Maximizing Your Annual Exam: A Guide for Women Over 40
How learning to advocate for your health after 40 can change everything—and the essential questions you might not know to ask.
For years, I went to my annual doctor appointments like most people do: maybe a little nervous, a little rushed, and hoping for a quick thumbs-up. I never questioned the labs they ordered—or the ones they didn’t. I didn’t know what ferritin was, or why a full thyroid panel mattered. I just assumed they knew best.
And let me be clear—many doctors are doing their best in a very broken system. But I now understand that being informed and involved in my care is essential. And frankly, it’s the only way I began to feel better.
After being diagnosed with Hashimoto’s and struggling with chronic inflammation, I learned that what’s considered "normal" in a lab result doesn’t always mean optimal for my body. That symptoms like bloating, exhaustion, brain fog, and hormonal issues don’t just mean "you’re aging” or “maybe you’re just depressed”.
Especially for women over 40, this is when things shift—sometimes subtly, sometimes dramatically. Hormones fluctuate, stress accumulates, and resilience needs support. It’s a time when being dismissed or told "you’re fine" just doesn’t cut it. So if I could go back and do it differently? Here’s what I’d ask. And what I do ask now.
Labs & Data: Ask for the Full Picture
"Can you run a full thyroid panel?" (TSH, Free T3, Free T4, Reverse T3, and Thyroid Antibodies)
Why it matters: Most standard screenings only test TSH, which doesn’t give the full picture of how your thyroid is functioning. For conditions like Hashimoto's, it's crucial to test antibodies and active hormone levels to catch issues early."What are my ferritin, vitamin D, and B12 levels?"
Why it matters: These nutrients impact energy, immunity, hair growth, mood, and thyroid health. Low ferritin, in particular, is a common cause of fatigue that often goes undiagnosed."Can we look at my fasting insulin and A1C to get a clearer picture of my blood sugar health?"
Why it matters: These markers are early indicators of insulin resistance, even when fasting glucose looks normal. Managing blood sugar is key for hormone balance, weight, and long-term metabolic health."What is my CRP (C-reactive protein) or other inflammation markers?"
Why it matters: Chronic inflammation is linked to autoimmune conditions, gut dysfunction, and disease risk. CRP is a simple way to track underlying inflammation in the body.
"Can we test my sex hormones?" (Estradiol, Progesterone, Testosterone, DHEA)
Why it matters: Hormonal changes during perimenopause and menopause can significantly affect mood, metabolism, sleep, libido, and more. Understanding your hormone levels provides insight into symptoms and guides individualized support strategies. This is especially critical in your 40s and beyond, when fluctuations can be dramatic—and easily overlooked. Please note you will want to have these run during a specific time frame during your cycle- ask your doctor for
Sometimes you have to spell it out. If your doctor says, "You don’t need that," you can respond with: *"I'd like to have a baseline so I can better understand my whole picture." Please note you’ll want to ask what is covered by insurance and what may not be. Plans can differ greatly.
Symptoms: Honor What You Feel
"I’ve been feeling ___ (bloated, exhausted, anxious, foggy, inflamed). What could be causing this?"
Why it matters: These symptoms are signals. Even if labs look "normal," persistent symptoms are worth investigating further. You deserve a provider who listens"Could this be related to perimenopause or hormone shifts?"
Why it matters: Hormonal changes can begin as early as your mid-30s. Recognizing the signs and supporting your body during this transition can prevent more disruptive symptoms later."This doesn’t feel normal for me—what else can we look into?"
Why it matters: You are the expert on your body. If something feels off, it usually is. Don’t be afraid to speak up or ask for further evaluation.
Medications & Supplements: Get Curious
"Are there potential interactions with the supplements I’m taking?"
Why it matters: Even natural supplements can interact with medications or each other. It's important to make sure your care is safe and integrated. Always check with your provider before starting new supplements to ensure there won’t be negative interactions."Could we consider lifestyle-based options or lower-intervention choices first?"
Why it matters: Many conditions can be improved with nutrition, stress management, and sleep before jumping to prescriptions. It's okay to ask about alternative or complementary strategies."What’s the long-term plan if I stay on this medication?"
Why it matters: Medications can be necessary, but you deserve to know the exit strategy or what long-term use means for your health.
You deserve to understand every option—and the side effects that may come with it.
Preventative Care: Think Ahead
"Can we take a more proactive approach to my hormone health?"
Why it matters: Waiting until menopause symptoms are severe means suffering unnecessarily. Prevention and gentle support early can make a big difference."What are some functional or integrative supports I could consider alongside this treatment?"
Why it matters: Nutrition, acupuncture, bodywork, herbs, and other supports can often improve outcomes. Many providers are open to collaboration if you ask."Are there referrals you trust for nutrition, physical therapy, or mental health?"
Why it matters: Health is multidimensional. Having a care team that supports all areas of well-being creates better outcomes.
Taking a holistic approach is key to managing your health for the long term.
What I Do Differently Now
I track my symptoms and bring notes.
I ask for copies of all labs.
I bring a list of questions so I don’t freeze up or forget.
I don’t take "you're fine" as the end of the conversation if I still feel off.
I stay informed and educated from a variety of resources - trusted doctors and specialists online, podcasts, medical journeys and studies.
I also remind myself going in that I live in this body every day and I want to feel my best possible. I know what feels right and that I need to advocate for myself.
Want Support for Your Next Appointment?
I created a free Doctor Visit Prep Sheet that includes the top questions to ask, symptom tracker prompts, and a checklist to help you walk in calm and walk out clear.
Download it here and feel empowered to speak up for the care you deserve.
Because the best expert on your body? Is you. If you want more support and guidance, please reach out.
