Menopause is a time of change in your overall health. Without the protective effect of estrogen (produced by the ovaries), the body goes through various changes that require special tests to assess the changes in your health.
Some tests that you may need after menopause include the following:
- Mammogram. One in 8 women will have breast cancer at some point during their lives. The risk of breast cancer increases with age so that women who have undergone menopause should have an annual mammogram and breast exam in order to look for areas that might be suspicious for cancer of the breast. The test takes only fifteen minutes or so and can detect breast cancer in the earliest stages.
- Central DXA scan. This is a test done on women after menopause, especially those who are 65 years of age or older. It is a test that can detect the bone mineral density of the hip and spine to see if a woman has osteoporosis. This is a very sensitive test involving extremely little x-ray exposure. If the central DXA test indicates that you have osteoporosis, there are medications you can take along with increasing the calcium intake in order to prevent further bone loss from occurring. Women who have had premature menopause should have this test sooner than aged 65 as they are at a higher risk of developing menopausal-related osteoporosis.
- Cardiac Stress test. This involves running on a treadmill or using a stationary bicycle to increase the heart rate while the heart is hooked up to an EKG machine. You basically walk and/or run on the treadmill until you reach a target heart rate; all the while, a doctor stands by to evaluate the EKG for evidence of heart disease. As the risk of heart disease increases after menopause, women who have a history of heart disease in the family or who have symptoms suggestive of stress on the heart should undergo a cardiac stress test that can be paired with an echocardiogram of the heart to see if there is the potential for blockages of the blood vessels of the heart. If the cardiac echocardiogram or cardiac stress test is abnormal, a coronary angiogram can be performed to see whether or not there are blocked arteries in the heart. If this is the case, open heart surgery or a coronary angioplasty can be done to open the blood vessels and to decrease the risk of a heart attack.
- Carotid Ultrasound. Women after menopause are at a greater risk of plaques building up on the carotid arteries, which can lead to a thrombotic stroke (ischemic stroke). If the doctor detects noisiness in the area of the carotid arteries (also known as a carotid bruit), a carotid ultrasound can be done to look for narrowing of the carotid arteries. If they are found to be narrowed, this can be followed up by a carotid angiogram and surgery to remove the plaque inside the carotid arteries so as to decrease the risk of stroke.
- Endometrial biopsy. If a woman after menopause suffers from any kind of vaginal bleeding, this can be suspicious for uterine or endometrial cancer. In such cases, a dilatation and curettage is performed to look for cancerous areas. It involves opening the cervix and passing a sharp curette through the opening. The curette can scrape the endometrial tissue (the lining of the inside of the uterus) in order to look at the tissue under the microscope for cancerous cells. Sometimes a biopsy is taken of the uterus using a hysteroscope, which is a test involving a camera placed inside the uterus. The camera can detect suspicious areas of the uterine lining and direct biopsies of that tissue can be taken and further evaluated for endometrial cancer.
Just because a woman is going through menopause doesn’t mean that she has to have all of these tests.
Mammograms should be done by every woman on an annual basis but tests such as a cardiac stress test, stress echocardiogram, carotid ultrasound, and an endometrial biopsy are done if there are suspicious symptoms or a high risk of suffering from a particular disease.
Talk to your doctor about what tests you may need to have after going through menopause.