Women's Health Blood Tests Guide

Women’s health blood tests at a glance

From puberty to menopause, women have distinct testing needs — timed hormones, iron and nutrition, and age-based screening. This table compiles the key tests; the schedule section shows when each is done.

Hormone tests important for women

Tests for iron and nutritional status (high risk in women)

Menopause blood tests

Menopause is clinically diagnosed after 12 consecutive months without a period in women over 45. Blood tests are not always needed for diagnosis but can be helpful in: women under 45 (premature ovarian insufficiency, POI), women with a uterus who have had irregular periods, and women on hormonal contraception masking periods.

Women's cancer screening blood tests

Recommended blood test schedule for women

Questions to ask your doctor

• Is my FSH result consistent with my reproductive status?
• Should I have an AMH test to check my egg reserve?
• Is my thyroid causing my irregular periods?
• Am I iron deficient despite a normal haemoglobin?
• When should I start bone density monitoring?

Cervical screening, what the HPV test detects and why it changed

England switched from cytology-based cervical screening (looking at cells directly under the microscope) to primary HPV testing in 2019.² The change reflects the biology of cervical cancer: virtually all cases (99.7%) are caused by persistent infection with high-risk strains of human papillomavirus (HPV), particularly HPV 16 and 18. HPV testing detects the cause, not the consequence. It is more sensitive than cytology, detecting pre-cancerous cell changes earlier, while maintaining specificity through the reflex cytology step (cells are only examined under the microscope if HPV is detected).

Current NHS schedule: HPV test every 5 years for women aged 25–64. The test is performed from a cervical sample collected during the same appointment as the previous smear test (the sample collection procedure is identical). A negative HPV result is highly reassuring, lifetime risk of developing cervical cancer with a consistently negative HPV test is near zero. A positive high-risk HPV result with normal cytology triggers repeat testing in 12 months; positive HPV with abnormal cytology triggers colposcopy referral.

BRCA testing, who should be tested and what to expect

BRCA1 and BRCA2 are tumour suppressor genes. Pathogenic variants (harmful mutations) are found in approximately 1 in 400–500 women in the general population, rising to 1 in 40 in the Ashkenazi Jewish population (three founder mutations account for most cases). Lifetime breast cancer risk with BRCA1 mutation: approximately 72%; with BRCA2: approximately 69%, compared with a population lifetime risk of approximately 12%. Ovarian cancer risk: BRCA1 approximately 44%; BRCA2 approximately 17%.³

NICE (DG27) recommends genetic testing for women with a personal or family history suggesting high BRCA probability, calculated using the Manchester Scoring System or similar risk tools. A score suggesting more than 10% probability of a BRCA variant warrants referral to a cancer genetics service. Testing requires genetic counselling before and after the result. Women who test positive can choose between enhanced screening (annual breast MRI from age 30), risk-reducing surgery (bilateral mastectomy reducing risk by 95%; bilateral salpingo-oophorectomy reducing ovarian cancer risk by 85–90%), and chemoprevention (tamoxifen or anastrozole, reduces breast cancer risk by approximately 30% in high-risk women).

Bone density and the DXA scan

Women lose bone density rapidly in the first 3–5 years after menopause (approximately 1–3% per year during this phase, compared with 0.3–0.5% per year in premenopausal women). The WHO defines osteoporosis as a T-score below −2.5 standard deviations from the mean peak bone density of a young adult woman at the hip or spine on DXA (dual-energy X-ray absorptiometry). Osteopenia is a T-score between −1 and −2.5. NICE recommends DXA scanning for postmenopausal women with: fragility fracture (fracture from low-energy trauma), prolonged steroid use (above 7.5 mg prednisolone per day for more than 3 months), early menopause, other specific risk factors. The FRAX tool (fracture risk assessment) estimates 10-year fracture probability, guiding bisphosphonate prescribing decisions.

Women’s health testing myths vs facts

What matters most in women’s health testing

• Time every hormone test. Cycle day on the request form is as important as the test itself; wrong-day results mislead.
• Check ferritin, not just haemoglobin. Iron deficiency is the nutritional gap most worth checking in women, and ferritin catches it early.
• Follow the screening schedule. Cervical screening now uses primary HPV testing every 5 years (ages 25–64 in the NHS); mammography from 40–45; BRCA testing only for qualifying family-history patterns.
• Protect bone early. DXA for women over 65 (earlier with risk factors); rapid bone loss starts in the first years after menopause.

Practical notes

Note where you are in your cycle before any hormone blood test. FSH, LH, oestradiol and progesterone are all cycle-day dependent — progesterone, for example, is usually checked about a week after ovulation — so tell the clinic your last period date and ask which day they want the draw. A hormone result without its cycle day is hard to interpret.

Bring your screening history, not just your symptoms. Dates of previous smears, HPV tests, mammograms and bone density scans let the clinician see whether you're due, overdue, or fine until the next round. If you've moved cities or changed doctors, these dates are the single most useful thing you can carry in.

Read screening results as risk information, not verdicts. An HPV-positive result means the virus was found, not that cancer is present — most infections clear on their own, which is why the result leads to surveillance or triage rather than alarm. Bone density T-scores describe fracture risk relative to young adult bone, not a fracture that has happened.

Ask about your personal interval. Standard screening schedules assume average risk; a strong family history of breast or ovarian cancer, for instance, can bring mammograms or genetic counselling forward. If anything in your family history has changed, say so — screening plans should be revisited, not just repeated.

In India

A mammogram at a large Indian diagnostic centre typically costs around ₹1,500–₹3,500 and a DXA bone density scan around ₹1,500–₹3,000 — though prices vary by city and lab — while Pap smears and HPV tests typically range from a few hundred to a few thousand rupees.

Most large labs are NABL-accredited, and home sample collection in major cities covers the blood-based tests. For imaging like mammograms and DXA scans, choose a centre with a female technician if that matters to your comfort — most large centres offer this on request. The reference range printed on your own report is the one that counts.

Frequently Asked Questions

References

Sources cited on this page. PubMed links open the original abstract.

1. American College of Obstetricians and Gynecologists. Well-woman visit. Obstet Gynecol. 2018;132(4):e181–e186. PMID 30247356 · doi:10.1097/AOG.0000000000002897
2. US Preventive Services Task Force. "Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement." JAMA. 2018;320(7):674–686. PMID 30140884 · doi:10.1001/jama.2018.10897
3. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA. 2017;317(23):2402–2416. PMID 28632866 · doi:10.1001/jama.2017.7112