Prevention Guidelines for Women 40-49

Here are the screening tests and immunizations that most women ages 40 to 49 need. 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 and pregnant women

At routine exams

Anemia - Iron Deficiency

All pregnant women

At prenatal visits, especially the first

Asymptomatic Bacteriuria (with urine culture)

All pregnant women

At 12–16 weeks' gestation or the first prenatal visit, if later

Blood pressure

All adults

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

Every two years if blood pressure reading < 120/80 mm Hg, and

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

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 pre-cancer   

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

Chlamydia

Women at increased risk for infection, and pregnant women

At routine exams

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 are asymptomatic with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At routine exams

Gonorrhea

Sexually active women at increased risk for infection, and pregnant women

At routine exams

Hepatitis B virus

All pregnant women

At first prenatal visit

HIV

Anyone at increased risk for infection, and pregnant women

At routine checkups

Lipid Disorders

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

For women ages 19 to 44, ACOG recommends screening based on risk factors. Please discuss with your health care provider.

At least every five years

Obesity

All adults

At routine checkups

Preeclampsia

Given the availability of new evidence, USPSTF has decided to update this recommendation. The recommendation below may contain information that is out of date. Please consult your health care provider.

All pregnant women

The recommendation below may contain information that is out of date. Please consult your health care provider.

At routine checkups

Rh (D) Incompatibility

All pregnant women

First prenatal visit

Rubella

Given the availability of new evidence, USPSTF has decided to update this recommendation. The recommendation below may contain information that is out of date. Please consult your health care provider.

All pregnant women

The recommendation below may contain information that is out of date. Please consult your health care provider.

At routine checkups

Syphilis

Women at increased risk for infection, and all pregnant women

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider

Counseling

Who needs it

How often

Breast cancer, chemoprevention

An update to this recommendation is currently in progress and being reviewed by the USPSTF.

The recommendation below may contain information that is out of date. Please discuss with your health care provider.

Women with high risk

The recommendation below may contain information that is out of date. Please consult your health care provider.

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with increased risk

When risk is identified

Breastfeeding

All pregnant women

During pregnancy and after delivery

Diet, behavioral counseling

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

When diagnosed

Tobacco use and tobacco-caused 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 - once after age 18

Chickenpox (varicella)

All adults ages 19 to 49 and who lack evidence of immunity (no documentation of prior infection or vaccinations)

Pregnant women should be assessed for evidence of immunity.

Two doses. The second dose should be administered four to eight weeks after the first dose.

Measles, mumps, rubella (MMR)

All adults ages 19 to 49 and who lack evidence of immunity (no documentation of prior infection or vaccinations)

One or two doses

Flu vaccine (seasonal)

People at risk**

Yearly

Hepatitis A vaccine

People at risk**

Two doses

Schedule:

Zero and 6 to 12 months (Havrix), OR

Zero and 6 to 18 months schedule (Vaqta)

Hepatitis B vaccine

People at risk**

Three doses. The second dose should be administered one month after the first dose; the third dose should be administered at least two months after the second dose (and at least four months after the first dose).

Meningococcal

People at risk**

One or more doses

Pneumococcal (polysaccharide)

People at risk**

One or two doses


Did You Know?

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The average age of a woman having her last period is age 51.