Preventive screenings

Measures your cholesterol and triglycerides — the core numbers behind heart health.

Why now: menopause is a cardiometabolic transition. The drop in estrogen shifts lipids, often unfavorably, and cardiovascular risk should be reassessed regularly in women 40–75 — with your full 10-year risk recalculated every 4–6 years to guide decisions like statin use.^3,10,11 Female-specific factors — early menopause, preeclampsia, gestational diabetes, autoimmune disease — can upgrade your risk category, so tell us if any apply.¹¹

Blood pressure belongs in this picture too: at least every 2 years if yours runs below 120/80, and yearly from 40 or if it runs higher.³

A three-month average of your blood sugar — the standard screen for prediabetes and diabetes.

Why now: insulin sensitivity often declines through the menopause transition, and diabetes screening is recommended from age 35, repeated at least every 3 years when normal.^3,10 We check it yearly so a shift never goes unnoticed between guideline intervals.

Checks whether your thyroid is over- or under-active.

Why now: thyroid problems and menopause share symptoms — fatigue, mood changes, temperature swings, weight shifts. Checking it means we treat the right cause, not the loudest symptom.

Being honest about the evidence: guidelines actually conflict here. Routine thyroid screening in women with no symptoms isn't recommended by the USPSTF or AAFP, while the American Thyroid Association suggests checking TSH every 5 years from age 35.^1,12 Our approach: we don't screen it reflexively — we check it when your symptom picture shifts or doesn't respond the way it should, because that's when the overlap matters.

A quick, low-dose scan that measures the strength of your bones at the hip and spine.

Why now: bone loss accelerates in the years around menopause, and it's silent until something breaks. Every woman should have a DEXA at 65 — and earlier if a validated risk tool or a prior low-impact fracture flags elevated risk.^7,8 Use the calculator below to see whether earlier testing makes sense for you.

How often it repeats depends entirely on your first result — no sooner than 2 years apart, and a normal baseline may not need rechecking for many years, while advancing osteopenia can warrant yearly follow-up.⁷

Breast cancer screening starts at 40 for average-risk women — mammography, ideally with tomosynthesis (3D), every 1 to 2 years (yearly per NCCN), continuing to about 74–75.^3,4

Higher lifetime risk — strong family history, genetic predisposition, prior chest radiation, dense breasts — can mean starting earlier, screening annually, or adding breast MRI. If any of those apply to you, tell us and your PCP.⁴ Staying current is part of staying on hormone therapy safely, and up-to-date mammography is part of the baseline assessment before starting it.¹

From 30 to 65, the preferred test is a primary high-risk HPV test every 5 years — including newer self-collected options — with co-testing every 5 years or a Pap every 3 years as alternatives.^5,6

Screening can stop at 65 if your prior screening history is adequate and negative — or after a hysterectomy that removed the cervix, with no history of significant precancerous changes. Your PCP can confirm which applies to you.^5,6

Average-risk screening starts at 45. Options include colonoscopy every 10 years, an annual stool test (FIT), stool DNA every 1–3 years, or CT colonography or sigmoidoscopy every 5 years — continuing to 75, then selectively to 85.³

The best test is the one that actually gets done — if a colonoscopy keeps getting postponed, ask your PCP about the stool-based options.

An annual low-dose CT is recommended from 50 to 80 for anyone with a 20+ pack-year smoking history who currently smokes or quit within the last 15 years.³

A pack-year is one pack a day for one year — so half a pack a day for 40 years counts too. If this might be you, it's worth one conversation with your PCP.

Perimenopause carries a genuinely elevated risk of mood disorders — depression screening is recommended for all women, and anxiety screening under 65.³ Your symptom tracker already watches this with us; if your mood shifts, that's a message-us-now item, not a wait-for-the-next-check item.

One-time tests worth confirming you've had: HIV (at least once before 65), hepatitis C (once, ages 18–79), and hepatitis B (once for everyone). And a fact worth knowing: STI rates are currently rising fastest in women 55–64 — if your situation warrants it, testing is nothing to be shy about.³