Screenings after menopause: what changes and what doesn't

At a glance

Everything else, such as blood pressure, diabetes and colorectal screening, follows your age as before. Your screening plan lists them; tick "past menopause, with risk factors for weak bones" to include the earlier bone density test.

What changes: bone density before 65

The USPSTF recommends screening for osteoporosis in women 65 and older, and in postmenopausal women younger than 65 who are at increased risk of a fracture, as estimated by a clinical risk assessment (grade B). Tools it names include FRAX, which estimates fracture risk, and simpler ones such as the Osteoporosis Self-assessment Tool (OST). Screening is a DXA scan of bone mineral density, with or without a fracture risk estimate. (USPSTF, 2025)

Why menopause matters here: in the first 4 to 8 years after menopause, women lose bone faster because estrogen falls, ACOG explains. (ACOG) ACOG's advice matches the USPSTF: everyone 65 and older should have a bone density test, and younger postmenopausal women should have one if they are at high risk of fracture. (ACOG)

What stays: mammograms by age

The USPSTF schedule does not change at menopause: a mammogram every 2 years from 40 to 74. (USPSTF, 2024) The American Cancer Society sets its interval by age rather than menopause too: yearly from 45 to 54, then at 55 and older you can switch to every other year or keep yearly mammograms. (ACS, 2026)

What stays: cervical screening to 65

Cervical screening continues to 65 on the usual schedule. After 65, the USPSTF recommends against screening for women who have had adequate prior screening and are not otherwise at high risk; see what adequate prior screening means. After a hysterectomy with the cervix removed, it recommends against screening unless you have had a high-grade precancer (CIN 2 or 3) or cervical cancer. (USPSTF, 2018)

What you usually do not need: a hormone test

Menopause is identified from your symptoms and periods, not a screening test. The UK NICE guideline says to identify perimenopause and menopause without lab tests in otherwise healthy people 45 and older with menopause symptoms, and not to use tests such as estradiol or anti-Müllerian hormone for this at that age. It reserves an FSH blood test for people 40 to 45, or under 40 when early menopause is suspected. (NICE NG23) MedlinePlus likewise says that at 45 or older FSH testing usually is not needed, because high FSH is a normal sign of perimenopause and menopause. (MedlinePlus)

Hormone therapy is not a prevention tool

The USPSTF recommends against estrogen with progestin, and against estrogen alone after a hysterectomy, for preventing chronic conditions such as heart disease or fractures (grade D). The recommendation does not apply to hormone therapy for menopause symptoms such as hot flashes or vaginal dryness. (USPSTF, 2022) Whether to use it for symptoms is a decision to make with your doctor.

Questions people ask

Do I need a bone density test after menopause?

At 65 and older, yes, for all women (USPSTF grade B). Before 65, the USPSTF recommends it for postmenopausal women at increased risk of fracture, judged with a clinical risk assessment. ACOG says the same. (USPSTF, 2025) (ACOG)

Do I need a blood test to confirm menopause?

Usually not if you are 45 or older. The UK NICE guideline says to identify menopause from symptoms and periods, without lab tests, in otherwise healthy people 45 and over, and MedlinePlus says FSH testing usually is not needed at that age. Testing may be considered at younger ages. (NICE NG23) (MedlinePlus)

Do I still need Pap tests after menopause?

Yes, until 65, on the usual schedule. After 65 the USPSTF recommends stopping if you have had adequate prior screening and are not at high risk. After a hysterectomy with the cervix removed, for reasons other than precancer or cancer, it recommends against screening. (USPSTF, 2018)

Should I take hormone therapy to prevent heart disease or fractures?

The USPSTF recommends against hormone therapy to prevent chronic conditions (grade D). That recommendation does not cover hormone therapy for menopause symptoms such as hot flashes, which is a separate decision with your doctor. (USPSTF, 2022)

Related

• Women's preventive services guidelines (WPSI) vs USPSTF
• Osteoporosis screening (bone density test)
• Bone density test: how often to repeat it
• DEXA bone density scan: what to expect
• Screenings for women over 50
• What tests should a woman have every year
• When can you stop screening? Ages by test
• Screening glossary