According to Michael L. Blumenfeld, MD, director of clinical services, Center for Women's Health at Ohio State University's Wexner Medical Center it's important for women to be proactive when it comes to their own well-being.

"This means getting annual exams, which are still important," says Blumenfeld who admits to being concerned women will see doctors less in response to new national guidelines advocating less frequent mammograms and Pap smears. (In 2009, the United States Preventive Services Task Force raised the recommended age for mammography from 40 to 50 and specified every two years, rather than annually. Recommendations regarding cervical cancer screening with Pap smear have also been tweaked. Screening is now recommended once every three years beginning at age 21.) "Women often associate Pap smear guidelines with exams but they should be treated as two separate issues."

Screening tests are an important component of good health but so are yearly trips to the physician. Blumenfeld urges women to ask their doctor the following questions:

Q: What are some health screenings that I need as I get older, and when do I need them?

There are a number of regular women's health screenings that you'll need, depending on your age and your health status. Here are some of the common recommendations:

  • Blood Pressure Reading:The American Heart Association says that all women age 20 and older need to have their blood pressure tested at their annual doctor's office visit or at least every two years as long as their readings fall within the normal range, which is less than 120/80. Women with abnormal readings need to have them repeated more often.
  • Cervical Cancer Screening:The Centers for Disease Control and Prevention (CDC) recommends that women age 21 and older undergo a Pap test every three years. This identifies any cervical changes that could become cancerous. The CDC also recommends the HPV test, which looks for the Human Papillomavirus. If left untreated, HPV can lead to cancer. This HPV test is recommended for women age 30 and over and should be performed along with the Pap test.
  • Breast Cancer Screening: The American Cancer Society (ACS) recommends that starting at age 40, women have a mammogram-although this contradicts the national guidelines recommending screening begin at age 50. (People who have any risk factors may need to start testing even earlier and repeat the testing more often.) In addition, ACS recommends that women in their 20's and 30's undergo a clinical breast exam every three years, then increase these exams to yearly once they hit 40. All women should also perform regular self-breast exams so they will notice any changes and can have them checked right away by their doctor.
  • Cholesterol Test: All women, starting at age 20, should have their cholesterol levels tested and repeated every five years as long as she has no other health issues and the levels are normal.  Check with your doctor to find out how often this testing needs to be repeated. 
  • Diabetes Test: If your blood pressure is elevated (higher than 135/80), you should be screened for diabetes. Ask your doctor how often you'll need to have this test repeated.
  • Bone Mineral Density Test: Most women should have this test performed at least once at age 65 or older. People at higher risk for osteoporosis can talk to their doctors about having this test done earlier.
  • Colorectal Cancer Screening: This screening should be conducted on women between the ages of 50 and 75. Several different tests can be used, depending on your specific circumstances. Again, speak with your doctor for guidance.
  • Weight Check: Maintaining a healthy weight is important to your overall health. Therefore, you should have your weight checked periodically so you can make changes to your eating and exercise routine as needed. As you get older, you may find your weight changing and you'll have to adjust your lifestyle accordingly to avoid associated health risks.

Blumenfeld stresses that these screening recommendations are only guidelines and should be individualized based on your specific risk factors and situation.

Q: What do my health screening results mean?

Women need to know the results of their screenings and learn what they mean in terms of their overall health, says Laxmi S. Mehta, MD, FACC, clinical director, Women's Cardiovascular Health Program at the Center for Women's Health through Wexner Medical Center. They should know what they can do to improve the numbers. "Small changes can add up to big improvements in many cases," says Mehta. "A big part of prevention is knowledge."

Q: Will I need hormone replacement therapy to handle the effects of menopause?

The North American Menopause Society's position on using hormone replacement therapy recommends looking at each woman, her symptoms and her risk factors individually to determine whether hormone replacement therapy is an appropriate option for her. In general, Blumenfeld says current guidelines suggest using such therapy for short-term management of the worst symptoms during the menopause transitional period and usually not continuing it over the long-term.

Q: Do I need genetic testing if I have a family history of cancer or another serious disease?

Family health history should be taken seriously and shared with your doctor. Some diseases, like cancer, may warrant seeing a genetic counselor to review your risk factors. Many conditions can be treated if they are caught at an early stage, so you'll want to communicate any concerns you have and make sure that your doctor is proactive about getting a proper diagnosis for any ailments as soon as possible.

Michael Blumenfeld, MD, FACOG, and Laxmi S. Mehta, MD, FACC, reviewed this article.



Blumenfeld, Michael L., MD, director of clinical services, Center for Women's Health, The Ohio State University Wexner Medical Center. Phone interview, 22 March 2013. "American Cancer Society Guidelines for the Early Detection of Breast Cancer." American Cancer Society. 5 March 2012. Web. 28 March 2013. "Human Papillomavirus." Centers for Disease Control and Prevention (CDC). 29 Jan. 2013. Web. 25 March 2013. "Understanding Blood Pressure Readings." American Heart Association. 4 April 2012. Web. 25 March 2013.

Mehta, Laxmi S., MD, FACC, clinical director, Women's Cardiovascular Health Program, Center for Women's Health, The Ohio State University Wexner Medical Center. Email interview, 23 March 2013. "Menopause & Me." The North American Menopause Society. N.d. Web. 25 March 2013.

"The 2012 Hormone Therapy Position Statement of the North American Menopause Society." "Screening Tests and Vaccines." 19 Jan. 2012. 

US Department of Health and Human Services. Web. 25 March 2013.