Menopause test: there isn't one, but these health checks matter
There is no single menopause test: menopause is defined as 12 months without a period, a clinical definition and not a lab result, and a hormone blood test can't confirm it. The checks that earn their place at this stage are the routine ones, from blood pressure and cholesterol to bone density and cancer screening, all set out in the table below.
Let's be clear about where the value sits. Menopause usually arrives between 45 and 55, and from there the useful conversations are about heart, bones and cancer screening. The research points to something less glamorous than a kit in the post: a cuff, a tape measure, a blood draw and a few screening appointments. Each has its own schedule, and the table sets them side by side, with the UK line wherever it differs.
Do you need a menopause test once your periods have stopped?
Not to confirm it, and here's the truth about the blood test many women expect. The belief is that an FSH (follicle-stimulating hormone) result will tell you whether menopause has arrived. NICE NG23 (updated 2024) treats diagnosis as clinical for women over 45 with typical symptoms, because hormone levels swing from week to week and a single result can't settle the question. Your period history does the work. Testing is kept for unclear pictures, such as symptoms at a younger age.
That frees the appointment for better questions. If you are still sorting out which menopause symptoms are which, a thyroid (TSH) test is worth raising with your primary care provider (your GP in the UK), because thyroid symptoms overlap with menopause ones.
The other test-shaped conversation is the review. For women on hormone therapy (HRT in the UK) or another menopause treatment, a yearly review is the place to say plainly what is working, what isn't, and whether the bleeding pattern has changed since the prescription was written. A few dated notes make it far more productive.
If your periods are still arriving, however erratically, the perimenopause test page is written for the years before this one. For the years after it, FSH after menopause covers the checks that carry on. The full list across every life stage sits in health checks for women.
Check, when, what to look for
| Check | When | What to look for | Guidance by country |
|---|---|---|---|
| Menopause review | Yearly if you are on HRT or other treatment | Symptom control, side effects and bleeding patternA good time to ask whether your dose and type still suit you. | – |
| Bleeding after menopause | Whenever it happens, 12 months or more after your last period | Any bleedingUsually harmless, but it calls for a prompt doctor's visit so womb cancer can be ruled out. | – |
| Blood pressure | At least yearly | Under 120/80 is normal; 130/80 or above is high (US)A home monitor is useful. | UK threshold: 140/90. |
| Cholesterol | Every 1 to 5 years, yearly if raised | LDL, HDL and triglyceridesApoB and Lp(a) add detail where available; Lp(a) is measured once. | – |
| Blood sugar (HbA1c) | Every 1 to 3 years | Under 5.7% (42 mmol/mol)Reported as a percentage and in mmol/mol. | – |
| Waist measurement | Monthly at home | Under 31.5 in (80 cm) is ideal; over 35 in (88 cm) is high riskA tape measure is the only equipment; the aim is a waist under half your height. | – |
| Bone density (DEXA) | From 65, or earlier after menopause with risk factors | T-score plus a FRAX fracture risk scoreRisk factors: early menopause, low weight, steroid use, family history of hip fracture, smoking. | – |
| Breast screening | Mammogram every 2 years from 40 to 74 | Any breast change between screensChanges are reported when they appear, not saved for the next screen. | UK: every 3 years from 50 to 71. |
| Cervical screening | Every 5 years, to 65 | An HPV testStill due after periods have stopped. | – |
| Colorectal screening | From 45 | Home stool test (FIT) or colonoscopyBleeding or a changed bowel habit merits a doctor's visit at any age. | UK: every 2 years from 50. |
| Thyroid (TSH) | If you have symptoms | TSH levelThyroid symptoms overlap with menopause symptoms. | – |
| Vitamin D | Once, then as advised | Under 20 ng/mL (50 nmol/L) is lowRecheck after supplementing. | – |
| Eyes and teeth | Every 1 to 2 years | An eye exam for glaucoma and dry eyes, and a dental check for gum healthDry eyes and gum problems become more common, so mention either at the visit. | – |
| Mental health | Ongoing, and at any appointment | Low mood, anxiety and irritabilityCounts as a health check, the same as any blood test; raise it as you would a blood pressure reading. | – |
| Strength and fitness | Every 3 months | Grip strength, push-ups, sit-to-stand and 3-mile (5 km) walk timeCompare with your own last result, not anyone else's. | – |
Which bone and cancer screening checks come due around menopause?
Around menopause, the screening checks to know are bone density, breast, colorectal and cervical screening, with a vitamin D level as the simple first step for bone. The cancer screens run on fixed schedules, and bone gets a blood test now and a scan later.
Bone health starts with a one-off vitamin D level, rechecked after supplementing. The bigger question is osteoporosis, and here the USPSTF (2025) backs a DEXA scan (a bone scan in the UK) from 65, and sooner for women past menopause whose risk assessment points to a higher chance of fracture. A scan is a snapshot, so the score is read alongside your fracture risk.
Cancer screening is where the US and UK part ways. The USPSTF (2024) supports a mammogram every 2 years from 40 to 74, while UK breast screening runs every 3 years from 50 to 71. Colorectal screening starts at 45 in the US (USPSTF, 2021), with a home stool test or a colonoscopy, and UK bowel screening runs every 2 years from 50. Cervical screening continues after periods end: every 5 years with an HPV test, to 65, whether you call it a Pap smear or, in the UK, a smear test.
What numbers matter for heart and metabolic health after menopause?
Blood pressure, blood sugar, waist and cholesterol make up the heart and metabolic checks. Normal blood pressure for women is under 120/80, and US guidance calls 130/80 or above high, while the UK threshold is 140/90. The same reading can earn a different label on each side of the Atlantic, so it helps to know which yardstick is in use when a result is called fine.
HbA1c is the blood sugar check: under 5.7% (42 mmol/mol) is the mark, tested every 1 to 3 years. Waist is the free one. A sensible target for waist to height ratio is a waist under half your height, and it is a measure of health risk, not of worth or dress size. Strong and independent is the goal here, not small.
Cholesterol is the one that moves under your feet, so a result from your 40s may no longer describe you. It is a blood test, not something you can feel, so high cholesterol symptoms in women mostly don't exist; the schedule is every 1 to 5 years, yearly if raised. Bundling these checks into a well woman exam keeps them in one place. If breast cancer runs in your family, breast cancer genetic screening is a fair question to raise at the same visit.
Facts
Common questions
Do I need a bone density scan before 65?
Possibly. The USPSTF recommends scanning postmenopausal women under 65 only when a clinical risk assessment tool shows increased fracture risk. The risk factors that raise it are early menopause, low body weight, steroid use, a family history of hip fracture and smoking. If one or more applies, it is reasonable to ask for that assessment now.
Is bleeding after menopause always a sign of cancer?
No. It is usually harmless, but it is the one symptom here where the NHS advises having it checked rather than waiting to see if it settles. It helps to note the date of your last period and how often the bleeding happens. Bleeding on HRT that continues after 6 months is also worth raising.
Does cervical screening stop at menopause?
Not automatically. The USPSTF recommends screening up to 65, either every 5 years with an HPV test alone or with cotesting, or every 3 years with cytology alone. Women can stop after 65 if earlier screening has been adequate and risk is not high, which is a decision to make with your doctor.
Is colorectal screening still recommended after 75?
The USPSTF grades screening at Grade A for ages 50 to 75 and Grade B for ages 45 to 49. For ages 76 to 85 it is Grade C, meaning selective: it depends on your overall health and screening history. A conversation with your doctor, rather than a fixed rule, decides whether to continue.
Can a home FSH kit tell me whether I'm in menopause?
No. A kit can show only that FSH is raised on the day you test, and levels swing, so a normal or high reading doesn't settle anything. NICE NG23 (2024) looks to symptoms and period history for women over 45. A doctor may order blood tests when symptoms start younger or the picture is unclear.
Who arranges my screening, and who do I call?
In the US, a primary care provider or OB-GYN orders blood tests and refers you for a mammogram, DEXA scan or colonoscopy, often at an annual wellness visit. In the UK, the NHS screening programs send breast, cervical and bowel invitations; your GP or practice nurse handles blood pressure and blood tests.
Next steps
A practical way to start: go down the table and mark which checks you have had, which are coming up and which you are unsure about. Take the unsure ones, plus any results you already hold, to your next appointment. The at-home checks can begin this week with a tape measure and a note of the date. Screening schedules differ between the US and the UK, and your own history, family history and treatment shift the picture again, so you decide which of these fit you and in what order. It is not one size fits all.
See a doctor promptly if you have
- Any bleeding 12 months or more after your last period
- A new breast lump or any breast change between screens
- Bleeding from the bowel or a changed bowel habit, at any age
- Unexplained weight loss
Also in menopause
The same topic in the stage before and after
Sources
The guidelines and studies this page draws on.
- NICE NG23: Menopause: identification and management (updated 2024), NICE (2024)
- Osteoporosis to Prevent Fractures: Screening, USPSTF (2025)
- Breast Cancer: Screening, USPSTF (2024)
- Colorectal Cancer: Screening, USPSTF (2021)
- Cervical Cancer: Screening, USPSTF (2018)