Medically Reviewed by Samantha M. Dunham, MD on December 1, 2024 | Written by Progyny Editorial Team
As you approach menopause, there are likely many questions and hypothetical scenarios that run through your mind. With so many changes on the horizon, it’s no wonder you begin to think about how your health will change and how you can positively impact it.
One of the steps you can take to set yourself on a strong trajectory as you enter menopause is to speak with your doctor about health screenings. These screenings can provide your doctor with valuable information to recommend lifestyle changes or treatments to ease your transition into menopause.
This article will provide you with a checklist of assessments and screening to discuss with your doctor.
Firstly, a quick review of the difference among perimenopause, menopause, and postmenopause since these terms will be used throughout the article:
- Perimenopause: This is the transition period leading up to menopause. This phase can last for several years and involves changes in your menstrual cycle and hormone levels.
- Menopause: Menopause is a normal, natural, and distinct moment in time. It’s official 12 months after your final menstrual period.
- Postmenopause: This is the time of life after menopause. Previous symptoms associated with perimenopause and menopause may decrease, but some may remain.
Key Health Screenings Before Menopause
During perimenopause, your estrogen levels fluctuate and eventually decline, resulting in a variety of conditions and symptoms that can have a profound effect on your overall health. Undergoing health screenings, especially if your family or personal history puts you at higher risk, can prevent future medical problems. Performing health screenings in the commonly affected areas can prevent or lessen certain symptoms in the cardiovascular, musculoskeletal, and genitourinary systems.
Cardiovascular health screening
Your cardiovascular system is made up of your heart and blood vessels. Your cardiovascular health involves factors like blood pressure, cholesterol levels, and heart function. Genetics, age, and lifestyle habits affect your cardiovascular health, as does going through menopause.
Estrogen has a protective effect on your cardiovascular health. However, as your estrogen decreases at menopause your risk for cardiovascular disease starts to increase. Additionally, menopause is associated with increased body mass index (BMI) and a change in body fat distribution – risk factors for cardiovascular disease. Cardiovascular disease is often caused by plaque buildup in the arteries which can result in heart attack and stroke.
Cardiovascular screening can include blood pressure monitoring, lipid panels, or more extensive heart function tests.
- Blood pressure: Blood pressure monitoring can be done at home or at a doctor’s office. High blood pressure over a long period of time can cause your heart to work too hard, which increases the risk of heart disease and other health issues.
- Lipid panels: This group of tests measures your cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. A lipid panel can inform your doctor if you are at higher risk of heart disease or stroke.
- Heart function tests: This could include tests like an electrocardiogram (ECG), stress test, magnetic resonance imaging (MRI), or coronary angiogram. These can be used to diagnose heart conditions like coronary artery disease or an enlarged heart.
The results of your cardiovascular health screening can prompt your doctor to recommend lifestyle changes like improving diet and exercise habits. Or your doctor may prescribe medications to lower your cholesterol levels or blood pressure.
Musculoskeletal health screening
Your musculoskeletal health is the overall well-being of your muscles, bones, joints, and connective tissues. Menopause can have a dramatic effect on your musculoskeletal health, particularly your bone health. As estrogen decreases in menopause, your bone density decreases putting your bones at risk of fracture. Additionally, your risk of developing osteoporosis (a condition that causes your bones to weaken and be more prone to injury) increases.
Dual-energy X-ray Absorptiometry (DEXA) scans can be used to assess your bone density if you have a history of fragility fracture (a fracture caused by a minor fall or injury) or a secondary cause of osteoporosis or bone loss. Routine bone density screening is not recommended for most premenopausal women. However, your doctor may recommend lifestyle changes like eating a diet high in calcium, vitamin D, and protein and performing weight-bearing exercises to preserve bone density and reduce your risk of osteoporosis.
Genitourinary health screening
Your genitourinary system includes your reproductive and urinary organs. This includes your kidneys, bladder, ovaries, and uterus. Menopause can lead to drastic changes in this system, sometimes even resulting in genitourinary syndrome of menopause (GSM). GSM is caused by decreased estrogen and results in the following:
- Vaginal dryness
- Vaginal burning and irritation
- Painful urination
- Urinary urgency
- Recurrent urinary tract infections (UTIs)
- Painful sexual intercourse
A genitourinary health screening can include a pelvic exam, urine test, and Pap smear to check the health of your urinary and reproductive organs.
- Pelvic exam: This exam is used to detect abnormalities in your uterus, ovaries, cervix, vagina, and vulva.
- Urine test: Urine tests can help identify infections, kidney problems, or other conditions like diabetes.
- Pap smear: A Pap smear screens for cervical cancer and should be done every 3 years or if HPV co-testing is employed and is negative, every 5 years.
Treatment options such as vaginal moisturizers or vaginal estrogen therapy may be prescribed for issues such as vaginal dryness or painful sexual intercourse. Non-hormonal therapies are effective for most women with mild symptoms.
Mental Health Screening
Hormonal changes in perimenopause can cause or exacerbate mental health issues like anxiety and depression. If you notice these changes, you should reach out to your primary care clinician. A comprehensive mental health screening can help identify any of the following:
- Mood disorders like bipolar disorder or depression
- Anxiety disorders
- Eating disorders
- Substance use disorders
- Post-traumatic stress disorder (PTSD)
- Psychotic disorders
During this screening you will answer questions about your feelings, mood, sleep, and appetite. Your answers will provide your doctor with valuable information about possible treatment options. They may recommend lifestyle changes or treatments such as therapy or medication.
Diabetes Screening
Your risk for type 2 diabetes increases as you enter postmenopause. A diabetes screening can identify if you have insulin resistance or increased risk of diabetes.
Your doctor may recommend lifestyle changes or medications like insulin to control your blood sugar.
Your Health Screening Checklist
Here’s a checklist of health screenings to discuss with your doctor:
- Cardiovascular tests: Lipid panel, blood pressure monitoring, possible function tests
- Bone density scan: DEXA scan if you have a history of fragility fracture or if you have elevated risk for osteoporosis based on your personal or family history
- Mental health screening: Comprehensive mental health assessment if needed
- Genitourinary screening: Pelvic exams, Pap/HPV co-test, urine tests as needed
- Diabetes screening: Blood glucose and HgbA1c
- Vaccinations: Stay up to date on flu, shingles, pneumococcal, Tdap/Td booster, and COVID-19
- Colonoscopy: If there’s no family history and you’re 45 or older
When to Talk to Your Doctor
It may be time to consult your doctor if you are experiencing symptoms of perimenopause like irregular bleeding, hot flashes, or mood disturbances.
You may also consider talking with your doctor if you are getting close to the typical age of menopause onset, which is around 45-56 years of age.
Regular check-ins with your doctor as you approach menopause help set you on a strong path forward, helping to keep your health on track and ease the transition as your body changes.