.
  • Adults who have a fracture after age 50 years.
  • Adults with a condition (eg, rheumatoid arthritis) or taking medication (eg, glucocorticoids in a daily dose ≥5 mg prednisone or equivalent for ≥3 months) associated with low bone mass or bone loss.

The ISCD recommends measurement of BMD (DXA of the hip and spine) in:

  • All women age 65 years and older and men age 70 years and older regardless of risk factors.
  • Postmenopausal women and men age 50 to 70 years when risk factors are present.
  • Adults with a fragility fracture.
  • Adults with a condition or taking a medication associated with low bone mass or bone loss.
  • Anyone being considered for pharmacologic therapy for osteoporosis.
  • Anyone being treated for osteoporosis to monitor response to therapy.
  • Anyone not receiving therapy when evidence of bone loss would lead to treatment.
  • Women in the menopausal transition if there is a specific risk factor associated with increased fracture, such as low body weight, prior low-trauma fracture, or high-risk medication.
  • Postmenopausal women discontinuing estrogen should be considered for bone density testing.
  • The 33% forearm (one-third radius) site is recommended in the following cases:
  • If hip and/or spine cannot be measured or interpreted
  • Hyperparathyroidism
  • Severe obesity (over the weight limit of DXA table)


16. Physical Exam:

Your blood pressure should be checked at least every year.

Your provider may recommend checking your cholesterol every 5 years if you have risk factors for coronary heart disease.

Your height, weight, and body mass index (BMI) should be checked at each exam.

During your exam, your provider may ask you about:

  • Depression.
  • Diet and exercise.
  • Alcohol and tobacco use.
  • Safety issues, such as using seat belts and smoke detectors.


17. Skin Exam:

Skin Exam

Your provider may check your skin for signs of skin cancer, especially if you're at high risk. People at high risk include those who have had skin cancer before, have close relatives with skin cancer, or have a weakened immune system.

Once you reach age 40, your doctor may check your skin even if you have an appointment for another reason. If you are at high risk for skin cancer, you should have a complete skin check every 6 to 12 months.


18. Stroke assessment:


If you are at high risk of a stroke, your doctor should assess you every 12 months.

The assessment may involve a series of questions and tests for CVD risk factors, including atrial fibrillation. Medicines may be available for these conditions if you have them.


19. Kidney disease:

kiedney disease Physical Exam

Kidney disease should be assessed every 1 to 2 years if you are at high risk.  Risk factors can be similar to CVD or could involve an injury to your kidney. 

Your doctor may ask you a series of questions as well as checking your blood pressure and doing a urine test. You may need to take some medicine to lower your blood pressure if it is high.


20. Depression screening:


The National Alliance on Mental Illness estimates that 16 million American adults had at least one major depressive episode in the last year. They add that women are 70 percent more likely than men to experience depression. If you’re concerned about your mood, ask your doctor for this screening. Your doctor will ask questions about symptoms, such as:

  • sleep troubles.
  • Irritability.
  • loss of libido or sexual interest.
  • sluggishness.
  • loss of interest in usual activities.



Internal Medicine Check-Up

You're nearing middle age in your 40s, so preventative care is essential. You want to address concerns before they become problems and measure your progress toward your health objectives.

A routine annual physical check is a good way to start monitoring your health and preventing small concerns from becoming major ones. Your physical typically takes less than 30 minutes and is completely covered by your health insurance as a preventative treatment.

Regular health checks and screenings, combined with a good diet and regular physical exercise, can aid in disease or sickness prevention. There are recommendations for how frequently you should get your blood pressure, cholesterol, Cervical Screening Test, blood sugar, breast, skin, and immunizations checked.