Women’s health after 50: the checkups that matter

After 50, the focus of a woman’s preventive care shifts. Menopause changes heart and bone risk, some screenings become more important, and one, the Pap test, can often stop. Heart disease is the leading cause of death for women in the United States, yet it is often the risk women think about least.

The list below follows the U.S. Preventive Services Task Force (USPSTF) and the CDC, with the year of each current recommendation. Your history may call for a different schedule.

A quick key to the Task Force’s language: an A or B grade means the service is recommended; a C means it should be offered selectively, based on your situation and preferences; a D means the Task Force recommends against it; and an I means the evidence is not yet good enough to decide. Grades describe people of average risk, so a strong family history or a past abnormal result can change the plan.

Heart and metabolic health

• Blood pressure. Checked at least yearly from age 40, with a high office reading confirmed at home before treatment (USPSTF, 2021).
• Blood sugar. Screening for adults 35 to 70 with overweight or obesity (USPSTF, 2021).
• Cholesterol and statins. Recommended for adults 40 to 75 with a risk factor and a 10-year risk of 10 percent or more (USPSTF, 2022).

Heart symptoms in women can be less obvious. Along with chest discomfort, the CDC lists pain in the neck, jaw, throat, upper abdomen or back, nausea, and unusual tiredness. If those come on suddenly, call 911. Our article on menopause and heart health covers why risk rises after menopause.

Breast and cervical cancer

Mammograms. The USPSTF (2024) recommends a mammogram every two years from age 40 through 74. For women 75 and older, it found the evidence insufficient, so the decision depends on health and preferences. If you have dense breasts or a strong family history, ask whether extra imaging makes sense for you. See breast cancer screening from 40.

Cervical cancer. Screening continues to 65. After that, the current USPSTF recommendation (2018) is no further screening for women who have had adequate prior screening and are not at high risk. “Adequate” means three normal Pap tests in a row, or two normal co-tests, within the ten years before stopping, with the most recent in the past five years. If your records are incomplete, screening may still be worth doing. The Task Force is updating this recommendation; a 2024 draft added HPV tests that women can collect themselves.

Bones and other cancer screening

• Bone density. The USPSTF (2025) recommends osteoporosis screening for women 65 and older, and for younger postmenopausal women with risk factors such as a parent who broke a hip, smoking, low body weight or heavy drinking. See bone density screening.
• Colorectal cancer. From 45 through 75, with a selective decision from 76 to 85 (USPSTF, 2021).
• Lung cancer. Yearly low-dose CT for adults 50 to 80 with at least a 20 pack-year history who smoke now or quit within 15 years (USPSTF, 2021).
• Skin. Worth discussing in Florida; see skin cancer checks.

Vaccines, falls and the conversations to have

• Shingles: two doses of Shingrix for adults 50 and older.
• Pneumococcal: recommended for all adults 50 and older.
• RSV: for all adults 75 and older and those 50 to 74 at increased risk.
• Falls: exercise programs for adults 65 and older at increased risk (USPSTF, 2024). Strength work helps both bones and balance; see strength training after 50.

Some topics do not appear on screening lists but belong in the visit: menopause symptoms and whether treatment makes sense for you, bladder control, sleep, mood, memory and hearing. Many women do not raise these because they assume nothing can be done. Often something can.

One practical habit helps more than any single test: keep a short record of when you last had a mammogram, colon screening, bone density scan and each vaccine, and where it was done. Results scattered across several offices, or across two states for seasonal residents, are the most common reason a screening is repeated too soon or quietly missed.

At Legacy Medical, the annual executive physical is where Dr. Shtern keeps track of what is due and when, coordinates with your gynecologist and other specialists, and makes time for the questions that do not fit a checklist. To meet her first, book a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.