Essential Health Tests for Women in Midlife

This article highlights critical health tests women should consider during midlife. Understanding these measures is essential for better health management.

Body Mass Index (BMI) & Body Composition

Why It Matters

BMI is a general indicator of health, but it doesn't tell the whole story. Muscle mass and fat distribution become increasingly important in midlife. Many women may have a "normal" BMI but lose muscle while gaining visceral fat. This change reduces metabolic rate, affects insulin sensitivity, and heightens metabolic risk.

How to Check

• BMI Calculation This method uses height and weight but doesn’t differentiate between muscle and fat.

• DEXA Scan / Bio-electrical impedance scales: These tests measure muscle mass, fat percentage, and visceral fat accurately.

  
  

Blood Pressure

Why It Matters

High blood pressure, or hypertension, significantly increases the risk of cardiovascular disease, stroke, and kidney disease.

Aim

The ideal blood pressure reading is below 130/80 mmHg.

Waist Circumference & Visceral Fat

Why It Matters

Hormonal shifts during perimenopause lead to an increase in fat around abdominal organs. This accumulation of visceral fat raises the risk of insulin resistance, Type 2 Diabetes, cardiovascular disease, and inflammation.

How to Check

• Waist Circumference: Measure at the narrowest part of your waist. A circumference over 35 inches (88 cm) in women is linked to higher metabolic risks.

• Waist-to-Hip Ratio (WHR): A WHR of 0.85 or higher indicates a higher risk of metabolic dysfunction.

  
  

Lean Mass & Muscle Strength

Why It Matters

Muscle tissue is metabolically active, playing a crucial role in maintaining insulin sensitivity and metabolism. Losing muscle increases the risk of metabolic decline and frailty.

How to Check

• DEXA Scan: Measures lean mass versus fat mass.

• Grip Strength Test: Determines functional muscle strength.

• Sarcopenia Screening: Evaluates the risk of muscle loss through factors like low strength, slow walking speed, and low muscle mass.

  
  

Thyroid Function & Metabolic Regulation

Why It Matters

Thyroid hormones regulate metabolism, energy levels, and body temperature. Dysfunction, particularly hypothyroidism, is common in midlife and contributes to fatigue and weight gain.

How to Check (Blood Tests)

• TSH (Thyroid-Stimulating Hormone): High levels may indicate hypothyroidism.

• Free T3 & Free T4: Measure active thyroid hormones.

• Thyroid Antibodies (TPO, TG Antibodies): Indicate autoimmune thyroid disorders, such as Hashimoto’s.

  
  

Insulin Sensitivity & Blood Sugar Regulation

Why It Matters

Perimenopause can lead to increased insulin resistance, affecting blood sugar regulation and weight management. This is a key aspect of metabolic health.

How to Check (Blood Tests)

• Fasting Glucose: Normal range is between 3.9–5.5 mmol/L. Pre-diabetes is 5.5 - 6.9 mmol/L, while diabetes is characterized by levels ≥ 7.0 mmol/L.

• HbA1c (Glycosylated Hemoglobin): Assesses average blood sugar over three months. The ideal level is below 41 mmol/mol (5.9%). Pre-diabetes ranges from 42 - 47 mmol/mol (6.0 - 6.4%), and diabetes is classified as ≥ 48 mmol/mol (6.5%).

• Fasting Insulin: Elevated levels suggest insulin resistance.

  
  

Lipid Profile & Cardiovascular Health

Why It Matters

As estrogen levels drop in midlife, cholesterol levels can rise, increasing the risk of heart disease.

How to Check (Blood Tests)

• Total Cholesterol: The ideal level is below 5.0 mmol/L.

• HDL (“Good” Cholesterol): Should be above 1.2 mmol/L.

• Non-LDL (“Bad” Cholesterol): The ideal level is below 3.0 mmol/L.

• Triglycerides: Aim for levels below 1.7 mmol/L.

  
  

Hormonal Balance

Why It Matters

Changes in ovarian hormones affect metabolism, weight, mood, and energy levels. Cortisol, the stress hormone, can also influence fat storage and hormone balance.

How to Check

• Oestradiol (E2): Levels fluctuate across the menstrual cycle and decline during perimenopause. Testing can help identify whether your estrogen levels are high or low.

• Progesterone: Important for sleep and mood balance, low levels may indicate a lack of ovulation.

• Testosterone: Levels decline in perimenopause and after menopause. Monitoring helps assess both ovarian and adrenal function.

  
  

Inflammation & Gut Health

Why It Matters

Chronic inflammation is linked to insulin resistance and weight gain. Poor gut health affects hormone balance and digestion.

How to Check (Blood & Stool Tests)

• CRP (C-Reactive Protein, High Sensitivity): Measures systemic inflammation. Elevated levels require further investigation.

• Comprehensive Stool Test: Assesses gut microbiome health and inflammation levels.

  
  

Bone Density & Osteoporosis Risk

Why It Matters

Declining estrogen levels contribute to bone loss, increasing the risk of osteoporosis and fractures.

How to Check

• DEXA Scan: Measures bone mineral density (BMD).

• Vitamin D & Calcium Blood Tests: Checks for deficiencies impacting bone health.

  
  

Getting Blood Tests

You should ask your GP about testing options, which can often be arranged through them. There are also commercial testing options like Randox and Medichecks that provide comprehensive tests. Always opt for venous blood tests, as they offer greater accuracy than fingerprick options.

Understanding these tests can empower you on your health journey. Regular check-ups and awareness can lead to informed decisions, helping you optimize your metabolic health and overall well-being.