You have turned 45, your periods are changing, and someone has suggested a "full-body checkup". Which parts of a health checkup after 45 actually matter, and how often? Many people search this as "45 ke baad kaun se test".
It is written mainly for women around and after menopause, when bone and heart risks rise, but most of it applies to every adult over 45, men included. For menopause itself, read our guide to menopause in India: symptoms, age, tests and care.
Why checks matter more after 45 in India
What these checks look for usually causes no symptoms. National Health Service (NHS) notes that high blood pressure and high cholesterol have none, and the Indian Menopause Society calls osteoporosis "a silent disease, often undetected until a fracture occurs".
The society's 2026 guideline says heart and metabolic risks speed up around the final period, which comes at 46.6 years on average in India. About one in five Indian adults aged 45 or over has diabetes, and 43% of them do not know it. Hence its "Start at 35": awareness from 35, universal screening from 40.
Free screening under India's national programme
India's National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) screens every man and woman aged 30 or over for five conditions: high blood pressure, diabetes, and cancers of the mouth, breast and cervix (the neck of the womb). Your accredited social health activist (ASHA) worker fills a short risk checklist with you and invites you to your nearest sub-centre, Ayushman Arogya Mandir or primary health centre.
Blood pressure and sugar are checked once a year; mouth, breast and cervical screening once every five years, from 30 to 65. A camp result is not a diagnosis: a finger-prick sugar of 140 mg/dl or more makes you a suspected case who needs further tests, and a positive cancer screen means referral for confirmation.
Health checkup after 45: the checklist
These are starting points for adults without a known condition. If a result is borderline, or you have diabetes, heart or kidney disease, your doctor will set a different schedule.
| Check | Who and how often | What the number means | Who says so |
|---|---|---|---|
| Blood pressure | Adults 30+, yearly | 140/90 or more on two occasions is high blood pressure | NP-NCD; US Preventive Services Task Force (USPSTF): yearly from 40 |
| Fasting sugar or HbA1c | Adults over 30; every 3 years if normal, yearly with prediabetes | Diabetes: fasting 126 mg/dl or more, or HbA1c 6.5% or more, confirmed by a second test | Indian Council of Medical Research (ICMR), 2018; Indian Menopause Society (IMS) |
| Lipid profile | Women over 35 | Desirable: low-density lipoprotein (LDL) under 130 (lower at higher risk), triglycerides under 150, high-density lipoprotein (HDL) over 50 mg/dl | IMS; NHS: every 5 years at 40–74 |
| Bone density (dual-energy X-ray absorptiometry, DEXA) | Women over 5 years past menopause; sooner with risk factors | T-score −2.5 or lower is osteoporosis; read with fracture risk | IMS; USPSTF: 65+, or younger at risk |
| Cervical screening | Women 30–65, VIA every 5 years; after 50, Pap every 3 years or human papillomavirus (HPV) test | A positive result needs a follow-up examination | NP-NCD; IMS |
| Breast | Clinical exam every 5 years at 30–65; mammogram every 2–3 years after a risk discussion | Findings are confirmed by ultrasound or biopsy | NP-NCD; IMS; USPSTF: every 2 years at 40–74 |
| Mouth | Men and women 30–65, every 5 years | A non-healing ulcer or coloured patch needs referral | NP-NCD |
| Eyes | Every 2–3 years after 40; yearly with diabetes or high blood pressure | Vision, glasses, back of the eye | IMS; Indian Council of Medical Research (ICMR) |
| Haemoglobin | At a menopause check-up, then periodically after 40 | Low means anaemia; the cause needs finding | IMS |
| Thyroid-stimulating hormone (TSH) | In the IMS midlife check, especially with symptoms | A result outside the lab range needs a doctor’s review | IMS; USPSTF: too little evidence without symptoms |
| Vitamin D | Only if at risk | Read with your bone health | IMS |
Blood pressure, sugar and cholesterol
Blood pressure
The USPSTF advises confirming a high camp or pharmacy reading outside the clinic before treatment. The Indian Menopause Society encourages midlife women to aim for under 120/80 through food, activity and weight.
Blood sugar
A fasting sugar or an HbA1c (a three-month average) both work for screening, though ICMR's 2018 guideline notes HbA1c has some limitations in India. ICMR advises screening earlier with a family history, high blood pressure, a body mass index (BMI) of 23 or more, or a waist above 80 cm for women or 90 cm for men.
Indian guidelines disagree on prediabetes. ICMR and the national programme follow World Health Organization (WHO): a fasting sugar of 110–125 mg/dl is impaired fasting glucose. The Indian Menopause Society uses the American Diabetes Association's cut-offs: 100–125 mg/dl, or an HbA1c of 5.7–6.4%. So a fasting 104 is normal by one Indian guideline and prediabetes by another. Our reading: treat 100–109 as an early warning, a moment to work on food and activity and ask your doctor when to retest. The diabetes guide: symptoms, tests, treatment and everyday management explains the tests.
Lipid profile
A lipid profile measures LDL ("bad") and HDL ("good") cholesterol and triglycerides. There is no single "normal" LDL: the right level depends on your overall heart risk, which the society suggests estimating with Globorisk-India, a calculator built for Indians. We found no Indian repeat interval for a normal result; the NHS Health Check in the UK tests cholesterol every 5 years from 40 to 74.
Bone density scan (DEXA): when and how often
A DEXA (also dual-energy X-ray absorptiometry, DXA) scan is a low-dose X-ray of the hip and spine that finds osteoporosis before a fracture does. Indian and US guidance differ on timing. The Indian Menopause Society recommends it for all women more than five years past menopause; sooner for those with risk factors; and for anyone with a fragility fracture (a break from a minor fall) or a condition or medicine that causes bone loss. The USPSTF starts at 65, or earlier for postmenopausal women at higher risk.
With menopause at 46.6 on average, many Indian women would be due in their early 50s (our estimate from averages). Because hip fractures occur about a decade earlier in India, we suggest following the Indian guideline.
The society calls DEXA screening of the whole population not cost-effective in India. Doctors may first use Osteoporosis Self-Assessment Tool for Asians (OSTA), a score from age and weight, or Fracture Risk Assessment Tool (FRAX), a 10-year fracture risk; the society warns that the Indian FRAX model, built on a small North Indian group, likely underestimates risk. How often to repeat depends on your result. For food that supports bone, see menopause diet: calcium, protein and bone health with Indian food.
Cervical, breast and mouth cancer screening
Cervix: ask for a Pap or HPV test after 50
The national programme uses VIA (visual inspection with acetic acid, a vinegar test done during an examination). After menopause, VIA becomes less accurate, because the area where cervical cancer starts moves inside the cervical canal. The Indian Menopause Society says VIA is generally not recommended over 50 and suggests a Pap test every 3 years, or HPV testing where available.
If you have not been screened in 3–5 years, it says get screened now; never-screened women should be screened even after 65 if in good health. By its figures, screening coverage in India is only about 2%. The USPSTF adds that women whose cervix was removed at hysterectomy, with no history of pre-cancer, do not need screening.
Breast
Indian women are diagnosed with breast cancer nearly a decade earlier than Western women, at 49–53 years on average, the society notes. On mammography, guidance differs: the USPSTF recommends one every two years from 40 to 74, while the Indian Menopause Society calls mammography for everyone not yet practical in India and advises selective mammography every 2–3 years after a discussion of your own risk, plus knowing how your breasts normally look and feel. Over 45, we suggest having that discussion, especially if a close relative had breast or ovarian cancer.
Mouth, bowel and ovary
The oral examination matters most if you use tobacco in any form. The Indian Menopause Society lists a stool test for hidden blood among its midlife checks, and the USPSTF recommends bowel cancer screening from 45 to 75; India's programme does not include it, so ask your doctor. For ovarian cancer, the USPSTF recommends against screening women without symptoms or an inherited high-risk syndrome: tests such as cancer antigen 125 (CA-125) cause false alarms that can lead to unnecessary surgery.
Thyroid, vitamin D, B12, eyes, teeth and vaccines
- Thyroid. The Indian Menopause Society includes TSH in its midlife check on weaker (grade C) evidence, most of all with symptoms, autoimmune disease, high cholesterol, obesity or early menopause. The USPSTF found too little evidence to screen adults without symptoms. Our reading: a TSH at a menopause check-up, or when symptoms overlap, is reasonable; ask whether to repeat it. See TSH normal range, triiodothyronine (T3) and thyroxine (T4): how to read your thyroid report.
- Haemoglobin and B12. The society recommends checking for anaemia and its nutritional causes, such as low iron, B12 or folate. Your doctor picks the follow-up tests.
- Vitamin D. The society does not recommend routine testing of the general population, only of people at risk: osteoporosis, a fragility fracture, poor absorption, kidney or liver disease, obesity or little sun.
- Eyes. The society also advises a yearly eye examination with long-term steroids or hormone therapy. With type 2 diabetes, ICMR advises a retina check every year.
- Teeth, hearing and vaccines. Gum disease and tooth loss increase after menopause; the society includes routine oral and hearing checks, and adult vaccination following the Association of Physicians of India's schedule. Ask which vaccines you are due for.
Full-body packages: more tests are not always better
In our view, many "full-body" packages sold in India include tests without a clear reason, such as vitamin D for everyone (which the Indian Menopause Society advises against) or CA-125 without symptoms (which the USPSTF advises against), yet miss cervical screening, a breast examination, a timely bone scan and an eye check. The society says investigations should be individualised to your history and examination.
Before any test, ask: why this test for me, and what will we do with the result? Keep old reports in one file so each result can be compared with the last. A normal result is a snapshot, not a guarantee, so new symptoms still need a doctor.
When to see a doctor
The hub has the full list of when to see a doctor.
Emergency: get help now
- Chest pain that feels tight or crushing, or spreads to your arm, neck or jaw, especially with breathlessness, sweating or nausea.
- Signs of stroke: loss of balance, sudden vision trouble, a drooping face, arm weakness or slurred speech. Act fast; call 112.
- After a minor fall, severe hip or groin pain and you cannot put weight on the leg.
Prompt review: within days
- A repeat blood pressure reading of 160/100 or higher; the national protocol starts treatment the same day at this level.
- A sugar reading of 200 mg/dl or more with thirst, frequent urination, weight loss or tiredness.
- A breast lump or new breast or nipple change; a mouth ulcer that does not heal.
- Any bleeding or spotting 12 months or more after your last period; a broken bone from a minor fall.
- Any positive or abnormal screening result (VIA, Pap, HPV test or mammogram). Do not skip the follow-up.
Routine review
Book a visit if you are over 45 and are behind on the checks above, more than five years past menopause without a bone-scan discussion, or more than 3–5 years since your last cervical screening.
How Disha can help
Disha is an AI health coach that chats and calls in Hindi, English and Hinglish; it does not replace your doctor. Its onboarding call of about 15–20 minutes is conducted by Disha, the AI, with no human doctor or dietitian on the call. It can help you build the food, movement and sleep habits behind healthier numbers. It does not diagnose, order or interpret tests, prescribe, or provide emergency care. See how Disha coaching works.
This is not medical advice. This page is general education for adults (18+), not a diagnosis or a personal testing plan. Do not start, stop or change any medicine, supplement or hormone therapy because of a result or this page. Pregnancy is still possible in perimenopause; if you are pregnant, could be, or are breastfeeding, tell the person doing any scan or test. In an emergency, call 112.
Frequently asked questions
Which tests should I get after 45?
Most adults over 45 need a yearly blood pressure check, a fasting sugar or HbA1c test, and a lipid profile, plus eye and mouth checks. Women also need cervical screening, a breast examination and, about five years after menopause or sooner with risk factors, a bone density scan. Thyroid, vitamin D and other tests depend on your symptoms and risks, so ask your doctor.
How often should I get a full body checkup after 45?
There is no guideline for a yearly "full-body" package. Blood pressure is checked yearly, and sugar every 1–3 years depending on your last result. Cervical, breast and mouth screening under India's national programme is every five years. Other tests are done when there is a reason. Many packages include tests no guideline asks for in healthy adults, so ask why each test is needed.
When should a woman get a bone density (DEXA) test in India?
The Indian Menopause Society recommends a DEXA scan for all women more than five years past menopause, and sooner for women with risk factors, a fracture from a minor fall, or medicines or conditions that cause bone loss. The US task force starts at 65 for most women. Because Indian women reach menopause earlier and break hips about a decade earlier, the Indian timing makes more sense here.
Is a fasting sugar of 100 to 125 prediabetes?
It depends on the guideline. ICMR and India's national programme use WHO's cut-off, so impaired fasting glucose starts at 110 mg/dl. The Indian Menopause Society and the American Diabetes Association start at 100. Either way, 126 or more on two tests is diabetes. A reading of 100–109 is worth treating as an early warning: improve food and activity and ask your doctor when to retest.
Do I still need a Pap smear after menopause?
Yes, in most cases. The Indian Menopause Society recommends regular cervical screening through and after menopause, and says VIA, the vinegar test used in many camps, is less accurate after 50. It suggests a Pap test every 3 years or an HPV test. If you have never been screened, get screened even after 65. After a hysterectomy that removed the cervix, ask your doctor.
Should I get a mammogram after 45 in India?
Discuss it with your doctor. The US task force recommends a mammogram every two years from 40 to 74. The Indian Menopause Society advises selective mammography every 2–3 years after assessing your own risk, alongside clinical breast examination and knowing how your breasts normally feel. A family history of breast or ovarian cancer makes the discussion more important. Get any lump checked promptly, whatever your last result.
Do men over 45 need the same checks?
Most of them, yes. India's national programme screens men over 30 for blood pressure, diabetes and mouth cancer, and cholesterol, eye and dental checks apply to men too. Cervical and breast screening and the menopause-based bone scan timing are for women. The US task force found too little evidence to recommend routine bone scans for men, so men should ask their doctor if they have risk factors.
Sources
- Ministry of Health and Family Welfare, Government of India. National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD): Operational Guidelines 2023–2030 and National Health Mission, NP-NCD Training Module for Medical Officers. Accessed September 2026. Supports: population-based screening of adults 30+ for hypertension, diabetes and oral, breast and cervical cancer; ASHA risk checklist; yearly blood pressure and sugar screening and five-yearly cancer screening; VIA, clinical breast and oral examination every five years at 30–65; hypertension at 140/90 on two occasions; suspected diabetes at a strip reading of 140 mg/dl; impaired fasting glucose at 110–125 mg/dl; same-day treatment at 160/100; oral and breast warning signs; stroke warning signs.
- Meeta M, Anuradha M, Ashraf AB, Aggarwal K, Digumarti L, Singh T. Clinical Practice Guidelines for Menopause: An Executive Summary and Recommendations: Indian Menopause Society 2026. Journal of Mid-life Health, 2026. Supports: average menopause at 46.6 years; risks accelerating around the final period; "Start at 35" and screening from 40; diabetes in one in five adults 45+ with 43% undiagnosed; diabetes screening, prediabetes at 100–125 mg/dl or HbA1c 5.7–6.4% and retesting; lipid profile over 35, desirable lipid levels and Globorisk-India; blood pressure under 120/80; osteoporosis as silent; hip fractures about a decade earlier in India and how a hip fracture presents; DXA indications; DXA screening for all not cost-effective; OSTA and FRAX, Indian FRAX limits; later diagnosis of breast cancer in the West, selective mammography, clinical breast examination; VIA after 50, Pap and HPV testing, screening coverage of 2%, never-screened women; stool test for hidden blood; TSH screening (grade C); anaemia and its nutritional causes; no routine vitamin D testing; eye, oral and hearing checks; adult vaccination; individualised investigations.
- Indian Council of Medical Research. ICMR Guidelines for Management of Type 2 Diabetes. 2018. Supports: screening all adults over 30; earlier screening with family history, BMI 23 or more, waist over 80 cm (women) or 90 cm (men) or high blood pressure; fasting glucose or HbA1c with Indian limitations; retesting after 3 years if normal and yearly with prediabetes; diagnostic thresholds and confirmation; WHO and ADA prediabetes cut-offs; yearly retina examination in type 2 diabetes.
- US Preventive Services Task Force. Osteoporosis to Prevent Fractures: Screening (2025), Hypertension in Adults: Screening (2021) and Thyroid Dysfunction: Screening (2015). Supports: osteoporosis screening at 65+ and in younger postmenopausal women at increased risk; insufficient evidence for men; yearly blood pressure screening from 40 and confirmation outside the clinic; insufficient evidence for thyroid screening in adults without symptoms.
- US Preventive Services Task Force. Breast Cancer: Screening (2024), Cervical Cancer: Screening (2018), Colorectal Cancer: Screening (2021) and Ovarian Cancer: Screening (2018). Supports: mammography every two years at 40–74; no cervical screening after hysterectomy with removal of the cervix and no high-grade history; colorectal screening at 45–75; recommendation against ovarian cancer screening in women without symptoms, with false positives leading to unnecessary surgery.
- NHS. NHS Health Check (last reviewed 2023) and Heart attack (last reviewed 2026). Current patient guidance. Supports: check-up every 5 years for adults aged 40–74 without heart disease, including blood pressure and cholesterol; high blood pressure and high cholesterol have no symptoms; chest pain that feels tight or crushing or spreads to the arm, neck or jaw, with breathlessness, sweating or nausea, as emergency signs.
Related reads
- Menopause in India: symptoms, age, tests and care: the full overview. Its diagnosis section covers tests that confirm menopause; this page covers the routine checks that follow.
- Perimenopause symptoms in your 40s: what is normal and what needs a doctor: which symptoms are expected and which bleeding or mood changes need a doctor.
- Menopause diet: calcium, protein and bone health with Indian food: food for bones and heart to go with your checks.
- All menopause articles: every Disha guide on perimenopause and menopause.
- Diabetes: symptoms, tests, treatment and everyday management: more on sugar tests and what to do after a high result.
- BMI calculator with Indian cut-offs: a quick screening number; a BMI of 23 or more is one reason ICMR suggests earlier sugar checks.
