Screening across the decades

Recommendations vary by test and by individual risk; treat this as orientation rather than a personal schedule.

  • Cervical cancer — from 21, with intervals depending on whether cytology, HPV testing, or both are used, typically to around 65.
  • Breast cancer — mammography beginning in the forties, with expert bodies still discussing exact intervals and stopping age. Strong family history or known genetic variants usually mean earlier and additional imaging.
  • Colorectal cancer — from 45 for average risk.
  • Bone density — DXA from 65, and earlier for postmenopausal women at increased risk.
  • Blood pressure, lipids, and glucose — periodically from young adulthood, with intervals by risk.
  • Chlamydia and gonorrhoea — for sexually active women under 25 and older women at increased risk.
  • Depression and intimate partner violence — screening is recommended and often the only opportunity to raise these.

Heart disease in women

Cardiovascular disease causes more deaths in women than all cancers combined in many high-income countries, yet surveys consistently find that both women and clinicians underestimate the risk. Women are on average diagnosed later, receive guideline treatments less often, and are referred to cardiac rehabilitation less frequently.

Several female-specific factors raise later risk and are frequently missing from the record: pre-eclampsia or gestational hypertension, gestational diabetes, preterm delivery, polycystic ovary syndrome, early menopause before 45, autoimmune conditions such as lupus and rheumatoid arthritis, and migraine with aura.

  • Mention pregnancy complications even if decades ago — they change risk estimation.
  • Chest discomfort is still the most common heart attack symptom in women, often alongside breathlessness, nausea, jaw or back discomfort, and unusual fatigue.
  • Ask for cardiovascular risk assessment rather than waiting for it to be offered.

Bone health and menopause

Oestrogen restrains bone breakdown. When it falls during the menopause transition, loss accelerates — most rapidly in the first several years around and after the final period. That is why osteoporosis is more common in women and why perimenopause is a useful moment to act.

  • Progressive resistance training two or three times a week, loading hips and spine.
  • Weight-bearing impact where joints and existing bone health allow.
  • Balance training, since most fractures follow a fall.
  • Calcium from food first — around 1,200 mg a day after 50 — with supplementation guided by a clinician.
  • Vitamin D supports absorption; testing and dosing are individualised.

Menopausal hormone therapy is a symptom-focused decision made individually with a prescriber. The evidence has been substantially reinterpreted since early reporting, and benefits and risks depend on age, timing, and personal history.

Keeping your own record

Women often interact with healthcare through pregnancy or gynaecological care, which can mean general preventive items drift between providers. Keeping your own record closes that gap.

  • Record each screening test with date and result, including tests done elsewhere.
  • Record pregnancy history including complications — it is cardiovascular history too.
  • Record menopause timing; before 45 is relevant to bone and heart risk.
  • Document family history of breast, ovarian, and colorectal cancer with ages at diagnosis.
  • Keep an up-to-date medication and supplement list.
  • Ask at each visit what is due now and what is due next year.

Do not attribute every new symptom to menopause. Chest symptoms, unusual fatigue, and unexplained bleeding still need assessment.