Postmenopause health check
A bone, heart and metabolic baseline for the decades after menopause. Twelve markers in one fasting blood draw, explained by a doctor, with a referral pathway to a DEXA bone density scan if your results and risk factors point that way.
The postmenopause health check is for women who have passed menopause and want a proper baseline on the three areas that change most in the years after: bone, heart and metabolism. It costs $219 with your own doctor's request, or $299 with a KnowLuna doctor who requests it and explains the results in a 20-minute video consult.
What it measures
- Calcium: the mineral that bone is built from, kept within a narrow blood range by the parathyroid glands.
- Phosphate: calcium's partner mineral, read alongside it and with kidney function.
- Vitamin D (25-OH): needed to absorb calcium from food. Low levels are common in Australian women.
- Parathyroid hormone: the hormone that regulates calcium. It is normally a second-line test read against calcium, and it is included here so that any calcium abnormality can be interpreted straight away rather than needing a second collection.
- Lipid profile: total, LDL and HDL cholesterol plus triglycerides, the core of the heart-risk picture.
- HbA1c: a three-month average of blood sugar.
- Fasting glucose: your blood sugar on the morning of the test, read with HbA1c.
- Kidney function: creatinine and eGFR, a filter check that also matters for bone chemistry.
- Liver function: enzymes and proteins that reflect general health.
- TSH: the screening marker for thyroid function, which affects bone, heart and energy.
- Full blood count: red cells, white cells and platelets.
- Iron studies: ferritin and related markers, since iron stores can be low or high after menopause.
Who it's for
Women aged 18 and over who are postmenopause (usually twelve months or more since a last period, or after surgical menopause) and want a baseline on bone, heart and metabolic health. It suits women who have never had these markers checked together, and women with a family history of osteoporosis, heart disease or diabetes who want to know where they stand.
What you'll learn, and what you won't
You will get a plain-English read on your calcium and bone chemistry, vitamin D, cholesterol and blood sugar, and the kidney, liver, thyroid, blood count and iron results that round out the picture. Your doctor will explain what sits where it should, what needs watching, and whether a bone density scan is worth arranging.
What a blood test cannot do is measure your bone density. Calcium and vitamin D can be normal while bone is thinning, which is why the DEXA pathway exists. It also cannot see inside your arteries. A blood test is one input to a doctor's assessment, not a diagnosis on its own. If anything needs prompt attention, a doctor contacts you directly.
Why bone, heart and metabolic risk change after menopause
Oestrogen protects bone by slowing the cells that break it down. When oestrogen falls at menopause, bone loss speeds up, most noticeably in the first few years, and continues more slowly after that. This is why osteoporosis is far more common in women than in men, and why bone health becomes a routine part of care from the fifties onward.
Oestrogen also has favourable effects on blood vessels and cholesterol. After menopause, LDL cholesterol tends to rise, blood pressure often creeps up, and the gap in heart disease risk between women and men narrows. Blood sugar and weight distribution shift too, with more fat stored around the middle, which raises the chance of insulin resistance and type 2 diabetes. None of this is inevitable for any one woman, which is exactly why a baseline is useful.
Reference ranges and what they mean
| Marker | Typical adult range | What it usually means |
|---|---|---|
| Calcium (adjusted) | About 2.10 to 2.60 mmol/L | High or low calcium is read with parathyroid hormone and vitamin D to find the reason. |
| Phosphate | About 0.75 to 1.50 mmol/L | Interpreted with calcium and kidney function. |
| Vitamin D (25-OH) | 50 nmol/L or above at the end of winter is sufficient (60 to 70 at the end of summer) | Below 50 nmol/L is deficiency, graded by how far below: 30 to 49 mild, 12.5 to 29 moderate, and below 12.5 severe. Your doctor decides what follow-up is needed. |
| Parathyroid hormone | Lab-specific, because the interval depends on the assay | Raised with a high calcium, or raised with a low calcium, point to different causes. It is drawn in the same fasting morning sample as your calcium. |
| Total cholesterol | Under about 5.5 mmol/L is the common laboratory flag, not a target | Cholesterol is read as part of overall cardiovascular risk (Australian CVD risk guideline 2023), not against a single cut-off, and your doctor sets your own LDL target from that risk. |
| Triglycerides | Under about 2.0 mmol/L (fasting) | Higher values are linked to metabolic risk and are read with HDL. |
| HbA1c | Under 6.0% | 6.0 to 6.4% is a flag for follow-up; 6.5% or above is in the diabetes range. |
| Fasting glucose | About 3.0 to 5.4 mmol/L, which is a laboratory interval rather than a clinical threshold | 5.5 to 6.9 mmol/L prompts a further test, an HbA1c or a glucose tolerance test arranged through your doctor. Within that, 6.1 to 6.9 mmol/L is impaired fasting glucose. 7.0 or above is in the diabetes range and is repeated to confirm. |
| eGFR (kidney) | 90 or above | Chronic kidney disease is an eGFR below 60 for more than three months, or signs of kidney damage such as protein in the urine for more than three months. This panel does not include a urine test, so a normal eGFR here cannot rule it out. |
| TSH | About 0.4 to 4.0 mIU/L | Above the range suggests an underactive thyroid; below suggests overactive. |
| Ferritin | Lower limit about 30 ug/L | Low ferritin means depleted iron stores. High ferritin has several causes and is followed up. |
Ranges vary by laboratory; your report shows the range your lab uses. Typical ranges on this page are drawn from Pathology Tests Explained (RCPA) and the sources listed below.
DEXA scan: what it is and how the referral works
A DEXA (dual-energy X-ray absorptiometry) scan is a low-dose X-ray that measures bone mineral density, usually at the hip and spine. It is the standard test for osteoporosis and takes about 15 minutes. The result is reported as a T-score comparing your bone density with a young adult reference.
In Australia a DEXA scan needs a doctor's referral. Medicare covers the scan in specific circumstances, for example from age 70, after certain fractures, or with particular conditions and medicines, including early menopause or premature ovarian insufficiency; outside those, it is a self-paid scan and prices vary by provider. If your results or risk factors suggest a scan is worthwhile, the KnowLuna doctor can write the referral in your consult, or you can take your report to your own GP. The scan itself is done at a radiology practice, not at KnowLuna.
When to do this test
- Fasting: yes, 8 to 12 hours. Water is fine. This is for the glucose and lipid results.
- Morning collection so the fast is manageable and results are comparable next time.
- Supplements: if you take calcium or vitamin D, note it on your questionnaire so the doctor reads the result in context. Do not stop anything your doctor has prescribed.
- Timing: any day. There is no cycle timing after menopause.
How it works
- Order online. Either upload the request your own doctor has signed, or a KnowLuna women's health doctor reviews your questionnaire and requests the panel.
- Collect at an accredited (NATA) centre near you, fasting, in the morning, or choose a home kit or a nurse visit (options below). One blood draw covers all twelve markers.
- Results are usually ready within a few business days, explained in your account, with the doctor consult to talk them through and arrange a DEXA referral if appropriate.
Choose how you collect
Every option is the same accredited test and the same report. Pick what suits you at checkout; the fee, if any, is added to either pathway price.
A quick draw at an accredited pathology collection centre near you. Usually under ten minutes. Included.
Lancet kit posted to you with an Express return satchel. If the lab cannot test your sample we send a replacement kit at no charge.
A near-painless device draws a small sample from the upper arm, with far fewer failed samples than a finger-prick. Express return satchel included.
A registered nurse comes to your home or workplace for a standard blood draw. Metro areas of capital cities; other locations on request.
Common questions
What blood tests should women have after menopause?
A sensible baseline covers bone chemistry (calcium, phosphate, vitamin D and parathyroid hormone), heart and metabolic markers (lipids, HbA1c and fasting glucose), and general health (kidney, liver, thyroid, blood count and iron). That is what this panel includes. Your doctor decides what to add or repeat based on your history.
What is a normal calcium level?
Most Australian laboratories report adjusted calcium between about 2.10 and 2.60 mmol/L for adults. The exact range depends on the lab and the method, so your report shows the range that applies. A result outside it is interpreted with parathyroid hormone and vitamin D rather than on its own.
Why is parathyroid hormone tested with calcium?
Because the two move together. Parathyroid hormone raises blood calcium when it is low and falls when calcium is high. Seeing both tells your doctor whether the parathyroid glands are responding normally or driving an abnormal calcium. Either result alone can be misleading.
How do I get a bone density scan in Australia?
You need a doctor's referral to a radiology practice that offers DEXA. Medicare covers the scan in defined situations, such as age 70 and over, after certain fractures, or with conditions including early menopause or premature ovarian insufficiency; otherwise you pay for it and prices vary. If your results suggest a scan, the KnowLuna doctor can refer you, or your GP can.
How often should this check be repeated?
Your doctor decides based on your results and risk factors, and sets the interval from your risk rather than a fixed rule. For many women that means repeating cholesterol and blood sugar every few years rather than every year, with bone density on the interval your doctor sets after the first scan. Use the first check as your baseline.
Sources and further reading
- Pathology Tests Explained (RCPA): lipid profile
- Pathology Tests Explained (RCPA): HbA1c
- Pathology Tests Explained (RCPA): calcium
- Pathology Tests Explained (RCPA): parathyroid hormone (PTH)
- Medical Journal of Australia: Vitamin D and health in adults in Australia and New Zealand, position statement (2012)
- Australian guideline for assessing and managing cardiovascular disease risk (2023)
- Jean Hailes for Women's Health: bone health
- Healthdirect: post-menopause
General information only, not medical advice. A test result is one input to a doctor's assessment, not a diagnosis on its own, and every abnormal result is followed up by a KnowLuna doctor. If your symptoms are severe or sudden, see a doctor promptly. Read our medical disclaimer.
Related
- Postmenopause and beyond tests: the stage hub.
- Vitamin D test: the single test if that is all you need.
- Thyroid panel: the full thyroid picture beyond TSH.
- Iron studies: ferritin and iron on their own.
- Vitamin D deficiency in women: symptoms, the blood test and Australian targets
deserve a baseline.