Screening
For patients with the correct clinical presentation, no testing is needed to establish a diagnosis of menopause.
There are no menopause-specific screening recommendations. Age-appropriate screening is continued through menopause. Cervical cytology may be discontinued at age 65 years in women with a documented history of normal recent cytology tests in the proper clinical circumstance.[34] Screening for breast cancer is age-dependent, and recommendations regarding when to begin vary somewhat between different professional organizations.[35]
Osteoporosis
Bone mass density should be evaluated in all women who meet any of the following criteria:[8]
Age 65 years and older
History of fracture after menopause (with the exception of skull, facial bone, ankle, finger, or toe)
Medical causes of bone loss including >3 months of systemic glucocorticoid therapy.
Bone mass density testing should be considered for postmenopausal women younger than 65 years if one or more of the following risk factors is present:[8]
Discontinued estrogen with additional risk factors for fracture (e.g., any of those listed below)
Body weight <127 lb (57.7 kg) or BMI <21 kg/m²
History of hip fracture in a parent
Current smoker
Excessive alcohol intake
Long-term use of medications associated with bone loss including prednisone or aromatase inhibitors.
In the US, dual-energy x-ray absorptiometry (DXA) is the preferred technique for assessment of bone mass density.[8] Risk assessment and DXA screening policy for primary prevention of osteoporosis may vary regionally.
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