Who this checklist is for
This checklist is for men from 50 to 59. By now you probably have a routine of sorts: an annual physical, maybe a cholesterol number you remember. Your 50s change the conversation from “what should I test?” to “what should I decide?” Several items on this list are choices you make with a clinician after weighing benefits and harms, not simple yes-or-no tests.
If you skipped the 40s items, such as colon screening, ApoB and a one-time Lp(a), our checklist for your 40s is the place to catch up.
What the 50s add
| Decision or test | What to do | Why now |
|---|---|---|
| PSA screening | Decide with a clinician | Benefit and harm are closely balanced from 55 to 69 |
| Shingles vaccine | Two doses | Recommended for all adults 50 and older |
| Erection changes | Report them | ED can be an early heart warning |
| Metabolic labs | Every year or two | Risks rise steadily through the decade |
| Colon screening | Keep it current | Strongest recommendation from 50 to 75 |
| Lung screening | If you smoked heavily | Eligibility starts at 50 |
The 50s checklist, step by step
Step 1: Make a PSA decision, not a default
PSA screening can find prostate cancer early, but it also finds slow cancers that would never have caused harm, and a high result can lead to biopsies and treatment side effects. The USPSTF calls screening in men aged 55 to 69 an individual decision after discussing benefits and harms. It notes African American men have a higher prostate cancer death rate and that men with a family history are at higher risk, so these men should know their risk when they decide.
A good PSA conversation covers your family history, your ancestry, what a high number would lead to and how you feel about the trade-offs. If you choose to screen, a baseline PSA gives you a reference for every test that follows. Questions worth asking in that conversation:
- What is my personal risk, given my ancestry and family history?
- If my PSA comes back high, what happens next: a repeat test, an MRI or a biopsy?
- How often would I be retested if the first result is normal?
- What are the chances of finding a slow cancer that would never have harmed me?
Our page on the PSA blood test for men explains the number, and our page on what can raise PSA temporarily lists the false alarms.
Step 2: Get the shingles vaccine
Shingles becomes more common with age and can leave lasting nerve pain. The CDC recommends the shingles vaccine for adults 50 and older, given as two doses two to six months apart, with no upper age limit. It also advises getting vaccinated even if you have had shingles before or received the older vaccine. Your primary care doctor or pharmacist can give it, and while you are there, ask them to check your record for any other vaccines that come due in your 50s.
Step 3: Treat erection changes as a heart signal
New trouble getting or keeping an erection is common in the 50s, and many men put it down to age. It deserves a closer look. The American Urological Association guideline says men should be counseled that ED is a risk marker for underlying cardiovascular disease, and that it is also a marker for other treatable conditions.
The penile arteries are smaller than the coronary arteries, so narrowing can show up there first. A man whose erections have weakened over a year or two should have his blood pressure, cholesterol, blood sugar and weight checked, not only a pill. Our page on ED as an early sign of heart disease explains the link. Treating the cause and treating the symptom can happen together.
The same AUA guideline recommends a morning total testosterone measurement for men with ED, and notes that blood sugar or A1c and, in some cases, lipids are the other labs most likely to change management. So a sensible first workup is short: morning testosterone, A1c, a lipid panel and a blood pressure check, alongside an honest talk about sleep, alcohol, smoking and stress.
Step 4: Run metabolic labs every year or two
MedlinePlus says men aged 45 to 65 should have cholesterol checked every one to two years. Many men find it simpler to make the whole metabolic set a yearly habit: a lipid panel, A1c or fasting glucose, liver enzymes, kidney function and a blood count. Annual numbers let you spot drift early, such as triglycerides climbing with a growing waist or an A1c edging toward prediabetes.
This is also the decade when several risks cluster together. A larger waist, higher blood pressure, high triglycerides, low HDL and raised blood sugar together form metabolic syndrome, which our page on metabolic syndrome in men explains. Our page on the lipid panel for men shows how to read the cholesterol part.
Step 5: Keep cancer screening current
The USPSTF gives its strongest grade to colorectal cancer screening from 50 to 75, so if you started at 45, keep to the schedule your gastroenterologist set. If a parent or sibling has since been diagnosed with colon cancer or advanced polyps, tell your doctor, because that can shorten the interval between tests. If you smoked, check your eligibility for lung screening. The USPSTF lung cancer recommendation covers adults 50 to 80 with a 20 pack-year history who still smoke or quit within the past 15 years, using a yearly low-dose CT scan.
A one-page checklist for your 50s
- PSA screening discussed and a decision recorded
- Baseline PSA on file, if you chose to screen
- Shingles vaccine, both doses
- Erection changes reported to a clinician, with heart risk checked
- Lipid panel, A1c, liver, kidney and blood count within the past year or two
- Blood pressure checked yearly, with a home cuff if readings run high
- Colon screening up to date
- Lung screening eligibility checked, if you smoked
- Testosterone tested only if symptoms are present, with two morning draws
For a seasonal reminder of the same list, our Movember screening checklist is a good November habit.
When to call the clinic, when to call 911
Book a visit if you notice:
- erections that have weakened over months, or morning erections that have stopped
- needing to urinate more often at night, a weak stream or blood in the urine
- fatigue, low mood or loss of strength that has crept up
- weight gain around the middle despite no change in habits
Call 911 for:
- chest pain or pressure, pain spreading to the arm, jaw or back, or sudden breathlessness
- sudden facial drooping, arm weakness, slurred speech or sudden vision loss
- an erection that lasts more than four hours
How Ultimate Male supports your 50s
At our San Gabriel and Downey clinics, the yearly labs on this list can be drawn on site in one visit, and a PA-C or MD goes through them with you. The comprehensive men’s health blood panel covers hormones, heart, metabolic and organ markers together, including PSA.
If erection changes are what brought you in, the visit looks at heart risk and hormones before treatment options; our erectile dysfunction treatment page shows what follows. Vaccines and colon or lung screening stay with your primary care team. Our page for men over 50 goes further, the checklist for your 60s looks ahead, and all panels are listed under preventative blood testing.
