Your reproductive and sexual health care checklist for your 50s

Forget puberty: For many people, their 50s seems like a decade full of changes. They may have gone through menopause, or are getting close—and at this stage, having sex can feel pretty different because of the hormonal changes that come with periods ending. (FYI: To be considered menopausal, you have to be period-free for an entire year.)

Which means that taking care of yourself and your reproductive and sexual health couldn’t be more important.

We reviewed the clinical guidelines and recommendations for people with vaginas in their 50s so you know how to stay on top of your health this decade. Since recommendations may vary based on your health status and medical history, it’s always a good idea to talk to your health care provider about what’s right for you.

What sexual health screenings should you get in your 50s?

When it comes to reproductive and sexual health, you might be wondering: What medical tests do I need in my 50s? We’re here to help. Here’s an overview of what screenings and tests you can expect.

Cervical cancer screening

The United States Preventive Services Taskforce recommends that people with cervixes who are in their 50s get cervical cancer screenings at a frequency based on their age. Screenings for people in their 50s include Pap tests and/or human papillomavirus (HPV) testing. 

Pap tests (often called Pap smears) involve the collection of cervical cells to check for precancerous and cancerous cells caused by HPV. Follow-up testing may be needed.

HPV testing checks for strains of HPV that are associated with cervical cancer.

People with cervixes who are in their 50s are advised to meet one of the following guidelines:

• Get HPV tests every five years
• Get HPV tests along with Pap tests every five years
• Get Pap tests every three years

More frequent screening may be recommended based on your unique health history.

If you’ve had your uterus and cervix surgically removed (aka total hysterectomy) for reasons unrelated to cervical cancer, you don’t need vaginal Pap tests. If you had a total hysterectomy because of cervical cancer or precancer, your health care provider will recommend the best follow-up care for you.

Learn what you can expect from a Pap and HPV test.

Breast cancer screening

Like cervical cancer screenings, the American Cancer Society recommends that people assigned female at birth who are in their 50s get breast cancer screenings at a frequency based on their age and risk level. Screenings for people in their 50s include breast/chest magnetic resonance imaging (MRI) and mammograms.

Breast/chest MRI takes detailed images of the inside of breasts/chests to detect breast cancer signs among people with high risk for the cancer. 

Mammograms are low-dose x-rays that help detect breast cancer early — before there are physical symptoms to suggest it. 

These are the breast cancer screening guidelines for people in their 50s:

• People with high risk of breast cancer may have started screening with breast/chest MRIs and mammograms at age 30.
• After age 40 annually or every other year

Learn what you can expect from a breast/chest MRI and mammogram.

Screening for sexually transmitted infections (STIs)

Sexually transmitted infections (STIs) are extremely common and highly treatable. However, if left untreated, they can lead to issues like pelvic inflammatory disease (PID), infertility, pregnancy complications, and birth defects down the line.

The following STI tests are recommended for people with vaginas in and beyond their 50s:

• Anyone ages 13-64 should get an human immunodeficiency virus (HIV) test at least once.
• People with vaginas should get tested for gonorrhea and chlamydia annually when they have new or multiple sex partners—or if their sex partner has a history of STIs. 
• Early in pregnancy, pregnant people should get tested for syphilis, HIV, hepatitis B, and hepatitis C. Some pregnant people may also be tested for gonorrhea or chlamydia. Some may also need repeat testing.
• Everyone should get a Hepatitis C test at least once.

Additional testing may be recommended based on your unique circumstances. Talk to your healthcare provider about what STI testing is right for you.

Learn what you can expect from STI testing.

Diabetes screening

Diabetes is a health condition where the body has difficulty regulating its levels of blood sugar. Issues with blood-sugar control like diabetes or insulin resistance can impact menstrual cycles and make it harder to get pregnant. People who have diabetes are also monitored more closely in pregnancy. Uncontrolled diabetes can cause pregnancy and birth complications.

Diabetes screenings are recommended at a frequency based on age, body-fat percentage (based on body-mass index or BMI), and pregnancy status. Screenings include testing A1C or oral glucose tolerance tests.

Diabetes screenings are also recommended for pregnant people. Screenings include glucose screening tests and glucose intolerance tests.

A1C tests examine the average blood-sugar levels from the prior 2-3 months.

Glucose tolerance tests measure blood-sugar levels before and after drinking a high-glucose beverage.

Glucose screening tests measure blood-sugar levels after drinking a high-glucose beverage.

Diabetes screening guidelines are different for different people:

• Non-pregnant people ages 35-70 who have a higher body-fat percentage (based on BMI) should be screened every three years for diabetes.
• Pregnant people should be screened between the 24th and 28th weeks of pregnancy. 

Learn what you can expect from diabetes screenings.

Osteoporosis screening

In the years after menopause, when periods come to a complete stop, the body’s lower levels of the hormone estrogen contribute to bone loss. Osteoporosis is a condition where the amount of new bone produced can’t keep up with bone less. The bones are weaker as a result. 

Osteoporosis screening is recommended for people assigned female at birth ages 50-64 if they are at higher risk of the condition. Screenings for people assigned female at birth who are in their 50s and have risk factors for osteoporosis include dual/energy x-ray absorptiometry (DXA).

DXA is a low-dose x-ray that measures bone density to check for signs of osteoporosis.

These are the osteoporosis screening guidelines for people assigned female at birth:

• People ages 50-64 who have risk factors for osteoporosis (like parents with bone loss) should be screened for the condition with DXA every two years.
• All people ages 65 and older should be screened for osteoporosis once every two years.

Learn what you can expect from DXA.

Pelvic exams

Pelvic exams are an important part of reproductive and sexual health care. But, according to the American College of Obstetricians and Gynecologists (ACOG), they should only be conducted when necessary based on symptoms or medical history. As Hey Jane’s Medical Director Alyssa Wagner (DNP, RN, APRN, WHNP-BC) always says: “No search without probable cause!” Unless there’s a reason, it is not recommended to do a pelvic exam. 

The following symptoms might indicate that a pelvic exam is medically necessary:

• Any vaginal bleeding post-menopause
• Pain during sex
• Pelvic pain
• Sexual dysfunction
• Vaginal dryness
• Vaginal prolapse
• Urinary issues
• Issues with inserting tampons
• Vaginal discharge or odor
• Changes in bleeding patterns

Learn what you can expect from a pelvic exam.

Immunizations

Many people may not realize that there are vaccines for certain diseases related to sexual and reproductive health. There is a vaccine for HPV and hepatitis B, both of which can be transmitted sexually. Some strains of HPV can lead to cervical cancer.

HPV vaccination is typically recommended between the ages of 11 and 12. Between age 27-45 some people may be advised by their healthcare provider to get vaccinated against HPV. However, by this age, most people have already been exposed to the virus.

Hepatitis B vaccination is recommended for all adults ages 19-59.

How often should you get checked out in your 50s?

ACOG recommends that people with vaginas should visit with their OB-GYNs at least once every year for general sexual and reproductive wellness. This includes people who are in their 50s.

Outside of annual visits, there are other times checking in on your reproductive and sexual health with a health care provider is important:

• When you’re experiencing vaginal symptoms (discharge, odor, burning or changes in bleeding patterns)
• When you’ve noticed changes in your breasts/chests
• When there’s any vaginal bleeding post-menopause
• When you think or know you’ve been exposed to an STI
• When you’re pregnant 
• If you want to talk about not getting pregnant
• If you are experiencing disruptive symptoms of menopause (while you have to be period-free for a whole year before you are considered menopausal, the symptoms leading up to it can start and continue before then)
• To discuss menstrual management leading up to menopause

How often should you get a general health checkup in your 50s? This depends on your health status and medical history. Some healthcare providers suggest having physical exams every year starting at age 40. Additional screenings and tests will be recommended to prevent, detect, or manage health conditions. If you have a chronic health condition or a family history of one, you can expect to visit with your healthcare provider more often.

How to get your reproductive and sexual health checked out

Although there are clinical guidelines for people in different age groups, your recommended screenings and tests may vary based on your health status and medical history. Talk to your health care provider about staying on top of your sexual, reproductive, and overall health.

If you have health insurance, know that all health plans cover preventive health services for people with vaginas. These can include:

• Birth control (unless you have an exempt religious employer)
• Gonorrhea screening
• Hepatitis B screening
• Syphilis screening
• Chlamydia infection screening
• HIV screening and counseling
• STI counseling
• Urinary tract infection (UTI) or other infection screening
• Mammograms
• Cervical cancer screening
• “Well-woman” visits (your annual OB-GYN appointment)

There are other essential reproductive and sexual health services — including abortion care Prep (prevention for HIV), emergency contraception or vaccinations — that may or may not be covered, depending on your age, medical history, and/or health plan. (Hey Jane does accept insurance for all of its services, though insurance is not required to receive care.)

What if you don’t have health insurance? Local health departments and organizations may offer free cancer screenings, STI testing, and follow-up services:

• Breast Cancer Assistance Program 
• National Breast and Cervical Cancer Early Detection Program
• Community health clinics
• Title X clinics
• Planned Parenthood

Hey Jane offers safe, supportive, and confidential telemedicine services for many of your reproductive and sexual health needs — including abortion care, birth control, emergency contraception, UTI treatment, yeast infection treatment, bacterial vaginosis treatment, and herpes treatment. 

Connect with a Hey Jane provider within 1 business day to get started on your treatment plan.