Menopause is the point at which several risks quietly change gear — bone, heart, and metabolic — and it is also the decade when many women stop having a routine reason to see a doctor. This is a plain checklist of what is worth having checked around the transition, what each test is for, and what to do with the answers.

Where we stand: Menova is an independent publication. We sell no tests and no supplements, we are not your doctor, and this is general education, not medical advice. Screening schedules differ by country, guideline body, and your personal risk — use this to prepare questions, not as a protocol.

Why this decade specifically

Two things change at once. The protective effects of estrogen on bone and the cardiovascular system taper, so risks that were low start rising. And symptoms in this decade get attributed to menopause by default, which means genuinely treatable conditions go unexamined — the pattern covered in when menopause might not be the answer.

A deliberate check-in near the transition is a cheap way to catch both.

The blood tests worth asking about

None of these is exotic and most are inexpensive:

  • Full blood count and ferritin. Heavy perimenopausal periods make iron deficiency common, and it produces exactly the exhaustion attributed to hormones; see low ferritin in perimenopause.
  • Thyroid function (TSH). The closest mimic of menopause there is; see perimenopause versus thyroid.
  • HbA1c. Blood sugar handling shifts around menopause and can stay invisible on a fasting glucose test; see insulin resistance in menopause.
  • Lipid panel. Cholesterol patterns commonly become less favorable after menopause.
  • Vitamin D, particularly relevant to bone.
  • B12, especially if you eat little meat, take metformin, or use long-term acid-reducing medication.

Note what is not on that list: routine hormone panels. For women over 45, guidance generally advises against using FSH or estradiol to diagnose the transition, because levels swing too much day to day. If a clinic is selling you an expensive hormone panel to tell you what your symptoms already say, that is a marketing decision rather than a clinical one.

Measurements to have taken

  • Blood pressure. The most valuable number-to-effort ratio in medicine, and it commonly rises in this decade.
  • Waist measurement. Tracks visceral fat and metabolic risk better than weight; see menopause belly fat.
  • Weight and height, for context rather than as the headline.

Cancer screening

Programs differ between countries and are updated periodically, so confirm your own schedule — but these are the ones to ask about:

  • Breast. Mammography schedules vary; several bodies now recommend starting at 40 with screening every one to two years, while others begin later. Ask what applies to you, and know that family history and breast density can change the recommendation.
  • Cervical. Screening continues past menopause on a schedule — typically every three to five years depending on the test used — usually until your mid-sixties. Being postmenopausal is not a reason to stop.
  • Colorectal. Screening now commonly begins at 45 in the US and at varying ages elsewhere. Options include stool-based tests and colonoscopy.
  • Skin. No universal program, but knowing your own moles and reporting changes matters.
  • Lung, if you have a significant smoking history — ask, because eligibility is specific.

Bone health

Bone loss accelerates around menopause, and fractures later are what the whole exercise is about.

  • Bone density (DEXA) is generally recommended from 65 for women, and earlier if you have risk factors: early or surgical menopause, long-term steroid use, a parent who fractured a hip, low body weight, smoking, heavy drinking, rheumatoid arthritis, or a fracture from a minor fall.
  • A fracture risk assessment such as FRAX is often used to decide whether a scan is warranted.
  • Calcium and vitamin D intake are worth reviewing, and resistance and impact exercise is the only intervention that builds bone rather than just slowing loss.

Our guide to bone health in menopause covers what to do with the results, and strength training in menopause covers the exercise side.

Heart health

Cardiovascular disease is the leading cause of death in women, and risk rises after menopause. Worth knowing your blood pressure, your cholesterol, your HbA1c, and your family history — and worth mentioning if you had pre-eclampsia or gestational diabetes in a pregnancy, since both are recognized markers of later cardiovascular risk that women are rarely asked about. See heart health in menopause.

The ones people forget

  • Eyes. Pressure checks for glaucoma, plus dry eye, which becomes common in this phase.
  • Hearing, which changes gradually enough to go unnoticed.
  • Dental. Dry mouth raises decay and gum disease risk, and gum health is worth active attention now; see menopause, teeth and gums.
  • Vaccinations, including shingles and the ones relevant to your age group.
  • Mental health. Worth an honest question rather than waiting for a crisis; see mood and anxiety in menopause.
  • Pelvic floor and bladder symptoms, which are treatable and almost never volunteered; see bladder leaks and pelvic floor changes.

What not to buy

Direct-to-consumer "menopause panels," full-body scans marketed to the worried well, and expensive hormone testing sold alongside a treatment plan. More testing is not the same as better care — it produces incidental findings, anxiety, and follow-up procedures without improving outcomes. Spend the money on the boring, evidence-based checks above.

How to get it done in one appointment

Book a longer appointment if your practice offers one, and bring a written list. Something like:

"I'm 51 and going through menopause. I'd like to cover screening: blood pressure, HbA1c, lipids, thyroid, ferritin and vitamin D, plus whether I'm due for mammography and cervical screening — and whether my history warrants a bone density scan."

That is a focused, reasonable agenda. Our free printable visit prep sheet gives you a page to hand over, and the free 2-minute self-check organizes the symptom side so the visit covers both.

This article is general education, not medical advice. Screening recommendations vary by country, guideline body, and individual risk, and they change over time. Confirm what applies to you with a licensed clinician.

Sources: US Preventive Services Task Force, ACOG, The Menopause Society, and NHS — Screening.