Ages 40-64

Screening and Consultation

History: Tell Us About You

  • Reason for visit
  • Health status: medical/surgical, menstrual, reproductive health 
  • Family Medical History
  • Dietary/nutrition assessment
  • Physical activity
  • Use of complementary and alternative medicine 
  • Tobacco, alcohol, other drug use
  • Pelvic prolapse
  • Menopausal symptoms
  • Abuse/neglect
  • Sexual practices (including vaginal, anal, and oral sex; sexual orientation, number of partners; contraceptive use; any high risk sexual practices)
  • Urinary and fecal incontinence

Physical Examination

  • Height
  • Weight
  • Body mass index (BMI)
  • Blood pressure
  • Neck: adenopathy, thyroid 
  • Breasts, axillae (yearly clinical breast examination)
  • Abdomen
  • Pelvic examination
  • Additional physical examinations as clinically appropriate


  • High-risk behaviors
  • Contraceptive options for prevention of unwanted pregnancy, including emergency contraception
  • Sexual function
  • Sexually transmitted infections— screening, treatment and barrier protection
  • Preconception and genetic screening (if having a child is desired or pregnancy is still possible)

Emotional and Social Evaluation

  • Family relationships
  • Intimate partner violence
  • Work satisfaction
  • Lifestyle/stress
  • Sleep disorders
  • Advanced directives

Cardiovascular Risk Factors

  • Family history
  • Hypertension
  • Dyslipidemia
  • Weight management concerns
  • Diabetes mellitus
  • Personal history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension
  • Lifestyle

Health/Risk Assessment

  • Aspirin prophylaxis to reduce the risk of stroke (ages 55-79 years)*
  • Breast self-awareness (may include breast self-examination) 
  • Chemoprophylaxis for breast cancer (for high-risk women)
  • Hormone therapy
  • Hygiene (including dental)
  • Sun exposure 
  • Suicide: depressive symptoms

Labs, Immunizations and Other Tests


  • Cervical cytology "Pap Smear": Preferred--Co-test with cytology and HPV testing every 5 years;  Option--Screen with cytology alone every 3 years
  • Colorectal cancer screening: Preferred--beginning at age 50 years: colonoscopy every 10 years*
Test That Detects 
Adenomatous Polyps 
and Cancer
Colonoscopy (preferred) Every 10 years
Flexible sigmoidoscopy with insertion to 40 cm or to splenic flexure Every 5 years
CTC† Every 5 years
gFOBT with high sensitivity for cancer Annual
FIT with high sensitivity for cancer Annual
sDNA with high sensitivity Interval uncertain
  • Diabetes testing -every 3 years after age 45 years
  • Hepatitis C virus testing -one-time testing for persons born from 1945 through 1965 and unaware of their infection status
  • Human immunodeficiency virus (HIV) testing (if pregnant and with consent)
  • Lipid profile assessment - every 5 years beginning at age 45 years
  • Mammography - yearly
  • Diphtheria and reduced tetanus toxoids and acellular pertussis vaccine booster - substitute one-time dose of Tdap for Td booster; then boost with Td every 10 years (See the Centers for Disease Control and Prevention for more information.
  • Herpes zoster - single dose in adults aged 60 years or older
  • Influenza vaccine - annually
  • Measles-mumps-rubella vaccine - for those born in 1957 or later and not previously immunized
  • Varicella vaccine - one series for those without evidence of immunity

High-Risk Groups (See "ARE YOU HIGH RISK" page for more information)

  • Bone mineral density screening
  • Colorectal cancer screening
  • Diabetes testing
  • Hemoglobin level assessment
  • Lipid profile assessment
  • Sexually transmitted infection testing
  • Thyroid-stimulating hormone testing
  • Tuberculosis skin testing
  • Hepatitis A vaccine - combination vaccine for those at risk for hepatitis A and
  • Hepatitis B vaccine - combination vaccine for those at risk for hepatitis A and B
  • Measles-mumps-rubella vaccine - for those born before 1957
  • Meningococcal vaccine
  • Pneumococcal vaccine

*Colorectal cancer screening for African American women should begin at age 45 years. 

Yes...We are thorough, but you are worth it.

Let us help you start healthy and stay healthy. Call us at 989-753-8453
to schedule your Well Woman Visit.