Essential health tests for women in their 40s and 50s

Turning 40 is a big milestone. Our bodies start changing dramatically once we hit 40. We may start noticing more grey hair, lower metabolism, more wrinkling of skin, vaginal dryness, or menstrual irregularities. Turning 40 calls for more attention to our health and well being so we can continue to be strong, healthy, and disease-free.

Here we talk about the most important health tests that women need in their 40s and 50s, and what their frequency should be.

1. Blood pressure
2. Blood cholesterol test
3. Breast exam and mammogram
4. Cervical cancer screening
5. Blood sugar
6. Osteoporosis screening
7. Eye test
8. Physical examination
9. Menopause related tests
10. Dental exam

1. Blood pressure

Women in their 40s, 50s and above should have their blood pressure (BP) checked at least once in two years. Women, who have diabetes, heart or kidney problems, need to get their BP checked more frequently or as advised by the doctor.

The risk of high BP increases in women post menopause. “The rise in systolic blood pressure with ageing is mainly caused by an increase in vascular stiffness of the great arteries in combination with atherosclerotic changes in the vessel wall. Systolic blood pressure rises more steeply in ageing women compared with men, and this may be related to the hormonal changes per se during menopause,” says a study published in the U.S. National Library of Medicine, National Institutes of Health.

High blood pressure usually has no symptoms, giving it the name “silent killer”. But if you feel lightheadedness or dizziness, have nosebleeds, it can be a sign.

2. Blood cholesterol test

A blood cholesterol test is recommended every five years or as per your doctor’s instructions. It checks the amount of each type of cholesterol and fats in the blood. Doctors usually recommend the test starting age 45, even if you don’t have risk factors for coronary heart disease. However, if you notice lifestyle changes like weight gain, or have conditions like heart or kidney problems, or diabetes, you may need the test more often. 

3. Breast exam and mammogram

Doctors recommend a mammogram for women above 40 every 1-2 years. Women should consult their doctor for the frequency of their breast exam and mammogram depending on their risk factors, which include: family history, obesity, smoking, alcohol, high stress, a fatty diet, bad lifestyle, and irregular sleeping time.

“Early menarche and late menopause are both risk factors. There is a hormone which acts on the breast and which is now being called responsible for breast cancer. The longer your breast tissue is exposed to this particular hormone, there are more chances that you will  get breast cancer,” says Delhi-based laparoscopic surgeon Dr. Usha Maheshwari. 

Doctors also recommend a monthly self-exam, and a clinical breast exam if your healthcare provider recommends it. A clinical breast exam is recommended annually.

Breast cancer is the most common kind of cancer amongst women in India. A malignant tumour which starts in the breast cells, it can spread to other parts of the body. The World Health Organisation (WHO) says breast cancer affects as many as 2.1 million women each year. Early diagnosis and screening (self-exam, clinical breast exam and mammography) are critical for prevention and treatment of breast cancer, according to the organisation.

4. Cervical cancer screening

Doctors recommend a pap smear for women between 30-65 years of age every three years, and a human papillomavirus HPV test every five years. Women who have undergone a total hysterectomy (removal of uterus and cervix) for a non-cancerous condition don’t need a pap smear. If the hysterectomy was done as part of treatment of cervical cancer or pre-cancer, then they may continue testing. Women who have had a supra-cervical hysterectomy, without removal of the cervix, should continue cervical cancer screening.

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5. Blood sugar

If left untreated, diabetes can lead to kidney failure, heart disease as well as blindness. Doctors recommend a fasting blood sugar test once every three years, unless you notice symptoms of diabetes like:

1. Extreme fatigue
2. Weight loss
3. Blurry vision
4. Dry skin and slow healing sores
5. Tingling hands and feet
6. Urinating often
7. Feeling very hungry and very thirsty

According to a study published in The Lancet Journal, the number of people with diabetes in India rose to 65 million in 2016, from 26 million in 1990. The study said “as compared with 1990, we observed higher age-specific prevalence of diabetes in 2016, starting in the young adult age groups, that reached statistical significance at age 50–54 years in men and 55–59 years in women”.

6. Osteoporosis Screening

Studies say that Asian women have a higher predisposition for osteoporosis compared to Caucasians. Some studies estimate that one in four women over 50 in India suffer from osteoporosis.

“The attainment of peak bone mass in adolescent years and the rate of bone loss during postmenopausal years are some of the major factors contributing to bone health in older women. The rate of bone loss accelerates during the early postmenopausal years. The accelerated bone loss in postmenopausal osteoporosis is a result of a decline in estrogen concentrations,” says a study.

Although women are recommended a bone density test after 65, women in their 50s who have a fracture should get a bone density or a dexa test, which is an X-Ray test that helps determine bone health and quality.

7. Eye Test

People may start having problems with their vision, trouble reading or working on their computer starting their mid-40s. People over 40 who have diabetes, high blood pressure, high cholesterol, anxiety or depression, can be at risk for developing vision problems. You should have an eye test every two years or as recommended by your doctor.

8. Physical examination

Apart from the blood pressure, blood cholesterol test, women should also get their weight, height, and BMI (body mass index) measured at each physical exam. During the exam, women can also discuss their medications, smoking, drinking, or drug usage, if any. Doctors may also ask about your mental health and whether you have been feeling anxious or depressed. It is helpful to talk to your physician about your mental health, in case you don’t have access to a mental health practitioner or if you aren’t sure that you need therapy or counselling. Your physician can make a recommendation if they see the need. 

9. Menopause related tests

The average age for menopause in India is 46.2 years. Women who might be entering menopause and experiencing symptoms like irregular periods, hot flushes, hair loss, vaginal dryness, mood swings, or painful sex, should see a doctor. Your doctor may administer a blood test to check for the levels of follicle stimulating hormone (FSH) and estrogen. You may also need a lipid profile, and a thyroid test to rule out any other conditions. A doctor can recommend measures for better management of your symptoms and also recommend dietary and lifestyle changes.

Some women may also experience early menopause (between 40-45 years of age). In this case, consult your doctor for better management of symptoms.

10. Dental Exam

A bi-annual or annual dental check up is recommended by dentists for an evaluation of your gums and teeth. A dental cleaning can be done once every six months, or according to what your dentist recommends. People who are at a higher risks of dental diseases like smokers or diabetics may need more frequent visits to the dentist’s.

Sources:

1. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016.
2. Women’s health in menopause with a focus on hypertension. A.H.E.M. Maas and H.R. Franke

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