Welcome back to Menopause Mondays! Today, we discuss a crucial topic for every postmenopausal woman: preventative health. Staying on top of your health is more important than ever during this stage of life, and knowing which tests and screenings to get can make all the difference.

Once a year, I make an appointment with my primary care physician for general screening and with my menopause specialist/gynecologist for my postmenopausal screening. Remember, this list is a general guideline, so always consult your healthcare provider to personalize your schedule based on your health needs.

Blood Pressure Screening

During menopause, we may find that our weight goes up, our temperature soars, but are you aware that even our blood pressure is prone to spike? High blood pressure can sneak up on you, so check it annually. While it’s easy to spot rising body temperatures (red faces and sweat-drenched clothes) and expanding waistlines (busted buttons and zippers and snaps — oh my!), an increase in your blood pressure may not be so obvious.

About 30 percent to 50 percent of women develop hypertension before 60. And it’s not fun: mild to moderate hypertension may cause complaints such as non-specific chest pain, sleep disturbances, headaches, palpitations, hot flushes, anxiety, depression, and tiredness. Just reading this can make a woman anxious! Managing your blood pressure is critical to reducing the risk of heart disease and stroke.

Lipid Profile (Cholesterol Test)

Staying on top of your heart health screenings is essential, especially after menopause. Here’s the scoop: As we go through menopause, our bodies undergo some big changes, including a drop in estrogen levels. This drop can speed up plaque buildup in our arteries, which is not great news for our hearts.

This matters because heart disease is a big deal for us gals. It’s the number one cause of death for women in the U.S. Yep, you heard that right. And in 2021, it was responsible for 1 in every five deaths among women. Scary stuff!

Get yearly checks of your cholesterol levels. If you have elevated cholesterol lipids, talk to your doctor about referring you to a cardiologist.  Then, discuss medications to keep those arteries clean! According to the American College of Cardiology (ACC), a 2024  study found that women who have gone through menopause and are taking statins to manage their cholesterol might not be getting enough protection against heart problems. It is important to note that if a person’s risk level is ambiguous or borderline based on standard risk factors, the ACC and American Heart Association guidelines recommend considering a coronary artery calcium (CAC) scan. A CAC scan checks for plaque buildup in your arteries.  Be proactive about your heart health, not reactive!!!

Blood Sugar Test (Glucose Screening)

Changes to our hormones can affect our blood sugar levels and make managing diabetes more difficult. Monitor your blood sugar annually, especially if you have risk factors for diabetes. Early detection can prevent complications down the road.

Bone Density Test (DEXA Scan)

Unless you break a bone, you may not be paying attention to your bone health. Bone loss is a silent process. The transition to menopause is the time when bone loss accelerates due to the loss of estrogen.  Osteoporosis is a significant concern for women. A DEXA scan every 1-2 years will help you and your doctor manage your bone health.  It is simple, quick, and noninvasive. It’s also the most accurate method for diagnosing osteopenia and osteoporosis. Osteopenia is reduced bone density and can be a warning sign of osteoporosis. It’s common in adults older than 50.

Mammogram

Are you confused about when to get your first mammogram, when to stop, and what type is best? The media often shares conflicting opinions about breast cancer, mammograms, and menopause. To address this confusion, I interviewed the amazing Dr. Daniel Kopans, a Professor of Radiology at Harvard Medical School and founder of the Breast Imaging Division at Massachusetts General Hospital. He is a leading international expert in breast cancer detection and diagnosis, having authored over 200 scientific articles and invented critical technologies like the Kopans Wire and Digital Breast Tomosynthesis (3D Mammography).

Dr. Kopans explained that there has been an effort to reduce access to mammograms to cut costs, often using scientific misinformation to support these reductions. He emphasized that annual screenings starting at age 40 save the most lives, as proven by rigorous studies. The American College of Radiology and the Society of Breast Imaging support this, showing that annual screening for women aged 40-74 can result in nearly 40% fewer deaths compared to biennial screenings starting at age 50, which reduce deaths by only 23.2%.

Dr. Kopans strongly advocates using digital breast tomosynthesis, which detects more cancers earlier and reduces unnecessary callbacks. Early detection through annual mammograms is crucial for saving lives, so healthy women should continue yearly screenings into their 70s and beyond.

If you have been informed that you have dense breasts,  Listen up! According to my interview with Robyn Seitzman, Ph.D., MPH, Director of Education and Epidemiology Research at DenseBreast-Info.org, it is important for both women and their healthcare providers to understand that having dense breasts increases the risk of developing cancer and of having that cancer hidden on a mammogram. A normal mammogram report in a woman with dense breasts does not mean that cancer is not there; it means that cancer was not seen, which is an important distinction. There are limits to the effectiveness of mammography in women with dense breasts. Women need to advocate for themselves and shouldn’t be afraid to initiate discussions with their providers about whether additional screening beyond mammography is right for them.

Annual mammograms are essential for detecting breast cancer early. Your breast cancer risk increases with age.  If you are a healthy woman who would be able to have surgery if a lump was found, then continue to have a yearly mamo in your 70s and beyond!  Early detection can save lives, so don’t skip this one!

Gynecologist Check Up 

See your gynecologist yearly.  Get a breast exam (in addition to the yearly mamo), pap smear, and pelvic exam. A pap smear screens for cervical cancer. It checks for precancerous or cancerous cells on the cervix. I ask for one every year!

Remember, whether you are having sex or not – your vaginal health screening is crucial. Your gynecologist should be screening you for symptoms of genitourinary syndrome of menopause (GSM). GSM is chronic and progressive if left untreated.  The treatment for this is LET or local estrogen therapy.  It works great!  Here are a few of the symptoms of GSM:

• Vaginal dryness
• Vaginal burning
• Vaginal discharge
• Genital itching
• Burning with urination
• Urgency with urination
• Frequent urination
• Recurrent urinary tract infections (Sadly, many elderly women die from untreated UTIs.)

So hop into those stirrups and giddy up!

Thyroid Function Test (TSH)

Are you experiencing fatigue, forgetfulness, cold intolerance, hair loss, constipation,  mood swings, and weight gain? These can be symptoms of thyroid disease.

If your thyroid is out of control, all of your efforts to curb your perimenopause and menopausal symptoms and achieve hormone happiness will be for naught. The symptoms of menopause and thyroid disease are very similar.  So you may find your symptoms might not be due to menopause at all. Or, if you are like me, you could be in perimenopause and find out you also have Hashimotos Disease, which results in hypothyroidism.  I call that a perfect storm!

Check your thyroid function annually by asking for comprehensive thyroid panel, especially if you have symptoms of thyroid dysfunction. Thyroid disease generally comes in two flavors: overactive (hyperthyroidism) and underactive (hypothyroidism). Your thyroid plays a significant role in your overall health.

Luckily, in most cases, simply taking thyroid medications can resolve symptoms completely. It sure did for me!

Vitamin Screening

• Vitamin D is essential for bone health and immune function and reduces the risk of osteoporosis.
• Calcium works with vitamin D to maintain bone strength and prevent fractures.
• Vitamin B12 is important for nerve function, red blood cell production, and anemia prevention.
• Folate (Vitamin B9)is vital for DNA synthesis and repair, red blood cell formation, and overall cell function.
• Iron needs may decrease after menopause, ensuring adequate levels to prevent anemia is still important.
• Magnesium supports bone health, muscle function, sleep, hair & nail health, and mood.
• Zinc is crucial for immune function and cell production.
• Omega-3 Fatty acids are beneficial for heart health, cognitive function, and reducing inflammation.
• C-Reactive protein (CRP) can monitor levels of inflammation.

Eye Exam

An eye exam every 1-2 years will help monitor vision and screen for glaucoma, cataracts, and macular degeneration.

Dental Exam

Hormonal changes can impact oral health by increasing plaque buildup, reducing saliva production, bleeding gums, tooth sensitivity, and even causing dry mouth. Many women change those yearly dental visits to every six months to keep their teeth and gums healthy.

Skin Cancer Screening

During menopause, we lose skin collagen – elastin — and even water. Oy Joy!  In addition, it seems like those of us who thought having a tan was vital when we were younger – now have lots of skin damage from that sun-worshipping:<(. This damage rears its ugly head in our later years and can result in skin cancers. The goal is to catch those pre-cancerous spots and changing moles before they become a problem.  Definitely, find a good dermatologist and get screened.  Your doctor will tell you if you need to come yearly or more often.  I am so fair, I have to be screened every 6 months. My derm and I are now besties.

Colonoscopy

I am still totally focused on all things vagina, but beginning at 45 years old, we must pay attention to the vagina’s next-door neighbor.  Time for a colonoscopy screening. Before you click delete, let me remind you that prevention is the key to good health.  A colonoscopy is not painful as you are sedated. However, the prep protocol is a total pain in the ass!

Get a colonoscopy every ten years unless your gastroenterologist specifies otherwise. This test is crucial for detecting colon cancer early. I have documented my experience for your reading pleasure! HA!

Hearing Test

Monitor your hearing every 1-2 years. Hearing loss can affect your quality of life, so it’s crucial to catch it early. This way, if you do need hearing aids, your brain can adapt better to them.

Immunizations

Stay up-to-date with vaccines, including your annual flu shot, COVID vaccines, and other recommended vaccines like shingles, pneumonia, and tetanus.

Ladies, taking charge of your health with these essential tests and screenings can make a world of difference in your well-being.

Stay healthy, stay informed, and keep thriving!

Suffering in silence is OUT! Reaching out is IN!