Health Encyclopedia

Prevention Guidelines for Women 40–49

Here are the screening tests and immunizations that most women ages 40 to 49 need. This plan does not include recommendations for pregnancy. Although you and your health care provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening

Who needs it

How often

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:

  • Every 2 years if blood pressure reading < 120/80 mm Hg, or

  • Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg

Breast cancer

All women*

Yearly mammogram and clinical breast exam*

Cervical cancer

All women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious precancer

Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years.

Chlamydia

Women at increased risk for infection

At routine exams if at risk

Depression

All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

At routine exams

Diabetes mellitus, type 2

Adults who have no symptoms and have sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At least every 3 years

Gonorrhea

Sexually active women at increased risk for infection

At routine exams if at risk

HIV

Anyone at increased risk for infection

At routine checkups

Lipid disorders

All women age 45 and older at increased risk for coronary artery disease

For women ages 19 to 44, screening should be based on risk factors1; discuss with your health care provider

At least every 5 years

Obesity

All adults

At routine checkups

Syphilis

Women at increased risk for infection

At routine exams if at risk

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider

Vision

All adults2

Baseline comprehensive exam at age 40; if you have a chronic disease, check with your health care provider for exam frequency

Counseling

Who needs it

How often

Breast cancer, chemoprevention

Women at high risk

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with increased risk

When risk is identified

Diet, behavioral counseling

Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease

When diagnosed

Tobacco use and tobacco-related disease

All adults

Every visit

Immunization

Who needs it

How often

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All adults

Td: every 10 years

Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years

Chickenpox (varicella)

All adults ages 19 to 49 who have no documentation of previous infection or vaccinations

Two doses; the second dose should be given at least 4 weeks after the first dose

Measles, mumps, rubella (MMR)

All adults ages 19 to 49 who have no documentation of previous infection or vaccinations

One or two doses

Flu vaccine (seasonal)

All adults

Yearly, when the vaccine becomes available in the community

Hepatitis A vaccine

People at risk3

Two doses given 6 months apart

Hepatitis B vaccine

People at risk4

Three doses; the second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)

Meningococcal

People at risk**

One or more doses

Pneumococcal (polysaccharide)

People at risk5

One or two doses

*Recommendation from the American Cancer Society (ACS). Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every 2 years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. The ACS also recommends annual clinical breast exams (CBEs) for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.

**Exceptions may exist, please discuss with your health care provider

1Recommendation from the American Congress of Obstetricians and Gynecologists

2Recommendation from the American Academy of Ophthalmology

3For complete list, see the CDC website

4For complete list, see the CDC website

5For complete list, see the CDC website

Immunization schedule from the CDC



Medical Reviewers:

  • Berry, Judith, PhD, APRN
  • Fraser, Marianne, MSN, RN
  • Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
  • Stump-Sutliff, Kimberly, RN, MSN, AOCNS