Tests Every Postmenopausal Woman Should Do
Dr. Megha Zacharia

Dr. Megha Zacharia

Aug 26Menopause

Tests Every Postmenopausal Woman Should Do

This article is compiled by Sanjana Varma, a freelance writer at Proactive For Her.

What is menopause?

Menopause is a part of the ageing process in women. It occurs when a woman hasn’t menstruated in 12 consecutive months. It usually begins between the ages of 45 and 55, but can develop before or after this age range.

Menopause is accompanied by symptoms such as hot flashes, irritation and weight gain. If the symptoms are hard to handle, you may seek treatment. Perimenopause is the time when your period starts getting irregular, menopause is the next one when the periods stop and the period after menopause is postmenopause.

Important tests you need to do when you hit the postmenopause phase

Screening tests are sneak peeks into your health. It can catch a health condition even before it starts showing symptoms, helping you take preventive measures early. It’s very important as many diseases are asymptomatic and by the time it is diagnosed, it might be late. Here is a list of tests every woman needs to do after menopause.

1. Complete Blood Count (CBC)

What is the test?

A complete blood count (CBC) is a blood test used to evaluate your overall health and can help detect a wide range of disorders, including anaemia, infection and even blood cancer. A complete blood count test measures several components of your blood, including platelets, haemoglobin, red and white blood cells.

What is the relevance of the test?

A complete blood count is a common blood test that's done for a variety of reasons:

  • It is used to diagnose infections and certain types of cancer.
  • It is used to diagnose anaemia and to further identify underlying causes of anaemia like iron deficiency, deficiency of vitamins like B 12 or other disorders of the red blood cells
  • It is also used to monitor the effectiveness of the medication or treatment you are undergoing. For example, if you are being given iron tablets to correct iron deficiency anaemia a follow-up CBC test would help us understand whether you are benefiting from the therapy, if not the mode of administration of the medication may have to be changed

2. Blood sugar test / Screening for diabetes

What is the test?

A blood sugar test is done to monitor blood glucose levels. It is a blood test and commonly consists of three types. Fasting blood sugar requires 8 hours of fasting before the blood sample is taken. HbA1C measures the average amount of blood glucose in your blood over three months. It does not require fasting just like a random blood sugar test which tests for the level of blood sugar at any random time.

What is the relevance of the test?

The test can help diagnose diabetes and monitor the effectiveness of your diabetic medication. Doctors may use it to adjust your dosage, change your medication and prevent the future increase in your blood sugar level. HbA1C which is less than 5.7 % is normal. For random the normal level is up to 200 mg/dl and for fasting it is less than 100 mg/dl.

3. Lipid Profile

What is the test?

The lipid profile measures the amount of specific fat molecules called lipids in the blood. As a panel test, it measures HDL, LDL, Triglycerides and Total cholesterol. This test helps to check for the risk of coronary heart disease, or as a preventive measure to check for heart diseases.

What is the relevance?

High cholesterol can result in heart attacks, strokes and coronary artery diseases. Keeping your cholesterol values in check can prevent it. If your lipid levels are elevated depending on the extent and your risk levels your doctor may recommend a trial period of lifestyle modification, to bring back your lipid levels to normal. If management with just lifestyle modification fails you may then be started on medication which helps keep your blood lipid levels under control. If you have elevated lipid levels it is best you periodically get your lipid profile checked to understand whether your medication is doing what it is meant to do.

The normal values for a lipid profile are as follows:

LDL: < 100 mg/dL (the lower, the better)

HDL: more than 40 to 60 mg/dL (the higher, the better). This is good heart-healthy cholesterol and we hope to see high numbers on this parameter

Total cholesterol: less than 200 mg/dL (the lower, the better)

Triglycerides: 10 to 150 mg/dL (the lower, the better)

Abnormal levels in one or more of these call for medical attention.

4. Liver Function Tests

What is the test?

Liver function tests help determine the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood. A blood sample is taken to analyze the levels of:

  • Alanine transaminase (ALT) test
  • Alkaline phosphatase (ALP) test
  • Aspartate aminotransferase (AST) test
  • Bilirubin
  • Albumin

What is the relevance?

Each of these components should be within the normal range if your liver is functioning properly. If the levels are off the charts it points towards liver damage or sometimes even due to the impact of another disease-causing liver damage.

An increase in ALT is the result of liver damage. It can be due to liver cirrhosis, non-alcoholic fatty liver or other diseases. An increase in AST levels indicates liver damage, disease or muscle damage. High levels of ALP may indicate liver damage, such as a blocked bile duct and even certain bone diseases. Low levels of albumin may indicate liver damage or disease. Elevated levels of bilirubin might indicate liver damage or disease or certain types of anaemia. Jaundice can be the result of the same.

5.Blood Pressure Test

What is the test?

Blood pressure is measured using a sphygmomanometer. A reading below 120/80 is ideal. Elevated blood pressure can cause stroke, heart diseases and breathlessness. High blood pressure puts stress on the walls of the blood vessels and takes a toll on the heart and brain.

What is the relevance?

Your systolic blood pressure (first number), is the amount of pressure against your artery walls during each heartbeat and the diastolic blood pressure (bottom number), is the pressure against your artery walls during the time in between beats. Your BP should be lower than 130/80. If your systolic pressure is 130 or higher in consecutive readings, your doctor might ask you to change your diet, lifestyle and start the medication to manage blood pressure.

6. Urinalysis

What is the test?

A urinalysis or urine test is a non-invasive procedure to check for the composition of urine, which will help us identify any kidney disease, infections or conditions such as diabetes. The urine is checked for its physical appearance, chemical composition and then examined microscopically. It is a convenient, easy, and affordable procedure.

What is the relevance?

A person’s urine is not always perfect. There might be components that are not supposed to be there such as protein, glucose, blood cells both white and red, crystals, and bacteria which will help in diagnosing various conditions. An incidental finding of glucose in the urine may be how the presence of diabetes is picked up for the first time in some patients. Urinary tract infections are common among postmenopausal woman because of change in the microbiome of the genitourinary tract. A urine analysis test can also help detect a urinary tract infection. An affordable yet highly informative test that is a must-do for a woman.

7. Kidney Function Tests

This test estimates how well your kidneys are functioning. Some of the parameters evaluated are Serum creatinine test, Blood Urea Nitrogen and Estimated GFR.

What is the relevance?

As age and menopause sets in the kidney function tend to deteriorate. So regular check-up is necessary to detect early on the onset of any kidney damage

A creatinine level higher than 1.2 milligrams/deciliter (mg/dL) for women is a sign of a kidney problem. A normal BUN level is between 7 and 20 mg/dL. In the case of Estimated GFR, any result lower than 60 millilitres/minute/1.73m2 may be a warning sign of kidney disease. If all these values are out of sorts, it points towards kidney diseases.

8. Thyroid Function Tests

What is the test?

Thyroid function tests check the function of your thyroid gland. They are mainly used to detect an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism). Available tests include the T3, T4, and TSH. Blood is drawn to check your thyroid levels. Thyroid hormones regulate the way your body uses energy. It also plays an important role in regulating your weight, body temperature, muscle strength, menstrual cycle and even your mood.

What is the relevance?

Thyroid hormone disturbances, especially hypothyroidism, can amplify and worsen the symptoms of menopause. Loss of bone is common in the postmenopausal period. Some studies show that having hypothyroidism can accelerate the loss of bone density. Menopause also predisposes a woman to develop cardiovascular diseases and the presence of hypothyroidism can have a compounding effect.

Thyroid imbalance, in general, can lead to irregular periods, hormonal weight gain, hair loss and also struggle with infertility. A high TSH level indicates that the thyroid gland is not producing enough thyroid hormone (hypothyroidism) and a low TSH level usually indicates that the thyroid is producing too much thyroid hormone (hyperthyroidism).

TSH normal values are 0.5 to 5.0 mIU/L. A normal Total T4 level in adults ranges from 5.0 to 12.0μg/dL. A normal Total T3 level in adults ranges from 80-220 ng/dL.

9. Pap smear

What is the test?

A pap smear is a screening procedure for cervical cancer. It is the recommended test for early detection of cervical cancer. During the procedure, cells from your cervix are gently scraped away and later examined under the microscope for abnormal cells or any infection.

What is the relevance of the test?

Pap testing is to be repeated every three years for women ages 21 to 65. It should be combined with the HPV test. HPV is a virus that causes warts and increases the chance of cervical cancer. HPV types 16 and 18 are the primary causes of cervical cancer. If you have HPV, you may be at an increased risk of developing cervical cancer.

10. STI Tests

What is the test?

If you're sexually active, using protection and getting tested is important because a person can have sexually transmitted infections without knowing it. In many cases, there aren't any signs or symptoms. Chlamydia, gonorrhoea, syphilis, HIV, Hepatitis B and Herpes are some of the most common ones. Tests can vary from blood tests, urine tests or swab tests.

What is the relevance?

As women age, the estrogen levels decline which makes the tissue lining the vagina thin out leading to the development of microabrasions which can put them at increased risk of contracting a sexually transmitted infection. Certain types of human papillomavirus (HPV) can cause cervical cancer while other varieties of HPV can cause genital warts. A pap smear can detect cervical cancer. If you test positive for an STI, the next step is to consider further testing and then get treatment as recommended by your doctor. In addition, inform your sex partners. Your partners need to be evaluated and treated because you can pass some infections back and forth.

11. Vitamin D

What is the test?

Vitamin D or the sunshine vitamin is a nutrient that is essential for healthy bones and teeth. Two forms of vitamin D that are important are vitamin D2 and vitamin D3. It is measured using a minimally invasive blood test.

What is the relevance?

Oestrogen regulates the amount of active Vitamin D being produced by the kidney As menopause sets in the oestrogen levels decline is associated with a decline in vitamin D levels. Vitamin D levels in desired range help prevent delay, or control diabetes and improve cardiovascular function. A periodic blood check can ensure that you are not running low on this all-important sunshine vitamin.

12. Vitamin B-12

What is the test?

Vitamin B-12 is an important vitamin for many bodily functions, such as brain health, blood cell production, and proper nerve functioning. There are several ways to test your B-12 levels. Vitamin B12 status is typically assessed by measurements of serum or plasma vitamin B12 levels. The cutoff between normal vitamin B12 levels and deficiency varies by method and laboratory, but most laboratories define subnormal serum or plasma values as those lower than 200 or 250 pg/mL.

What is the relevance?

As we age the body's ability to absorb Vitamin B 12 also declines, which may result in below optimum levels of this vitamin. Certain medications can also interfere with the absorption of vitamin B12. If you have unexplained fatigue, weakness, confusion, dementia, sense of disturbed balance, tingling or numbness, this test could help you get answers.

13. Serum calcium

What is the test?

The total calcium blood test is used to measure the total amount of calcium in your blood. Calcium is one of the most important minerals in your body which is stored in your bones. Most of your body’s calcium is stored in your bones. It is a part of your routine blood tests.

What is the relevance?

Your body requires calcium to maintain healthy bones and teeth. It’s also essential for keeping your nerves, heart, and muscles functioning properly. It can be ordered if your doctor suspects kidney disease. The normal blood total calcium test in adults is between 8.6 and 10.2 milligrams per deciliter (mg/dL).

14. Mammogram

What is the test?

This breast cancer screening is almost similar to an x-ray. It is recommended every two years. In case of any abnormal reports or high-risk factors, your doctor may ask you to repeat them. This test gives you a chance to catch breast tumours early.

What is the relevance?

It is found that in women aged 50 to 69, mammograms reduced the risk of advanced breast cancer by about 20 per cent. This test is recommended to be repeated if you have a family history of breast cancer.

15. ECG

What is the test?

An electrocardiogram records the electrical signals in your heart. It's a common and painless test used to quickly detect heart problems and monitor your heart's health. ECGs are often done in a doctor's office, a clinic or a hospital room.

What is the relevance?

ECG is used to detect arrhythmia, heart blocks, to check for chances of further heart attacks and also to find if the pacemaker is working.

16. Stool Occult Test

What is the test?

This test checks for hidden blood in the stool sample. If the presence of blood is found, it could mean bleeding in the abdomen, gut or rectum. The find may call for further medical examination as it cannot tell us the source of bleeding.

What is the relevance?

If you notice blood in your stool or the toilet or if you experience abdominal pain or a change in your bowel habits, it’s best to talk with your doctor and ask if this test should be done to rule out colon cancer.

17. Colonoscopy

What is the test?

During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon. Sometimes polyps or other abnormal tissues are removed through the instrument for biopsies.

What is the relevance?

You need to empty your bowel before going for a colonoscopy. Your doctor will ask you to follow a specific diet and take a laxative for the same. It is used to check for internal symptoms of colon cancer and check for the presence of polyps if you had it before.

18. DXA scan

What is the test?

DXA (Dual Energy X-ray Absorptiometry) bone density scan uses low dose X-rays to see how dense (or strong) your bones are. It is often used to diagnose or assess your risk of osteoporosis, a health condition that weakens bones and makes them more likely to break. It is quick, painless and more effective than normal X-rays in identifying low bone density.

What is the relevance?

If your body has had fractures easily and if you are at the postmenopausal stage, it’s better to get assessed to prevent osteoporosis.

Bottom Line

Postmenopause can have its share of problems and health issues. Tests in time can help you diagnose conditions before it’s out of control. Let your health remain in your control.

Disclaimer - This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.

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