Women’s health 1/2: Risks, biomarkers and screening across each decade

For Breast Cancer Awareness Month, we are bringing you a two-part series on women’s health in your 30s, 40s and 50s.

Which risks deserve greater attention at each stage? How do hormonal, metabolic, cardiovascular, muscular and bone health considerations evolve? Which biomarkers and screening tests should be included in your health monitoring, particularly for breast cancer?

This first part explores how these risks evolve, the data that can help assess them, the recommended screening tests and the warning signs that should not be ignored. The second part will focus on the most relevant preventive actions at each stage.

And if you are a man, this article is relevant to you too: understanding women’s health better also helps you better support the women around you.

Prevention evolves with age. In your 30s, the main priority is identifying individual risk factors. In your 40s, changes in symptoms and markers become more informative. In your 50s, organised screening and the prevention of chronic diseases become increasingly important. When it comes to breast health, the first step is to understand your risk and respond to any symptoms; from age 50, organised mammography screening is added to this approach.

In your 30s: identify your individual risk

Your 30s are often shaped by questions about your cycle, contraception, fertility, pregnancy or postpartum recovery. These factors can also provide valuable information about your long-term health. For example:

• Polyendocrine metabolic ovarian syndrome, formerly PCOS, affects around one in ten women. Beyond ovulation and fertility, it is associated with an increased risk of insulin resistance, type 2 diabetes, hypertension and dyslipidaemia. Metabolic health should therefore be included in its long-term management.

• Endometriosis is not limited to pain or difficulties conceiving. This chronic inflammatory disease can have a lasting impact on quality of life and has been associated with a higher cardiovascular risk in several studies.

• Amenorrhoea related to low energy availability, intense physical activity or eating disorders can reduce oestrogen production and compromise bone health. Heavy periods can deplete iron stores before anaemia even develops.

• Obstetric history also matters. Pre-eclampsia, gestational hypertension or diabetes, preterm delivery, or having a baby who was small for gestational age are associated with a higher subsequent risk of hypertension, diabetes and cardiovascular disease. Several meta-analyses have notably associated pre-eclampsia with a doubling of long-term cardiovascular risk. These events should remain documented in the medical record long after the postpartum period.

• Sleep, physical activity, muscle mass, nutrition, smoking, alcohol, stress and metabolic health also influence cardiovascular and bone health over time. Some are also associated with more pronounced perimenopausal symptoms.

The priority is to identify vulnerabilities early: document your cycles and medical history, investigate amenorrhoea or heavy periods, and review the family history of breast, ovarian, pancreatic and prostate cancers on both sides of the family.

What about breast cancer?

The absolute risk remains lower, but it is not zero. The priority is to determine whether your personal or family history warrants earlier surveillance. Several related cancers within a family, a diagnosis at a young age or male breast cancer may warrant a referral for oncogenetic counselling.

For women at average risk with no symptoms, routine mammography is not recommended before age 50 in France. An annual clinical breast examination is recommended from age 25. Any lump, nipple retraction, spontaneous discharge or persistent breast change should be investigated without delay.

What is useful to check in your 30s

• Family, gynaecological and obstetric history.

• Blood pressure.

• A targeted cardiometabolic assessment: lipid profile, fasting glucose and insulin and/or HbA1c depending on the context.

• A complete blood count and ferritin in cases of heavy periods or symptoms of iron deficiency.

• Thyroid testing when symptoms or the clinical context suggest it may be relevant.

• Lp(a), ideally measured at least once in adulthood.

• Cervical cancer screening: cervical cytology at ages 25 and 26, followed by a high-risk HPV test every five years from ages 30 to 65, in accordance with the French organised screening schedule.

The objective is to establish baseline data tailored to your medical history and then monitor how it changes over time.

In your 40s: monitor change rather than an isolated value

Some women enter perimenopause during this decade, while others maintain regular cycles until the end of it. The transition most often begins in the mid-40s and may last for several years.

As ovulation becomes less regular, oestradiol and progesterone can fluctuate considerably. Cycles may become shorter, longer or unpredictable, while hot flushes, night sweats, sleep disturbances, migraines, brain fog, difficulty concentrating or mood changes may appear.

After age 45, diagnosis is generally based on age, changes in the menstrual cycle and symptoms, rather than on an isolated hormone measurement. Blood tests can nevertheless help assess the wider health picture and investigate other causes, such as iron deficiency, thyroid or metabolic disorders, medication effects or another medical condition.

Why does cardiometabolic monitoring become more important?

During the menopausal transition, the lipid profile, body-fat distribution, blood pressure and insulin sensitivity can all change. Hormones do not explain everything: age, genetics, sleep, physical activity, muscle mass, nutrition and medication also play a role.

Weight may remain stable despite an increase in visceral fat or a reduction in muscle mass. Changes in blood pressure, waist circumference, lipids and glycaemic markers are therefore more informative than any isolated value.

A lipid profile includes total cholesterol, LDL-C, HDL-C and triglycerides; non-HDL cholesterol and ApoB can provide additional detail. Fasting glucose and HbA1c remain the standardised markers for prediabetes and diabetes; fasting insulin and HOMA-IR can complement the assessment of insulin resistance.

What about breast cancer?

Risk increases progressively with age. An annual clinical examination and prompt consultation in the event of any symptoms remain important. High or very high risk requires a personalised screening schedule, sometimes including earlier mammography and MRI.

What is useful to check in your 40s

• Blood pressure, waist circumference, lipid profile and glycaemic markers.

• A complete blood count and ferritin, particularly if periods become heavy or prolonged.

• Thyroid function when symptoms could resemble or exacerbate those of perimenopause.

• Bone health risk in cases of longstanding amenorrhoea, early menopause, low body weight, fracture or medication that affects bone health.

• Breast cancer risk, high-risk HPV testing, and the investigation of any breast symptoms or unusual bleeding.

Your 40s are therefore an active period of prevention: this is the time to strengthen the metabolic, cardiovascular, muscular and bone-health foundations for the decades ahead.

In your 50s: integrate organised screening and long-term risk prevention

Menopause is defined as twelve consecutive months without a period, in the absence of another cause. It occurs at an average age of around 51, although metabolic and bone changes often begin earlier.

In your 50s, breast, cardiovascular, metabolic and bone-health risks become increasingly significant. Organised breast and colorectal cancer screening also begins.

Breast cancer screening from age 50

Nearly 80% of breast cancers diagnosed in France occur after age 50. From ages 50 to 74, asymptomatic women at average risk are invited to have a mammogram and clinical examination every two years.

A genetic predisposition, personal medical history or certain family histories require a different monitoring schedule. Screening can detect some cancers earlier, but it also has limitations: false positives, additional examinations, interval cancers and overdiagnosis.

Prevention is not limited to mammography. Alcohol, smoking, physical inactivity and, after menopause, excess adiposity are among the modifiable factors associated with risk. We will return to these in the second part.

Cardiovascular and metabolic risks

After menopause, blood pressure, LDL-cholesterol, visceral fat and insulin sensitivity may change. Assessment should combine traditional risk factors (smoking, hypertension, diabetes, kidney disease, lipid levels and family history) with pregnancy complications, polyendocrine metabolic ovarian syndrome, certain autoimmune diseases and early menopause.

Menopause before age 45, and especially primary ovarian insufficiency before age 40, alters cardiovascular and bone-health risks and requires specific management.

Bone and muscle

Bone loss accelerates around menopause and remains silent until a fracture occurs. Calcium and vitamin D levels do not provide information about bone density. Bone densitometry measures it, but it is not routinely recommended from age 50: whether it is indicated depends particularly on fractures, early menopause, low body weight or long-term corticosteroid treatment.

Muscle mass contributes to blood-glucose regulation, supports bone health, protects balance and preserves independence. Its assessment is based on strength, physical capacity, activity and, where necessary, body composition.

What is useful to check in your 50s

• Blood pressure, waist circumference, lipid profile, blood glucose, fasting insulin and HbA1c.

• Lp(a) if it has never been measured, as well as kidney and liver function depending on the clinical context.

• Bone-health risk, the potential indication for bone densitometry, strength and physical capacity.

• Mammography every two years between ages 50 and 74 for women at average risk.

• Colorectal cancer screening with a faecal immunochemical test every two years between ages 50 and 74 for people at average risk.

• A high-risk HPV test every five years until age 65.

• An individualised assessment before considering menopausal hormone therapy.

Key takeaways

In your 30s, the priority is to establish the foundations: your cycle, family history, pregnancies and initial cardiometabolic markers.

In your 40s, the focus shifts to monitoring how they evolve: symptoms, blood-test results, and breast, cardiovascular, metabolic and bone-health risks.

In your 50s, organised screening becomes part of a broader preventive approach: breast and colorectal cancers, cardiometabolic, bone and muscle health.

This first part should help you understand what to monitor, which screening tests to check and which questions to ask. In the second, we will look at how to take concrete action on modifiable factors and tailor support to each stage.

To explore this further

In our episode with MiYé Health, we take a deeper look at the metabolic transition around menopause: lipid profile, blood-glucose regulation, muscle mass, protein and daily activity.

Main sources

1. El Khoudary SR et al. Menopause Transition and Cardiovascular Disease Risk. Circulation, 2020.

2. ESC/EAS. Guidelines for the Management of Dyslipidaemias. 2025.

3. Gordon CM et al. Functional Hypothalamic Amenorrhea: Clinical Practice Guideline. JCEM, 2017.

4. French National Authority for Health. Diagnosis of Osteoporosis in Postmenopausal Women.

5. French National Cancer Institute. Epidemiology and screening for breast, cervical and colorectal cancers.

6. International PCOS Network. Evidence-based Guideline for the Assessment and Management of PCOS. 2023.

7. Lumsden MA et al. Clinical Practice Guideline for Menopause and Perimenopause. European Journal of Endocrinology, 2025.

8. Parikh NI et al. Adverse Pregnancy Outcomes and Cardiovascular Disease Risk. Circulation, 2021.

9. Saad M et al. Cardiovascular Disease in Women With Endometriosis: Systematic Review and Meta-analysis. 2025.

10. Teede HJ et al. Polyendocrine Metabolic Ovarian Syndrome: the New Name for PCOS. The Lancet, 2026.

This content is for informational purposes only and does not replace a medical consultation. Tests and their frequency should be adapted to symptoms, medical history, treatments and individual risk level.