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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