For women navigating their 20s, 30s, and 40s, regular blood testing becomes especially crucial. During these pivotal decades, your body undergoes significant hormonal shifts, metabolic changes, and lifestyle transitions that can impact everything from fertility to heart health. Read on for clear, evidence-based recommendations for essential blood tests every woman should have.

Why Regular Blood Tests Matter for Women

Your blood tells a story that may not be evident in physical symptoms. 

Consider insulin resistance, which affects nearly 40% of adults in the United States. This metabolic dysfunction develops silently over the years, and can lead to type II diabetes, a long-term, chronic condition. Routine blood tests can detect metabolic imbalances and insulin levels years before any symptoms surface, when lifestyle modifications and medical interventions can have a larger impact.

Due to fluctuating hormones, during the menstrual cycle, pregnancy and menopause, women face unique challenges.  Even if you feel great, the years between 25 and 50 bring inevitable metabolic and cellular changes that can surface in your bloodwork. Just like Pap tests are part of preventive care, so are blood tests (which means they’re usually covered by health insurance). 

How Often Should You Get Blood Work Done?

For most healthy women, annual comprehensive blood work provides the necessary baseline for ongoing monitoring. However, certain circumstances warrant more frequent testing:

• A family history of chronic diseases increases risk and calls for closer monitoring
• Unexplained or sudden symptoms like persistent fatigue or an irregular menstrual cycle may require more frequent testing.
• Fertility, planning for pregnancy, and prenatal care usually require more testing.
• Chronic conditions, including diabetes or thyroid disorders, require regular testing.

Age Band Recommendations

Outside of pre-existing conditions or other reasons for increased screenings, how often you need screenings, and which screenings, depend on your age. 

Ages 25-34 

Basic blood work every 1-2 years for low-risk women includes CBC, basic metabolic panel, and TSH. Women with diabetes risk factors should begin glucose screening during this decade.

Ages 35-44 

Annual testing becomes more important as metabolic risks increase. Recommended medical tests for women over 40 include lipid panels, complete metabolic panels, and diabetes screening. Women planning pregnancy should add iron labs and infectious disease screening.

Ages 45-50

Comprehensive annual wellness blood work for women becomes a standard practice. Essential tests include lipid panels, diabetes screening with A1C, thyroid function, and CBC. Your provider may consider adding inflammatory markers and vitamin D levels as perimenopause approaches.

Core Blood Tests Every Woman Should Know

While your healthcare provider will likely bundle a few tests into one comprehensive panel, it’s helpful to know what each test measures and why they’re important.

Complete Blood Count (CBC)

CBC measures red blood cells, white blood cells, hemoglobin, and platelets, providing comprehensive information on blood health.

Why it matters: Detects iron deficiency, anemia (which affects ~13% of women), infections, immune disorders, and blood cancers. 

Frequency: As part of annual testing, more frequent during pregnancy or if you have heavy or prolonged periods.

Metabolic Panel (CMP/BMP)

A CMP checks your overall health by looking at blood sugar, levels of electrolytes like sodium and potassium, and how well your kidneys and liver are working.

Why it matters: Detects kidney disease, liver problems, diabetes, and electrolyte imbalances. It’s essential for monitoring the effects of certain medications. 

Frequency: Annually for healthy women, more frequently with chronic conditions.

Lipid Panel (Cholesterol Test)

A lipid panel measures total cholesterol, LDL, HDL, and triglycerides to assess cardiovascular disease risk—the leading cause of death among women.

Why it matters: Heart disease develops silently over decades. Women's risk increases significantly after menopause, but risk factors often accumulate earlier. Early detection significantly increases the chances of prevention and successful intervention with lifestyle changes and medication. 

Frequency: Women with low- to normal-risk factors should start screening at 45 and repeat it every 5 years. Earlier and more frequent testing is recommended for those with certain risk factors, such as a family history of heart disease.

Blood Glucose & HbA1c (Diabetes Screening)

Diabetes screening tests include fasting glucose, random glucose, or A1C (reflecting a 2-3 month average of blood sugar levels). Many providers prefer A1C for a more comprehensive picture of glucose control.

Why it matters: Diabetes affects over 11% of U.S.adults, and women are more likely to be undiagnosed. Glucose levels are an early indicator of both ​prediabetes and insulin resistance. If left unaddressed, both conditions can progress to type 2 diabetes and other metabolic diseases, but early lifestyle changes can prevent or even reverse them.

Prediabetes symptoms and risk factors

Some people are at an increased risk of diabetes, insulin resistance and other metabolic conditions. If you have any of the below, you may need more frequent testing and monitoring:

• Risk factors: excess weight, family history, certain ethnicities
• Physical signs: darkened skin patches around the neck/armpits,  a condition called acanthosis nigricans.
• Symptoms: increased thirst and hunger, frequent urination, fatigue, blurred vision

Thyroid Function (TSH & Free T4)

Your thyroid is a small gland located in your neck that produces hormones that regulate how your body uses energy. It regulates important functions like metabolism, growth, and body temperature. If your thyroid isn’t working properly, it can affect your entire body.

Thyroid disorders affect women five to eight times more than men. The thyroid-stimulating hormone (TSH) test measures thyroid hormone production. Abnormal results may require a thyroxine (T4) test, which measures the amount of a hormone called T4 in your blood.

Signs of thyroid issues in women​

Women are more likely to have thyroid issues, such as hypothyroidism (low hormone levels) or hyperthyroidism (excess hormone levels). Some signs and symptoms:

•  Hypothyroidism: fatigue, weight gain, feeling cold, hair loss, depression, irregular periods
• Hyperthyroidism: anxiety, rapid heartbeat, weight loss, feeling hot, tremor, sleep problems

If your test results come back with high TSH, it indicates hypothyroidism (not enough); low TSH suggests hyperthyroidism (too much). 

Ferritin

Ferritin is another blood test that measures iron levels. Unlike the CBC, ferritin measures your body’s iron stores. Both tests are used to determine your iron levels.

Signs of an Iron Deficiency

Some signs of low iron include persistent fatigue, hair loss, pale skin, brittle nails, restless legs, cravings for ice, and concentration difficulties.

Additional Blood Tests to Consider

Based on your health history and risk factors, your provider may recommend:

• Vitamin D & B12: These vitamins are essential for bone health, immune function, and energy. Deficiencies are common in women, especially with limited sun exposure or restrictive diets such as veganism.
• High-sensitivity C-reactive protein (hs-CRP): As part of cardiovascular risk assessment blood tests, hs-CRP identifies risk through inflammation markers beyond standard cholesterol testing.
• Lipoprotein(a): This genetic cholesterol marker identifies inherited heart disease and stroke risks that standard panels miss.
• Hormone and fertility blood work: AMH, prolactin, estrogen, or progesterone can pinpoint irregular periods, fertility concerns, or hormonal symptoms.
• STI screenings: Regular HIV, hepatitis, and syphilis testing provides crucial health information, as many infections remain asymptomatic while causing long-term consequences, like impacting fertility. 

What to Know About Blood Tests

As with any screening, you want to ensure you take the necessary steps to ensure accuracy in your results. From there, you can work with your healthcare provider to review and interpret your results and take the appropriate action.

Preparing for Your Blood Test

Preparation depends on the type of test you’re having:

• Fasting requirements: Some tests require 8-12 hours of fasting, typically allowing only water. Always clarify requirements with your provider to avoid having to return for a repeat visit.
• Medication disclosure: Provide a complete list of medications, supplements, and vitamins, as these can affect blood test results.
• Timing: For hormone testing, the timing of your menstrual cycle can significantly affect results. Your provider will specify the best collection days that align with your cycle. 

Understanding Your Results

The best way to understand your results is to consult with your healthcare provider. However, the following provides a general overview of what to look for:

• Reference vs. optimal ranges: A pro tip on how to read blood tests is that "normal" doesn't always equal optimal. Results should be interpreted within the proper context.
• Borderline results: Values near normal limits may warrant lifestyle modifications or closer monitoring. Don't automatically dismiss these results just because they aren’t drastically different from the “normal” range.
• Trend analysis: Tracking changes over time reveals important health patterns. Keep records to discuss trends with your provider.

The Takeaway

Essential blood tests every woman should have, including CBC, CMP, lipid panel, diabetes screening, thyroid function, and iron tests, are an important component of women’s preventive health. These tests provide an overview of your overall health and help identify potential problems earlier. 

The key is working with your healthcare provider to develop a personalized health risk assessment and screening schedule that matches your specific needs and circumstances.

Every woman's health journey is unique, influenced by genetics, lifestyle, environmental factors, and personal medical history. Consult with your healthcare provider about the best course of action for your situation.