Preventive Care Appointments to Consider Scheduling This Fall

Perimenopause |
10 min read

Published

September 14, 2026

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

The fall season is one of the best times to take stock of your health — and for those in perimenopause and beyond, staying current on women's health screenings after 40 may be more important than you realize. That's because hormonal changes that occur during the menopause transition can gradually cause changes to your cardiovascular risk, bone density, and more.¹

Keep reading to learn more about which preventive health appointments you should consider prioritizing this season, and why each one matters for where you're at right now and for supporting your overall wellbeing.

Annual Wellness Exam

An annual gynecological wellness exam as well as a physical, are the foundation of preventive care for women at every stage of life, and these appointments can be particularly valuable during the menopause transition when hormonal changes can begin shifting cardiovascular risk, bone health, and metabolism, even before hallmark symptoms appear.² This makes routine monitoring and early screening more important than ever.

These visits may include a breast exam and pelvic exam, a review of any age-appropriate screenings you may be due for, and counseling on topics including perimenopause and menopause.³

It's also a good time to bring up perimenopause symptoms, such as changes in your cycle, sleep disruptions, mood shifts, or any concerns that may have come up since your last visit. Your healthcare provider can help you understand what's worth monitoring and what options may be available to you.

Who may benefit: All women, annually.

Mammogram

The U.S. Preventive Services Task Force (USPSTF) breast cancer screening guidelines recommend that all women begin biennial (every other year) screening mammograms starting at age 40 and continuing through age 74.⁴ It’s important to note that there are multiple different guidelines that healthcare providers look to for mammogram guidance (The American Cancer Society or the American College of Gynecologists, for example, have different guidelines – therefore it’s important to check in on your individualized needs and risks with your healthcare provider).

It's worth noting that breast changes during perimenopause — including shifts in density and tenderness driven by fluctuating estrogen — are not uncommon, but they're not a reason to skip screening. Staying current on mammograms during and after the menopause transition is just as important as it was before.^.5

Women with a family history of breast cancer, dense breast tissue, or certain genetic risk factors may or may not benefit from earlier or more frequent screenings.⁶ That depends on the case and is a conversation worth having with your healthcare provider if this applies to you.

Who may benefit: Women ages 40–74, every two years; possibly more frequently for those with elevated risk based on recommendations from a healthcare provider.

Cervical Cancer Screening (Pap Test / HPV Test)

Regular cervical cancer screenings are potentially one of the most effective tools in menopause and postmenopause preventive care. That's because cervical cancer risk increases with age, and HPV infections that can lead to cervical cancer may appear decades after initial exposure.⁷

For women aged 21–29, the USPSTF recommends a Pap test every three years. For women aged 30–65, it recommends an HPV test every five years, though a Pap test every three years or combined co-testing every five years are also acceptable.⁸

Cervical screening can generally stop after age 65 for women who have had adequate prior screenings with normal results.⁸

Who may benefit: Women ages 21–65, on a schedule determined by age and prior results.

Blood Pressure Check

Menopause has been associated with measurable changes in cardiovascular health. Research from the American Heart Association suggests that perimenopausal women may be twice as likely to have lower overall cardiovascular health scores compared to women who are still having regular menstrual cycles — largely because of rising cholesterol and blood sugar levels.⁹

And blood pressure tends to peak during late perimenopause and early postmenopause,¹⁰ making this a particularly important time to stay on top of routine monitoring. The USPSTF recommends blood pressure screenings for all adults, with annual checks advisable for women at elevated risk.¹¹

Who may benefit: All women; annually for those at elevated risk.

Cholesterol and Lipid Panel

As estrogen levels decline during the menopause transition, cholesterol may begin to accumulate on artery walls — raising the risk of heart disease and stroke over time.¹² Research from the American Heart Association recommends that perimenopausal women be proactive about checking cholesterol levels rather than waiting until after menopause.¹³

Ask your healthcare provider whether you're due for a cholesterol and lipid screening and how often you may need it based on your personal risk factors.

Who may benefit: Women in perimenopause and beyond; frequency determined by individual risk.

Colorectal Cancer Screening

The USPSTF recommends that all adults begin colorectal cancer screening at age 45, continuing to age 75. This means many women in perimenopause are at or approaching the age when this screening becomes a priority for the first time.¹⁴

Screening options include colonoscopy every 10 years, annual stool-based tests, or other methods your healthcare provider may recommend based on your risk profile.¹⁴

Colorectal cancer is highly treatable when caught early, making this one of the more impactful routine medical checkups on this list.¹⁵

Who may benefit: All women starting at age 45, through age 75.

Bone Density Screening (DEXA Scan)

Estrogen plays a key role in maintaining bone density, so the bone loss that can accompany the menopause transition — up to 20% within the first five years¹⁶ — raises the importance of monitoring bone health.

The USPSTF advises all women aged 65 and older to receive a bone density screening, and that postmenopausal women younger than 65 with one or more risk factors — including menopausal status, low body weight, parental history of hip fracture, smoking, or excess alcohol use — should also be assessed to determine whether screening is warranted.¹⁷

Who may benefit: All women 65 and older; postmenopausal women under 65 with risk factors.

Flu Vaccine

The CDC recommends an annual flu vaccine for all adults, and fall is the ideal time to schedule it to ensure protection before flu activity ramps up for the season.¹⁸

Flu vaccination may be particularly meaningful for women at midlife, since cardiovascular health is already changing.¹⁹ For adults 65 and older, a high-dose flu vaccine may be recommended;²⁰ so be sure to ask your healthcare provider which formulation is right for you.

Who may benefit: All women, annually each fall.

Skin Check

A professional skin exam, either with your primary care provider or a dermatologist, may help detect early signs of skin cancer, including melanoma, when it's most treatable.

During the menopause transition, declining estrogen may contribute to skin sagging, dryness, and changes in collagen that can alter how your skin looks and feels as well – so it may be a good time to invest in a full skin check to cover all your bases.²¹

The USPSTF notes that evidence is insufficient to make a universal recommendation for or against clinical skin cancer screening in adults. But women with fair skin, significant sun exposure or burn history, a family or personal history of melanoma, or a history of many or unusual moles may want to discuss skin checks with their healthcare provider to determine what makes sense for their individual risk profile.²²

Who may benefit: All women; annually for those with elevated risk.

Diabetes Screening

The USPSTF recommends prediabetes and type 2 diabetes screening for adults aged 35–70 with overweight or obesity.²³ Additionally, during the menopause transition, shifts in estrogen can contribute to increased insulin resistance and blood sugar fluctuations,²⁴ making this an important screening to stay current on.

Who may benefit: Women ages 35–70 with overweight or obesity; discuss with your healthcare provider.

At-a-Glance: Fall Health Checklist for Women's Preventive Care ^{25, 26, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43}

Appointment type	Why it's important	Who may benefit
Annual Wellness Exam	Preventive care; during menopause, hormonal shifts can change cardiovascular risk, bone health, and metabolism	All women, annually
Mammogram	Breast changes during perimenopause are normal, but screening can help detect breast cancer	Women ages 40–74, every two years; possibly more for those with elevated risk, unique per patient
Cervical Cancer Screening (Pap Test / HPV Test)	Cervical cancer risk increases with age; HPV infections that can cause it may appear decades after exposure	Women ages 21–65, age- and result-dependent schedule
Blood Pressure Check	Perimenopausal women may have lower cardiovascular health scores than those having regular cycles; blood pressure can peak during late perimenopause / early postmenopause	All women; annually for those at elevated risk
Cholesterol and Lipid Panel	As estrogen declines during menopause, cholesterol may accumulate on artery walls, raising the risk of heart disease and stroke	Women in perimenopause and beyond; individual risk determines frequency
Colorectal Cancer Screening	Colorectal cancer screening recommended starting at 45, when many women are in perimenopause	Women ages 45–75
Bone Density Screening (DEXA Scan)	Estrogen is key in maintaining bone density, and there can be estrogen loss during menopause	Women 65+ and postmenopausal women under 65 with risk factors
Flu Vaccine	Protection for mid-aged women, as cardiovascular health is already shifting	All women, annually each fall
Skin Check	Helps detect early signs of skin cancer; declining estrogen may contribute to skin sagging, dryness, and changes in collagen that can impact skin's look and feel	All women; annually for those with elevated risk
Diabetes Screening	Estrogen shifts can contribute to increased insulin resistance and blood sugar fluctuations	Women 35–70 with overweight or obesity

A Note on Sleep and Emotional Health

Bonafide's 2026 State of Menopause Survey found that 60% of women say perimenopause and menopause symptoms affect their emotional or mental health, and anxiety and depression rank as the top reported impactful symptoms.⁴⁴

With that in mind, your annual physical wellness exam is also a great opportunity to bring up your current emotional wellbeing, any sleep disruptions, brain fog, or mood changes. These are real symptoms, and they deserve the same clinical attention as physical ones.

If sleep has become a persistent concern, supplementation may be worth discussing with your healthcare provider alongside other approaches.

Where to Start

You don't have to schedule every one of these recommended appointments at once. A good place to begin is with your annual wellness exams, which can serve as a starting point for determining which additional screenings you may be due for based on your age, health history, and current symptoms. Your healthcare provider can help you prioritize and coordinate from there.

Staying current on preventive care for women is a tangible strategy to help you take care of yourself during a transition that can feel unpredictable in many other ways.

Preventive Care Checklist for Menopausal Women Over 40 | Bonafide

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