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Disease Prevention and Screening in Menopause and Midlife

by , | May 18, 2026 | Articles, Hormone Health

doctor talking to woman

Menopause is a vulnerable window of time for women but also a window of empowerment and opportunity for preventive screening strategies that lower the risk of disease and improve quality of life. 

In this article, we share what you need to know to reduce your disease risk and increase your healthspan.

Cardiometabolic Health

  • Measure blood pressure, fasting glucose, fasting insulin, HbA1c (provides a 3 month average of blood glucose), fasting lipid profile, ApoB, high sensitivity CRP, and Lp(a) as part of baseline midlife screening. For more information on lipid panel and related markers, the information it provides and what it means, read this article and this article.
  • Discuss risk assessment calculators and cardiac imaging with your physician to estimate your 10 and 30 year cardiovascular risk, and whether you have plaque in the arteries of your heart and need more aggressive treatment. 
  • Monitor waist circumference and BMI, recognizing that central adiposity is a stronger predictor of risk than weight alone. 1
  • Screen for metabolic syndrome, as postmenopausal women often develop higher insulin resistance and visceral fat accumulation. 2

Bone Health

  • Women ≥65 years should undergo DEXA screening for osteoporosis. Younger postmenopausal women with risk factors (early menopause, low body weight, smoking, family history of fracture) should also be screened. In our practice, we offer this screening at menopausal transition given the many women affected by osteopenia and osteoporosis.
  • Use FRAX scoring to help estimate  fracture risk. 3 

Cancer Screening

Breast Cancer Screening

Guidelines recommend mammography for breast cancer screening, though recommended screening intervals vary somewhat among medical organizations. The National Comprehensive Cancer Network (NCCN) recommends annual mammography beginning at age 40. The U.S. Preventive Services Task Force (USPSTF) recommends biennial (every two-year) screening for women aged 40 to 74, citing a balance between early detection and minimizing potential harms such as false positives. The American Cancer Society (ACS) recommends annual screening from ages 45 to 54, with the option to continue annual screening or transition to biennial screening beginning at age 55.

In clinical practice, mammography is done every one to two years between the ages of 40 and 74 for average-risk women, with the specific interval individualized based on risk, personal values prior imaging findings, and discussion with a healthcare provider. Women with higher-than-average risk—such as those with a strong family history, known genetic mutations, or prior chest radiation—require a different screening approach and should follow personalized recommendations from their care team. 4 In our practice, we encourage patients to calculate their breast cancer risk using the Tyrer-Cuzick calculator. High risk women should ideally be followed at a high risk program and be offered mammography and breast MRIs annually, rotating between mammogram and breast MRI every 6 months. 

Cervical Cancer Screening

  • Cervical cancer screening guidelines recommend screening
    • 21-29yo: every 3 years with Pap alone (21–29), 
    • 30-65yo: every 5 years with Pap+ high risk HPV testing, high risk HPV alone or every 3 years Pap alone
    • Ages 65+: screening can stop if prior screenings were negative; shared decision making is recommended 5

Colon Cancer Screening

  • Colon cancer screening should begin at age 45 and continue through age 75. 6 High risk individuals (e.g., those with a family history, known genetic mutations, inflammatory bowel disease) start screening earlier and get screened more frequently than average risk individuals. 

Mental Health and Cognition

  • Screen for depression and anxiety with validated tools (e.g., PHQ-9 and GAD-7. Your physician should be assessing this annually, or more frequently if there are any concerns with respect to mood symptoms or anxiety.
  • Assess for insomnia and screen for sleep disorders, if indicated.
  • Evaluate for cognitive concerns, especially in women with cardiovascular risk factors, as these correlate with higher risk of dementia.

Other Preventive Health Measures 

  • Assess thyroid function annually and if symptoms such as fatigue, cold intolerance, or weight changes arise. Hypothyroidism is more common in women and one quarter of women over 60 years old have thyroid autoimmunity.
  • Preventive blood work including nutrient panel, complete blood count, metabolic panel and other markers, customized to each individual. 
  • Ensure vaccines are up to date. As we get older, our immunity weakens and we aren’t able to clear viruses and bacteria as efficiently. As a result, we are more prone to greater severity of symptoms and complications of infections.

As screening helps to identify emerging health risks, targeted nutrition, lifestyle and medical interventions form the foundation for managing these changes. In the other parts of our series, we discuss nutrition and lifestyle recommendations, menopausal hormone therapies and non-hormonal therapies that women should consider as part of their approach to optimize their health and function in midlife and beyond.

For more articles on hormone health, menopause, perimenopause, testing and treatment, please go here. https://drbojana.com/category/hormone-health/ 

We encourage all women experiencing menopausal symptoms to speak to their doctor, or qualified menopause specialist about symptom management and available treatment options.

Our team is here to guide and support our patients every step of the way. Dr. Bojana Jankovic Weatherly is a certified menopause practitioner. We are committed to providing the personalized care you deserve, helping you move forward with confidence and strength.

You have the power to take charge of your health during perimenopause and menopause. We are here to partner with you to achieve your goals. To learn more about our medical, nutrition and health coaching services, contact us at 646.627.8000, fill out this form for a complimentary discovery call, or email Bridget@drbojana.com.

References

  1. https://www.jacc.org/doi/10.1016/j.jacc.2018.11.002
  2. https://jamanetwork.com/journals/jama/fullarticle/2783414
  3. https://iscd.org/wp-content/uploads/2021/09/2019-Official-Positions-Adult-1.pdf
  4. https://jamanetwork.com/journals/jama/fullarticle/2818283
  5. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines
  6. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

Disclaimer

Nothing stated or posted in this article is intended or should be taken to be the practice of medical or counseling care. The information made available in this article, including, but not limited to, interviews, text, graphics, images, links to other articles, websites, and other material contained in this article, is strictly for informational and entertainment purposes only. The information in this article is NOT (and should not be used as) a substitute for professional psychiatry, psychology, medical, nursing, or professional healthcare advice or services, nor is it designed to suggest any specific diagnosis or treatment. Please always seek medical advice from your physician or a qualified health care provider regarding any medical questions, conditions or treatment, before making any changes to your health care regimen, medications or lifestyle habits. None of the information in this article is a representation or warranty that any particular drug or treatment is safe, appropriate or effective for you, or that any particular healthcare provider is appropriate for you. Never disregard professional medical advice or delay seeking help from a health care provider due to something you have read or seen in this article. Your reading/use of this article does not create in any way a physician-patient relationship, any sort of confidential, fiduciary or professional relationship, or any other special relationship that would give rise to any duties. This article does not recommend or endorse any specific tests, healthcare providers, procedures, or treatments, and if you rely on any of the information provided by this article, you do so solely at your own risk.