The Maintenance Checklist: Essential Screenings for Menopause (Mammograms, DEXA & More)

In your 20s and 30s, going to the doctor was usually reactive. You went because you had strep throat, a twisted ankle, or a positive pregnancy test.

In your 40s and 50s, the game changes. Medicine becomes preventative.

We know that "appointment fatigue" is real. Between work, aging parents, and your own symptoms, finding time for a colonoscopy seems impossible. But here is the reality: The diseases that kill women in their 60s (Heart Disease, Cancer, Stroke) are often detectable in their 50s.

Menopause is your biological alarm clock. It is time to audit your body.

Here is your definitive guide to the screenings you need right now, why the guidelines have changed, and how to schedule them without losing your mind.

Breast cancer risk increases with age.¹ While the debate over "when to start" continues, most major organizations (like the American Cancer Society) recommend the following:

• The Schedule: Annual screening starting at age 45 (with the option to start at 40). Many menopause specialists recommend sticking to every year rather than every two years to catch aggressive changes early.

• The "Dense Tissue" Note: As estrogen drops, breast density often changes.²

  • Action: Ask your doctor: "Do I have dense breast tissue?"

  • Why: Dense tissue appears white on a mammogram—and so does cancer.³ If you have dense breasts, a standard mammogram might miss a lump.⁴ You may need a 3D Mammogram (Tomosynthesis) or an additional Ultrasound.

We covered this in the [Bone Health] article, but it bears repeating because it is the most overlooked test.

• What it is: A painless X-ray that measures bone density.⁵

• The Guideline: Medicare typically covers it at age 65.

• The Menopause Adjustment: Do not wait until 65.

  • If you have gone through menopause (especially if you are thin, Caucasian/Asian, or a smoker), ask for a baseline scan now. Knowing your baseline "T-Score" early allows you to catch Osteopenia before it becomes Osteoporosis.

This is the one everyone dreads, but it is the only cancer screening that can actually prevent the disease (by removing polyps before they turn cancerous).

• The New Rule: The screening age has been lowered from 50 to 45.

• The Schedule: Every 10 years (if results are normal).

• The "Prep": Yes, the laxative prep is unpleasant. But the procedure itself is a breeze (best nap of your life!).

• Alternative: If you are low risk, ask about Cologuard (the at-home stool test), which is done every 3 years.⁶

Since heart disease is the #1 killer of post-menopausal women, a simple blood pressure cuff isn't enough anymore.

• Lipid Panel: Look specifically at LDL and Triglycerides.

• HbA1c: This tests your average blood sugar over 3 months. Menopause often triggers insulin resistance, leading to Pre-Diabetes.⁷

• Blood Pressure: Checked at every visit.

• Thyroid Panel (TSH, T3, T4): Thyroid disease mimics menopause symptoms (fatigue, weight gain, hair loss).⁸ Always rule this out.

Just because you don't have a period doesn't mean you stop seeing the Gynecologist.

• Pap Smear: You generally need these every 3–5 years until age 65.

• The "Vulvar Check": Post-menopausal women are at risk for Lichen Sclerosus (an autoimmune skin condition) and GSM (Atrophy).⁹ A doctor needs to visually inspect the tissue to ensure healthy cells.

• Ovarian Cancer: There is currently no reliable screening test for ovarian cancer, but a Transvaginal Ultrasound can be ordered if you have persistent bloating or pelvic pain.

Menopausal skin is thinner and has suffered decades of UV exposure.¹⁰

• The Schedule: Full body check with a Dermatologist annually.

• Why: Basal cell and squamous cell carcinomas are incredibly common in women over 50. Catching them early means a simple scrape; catching them late means surgery.

It is easy to forget these appointments.

The Fix: Schedule your "Maintenance Month" during your birthday month.

• Get the Mammogram, the Blood Work, and the Skin Check all in the same week.

• Treat yourself to a massage or a nice lunch afterward.

You spend your whole life scheduling appointments for your kids, your partner, and your job. It is time to put yourself on the calendar.

• Confused about bone results? Read Preventing Osteopenia & Osteoporosis.

Worried about heart numbers? Read Heart Health: The #1 Killer.