What Are NHS Health Checks?

NHS Health Checks are offered every five years to adults aged 40 to 74 who do not already have certain long-term conditions such as diabetes, heart disease, kidney disease, high blood pressure, or are taking a statin.

These checks usually last 20 to 30 minutes and are designed to identify those at increased risk of conditions including stroke, heart disease, and diabetes.

A typical check includes:

• Measuring height, weight, and waist circumference
• A blood pressure test
• A cholesterol test (and sometimes a blood sugar test)

After the check, you’ll receive:

• Scores for alcohol use and physical activity
• Your BMI
• Your blood pressure and cholesterol results
• Your diabetes risk
• Your cardiovascular risk score (using the QRisk2 calculator), which estimates your 10-year risk of developing heart disease. Importantly, QRisk2 does not include established female-specific risk factors such as pre-eclampsia — meaning it will underestimate cardiovascular risk in some women (Nature Medicine, 2024).

The menopause transition is a key time to assess cardiovascular risk, as there are numerous internal metabolic changes that take place, increasing this risk.

Who Delivers Health Checks?

Health checks are usually delivered by a Healthcare Assistant (HCA), although sometimes by a Practice Nurse or Pharmacist. Training is provided through e-learning. Many of the health care professionals carrying out health checks will not have had specific menopause training.

Not all GP practices offer health checks directly — in some areas, local councils or community settings may deliver them. There have also been workplace and digital pilot schemes.

Currently, uptake averages just over 50%, though recent figures (Q1 2025/26) show only 33% of those invited attended. Those who attend tend to be older and more often women, with similar ethnic and socioeconomic backgrounds to non-attenders (BMJ Open, 2020).

Why Include Menopause?

The move to ask about menopause in NHS Health Checks is of course positive. I welcome any opportunity to talk menopause! Menopause can affect many aspects of health, including cardiovascular risk. Yet it is still too often under-recognised and under-discussed in routine healthcare.

By including menopause questions, we can:

• Normalise conversations about hormonal health
• Identify those experiencing symptoms who may need support
• Identify those with premature ovarian insufficiency (POI), which carries significant long-term health implications if not diagnosed and treated

So this change could also help clinicians consider hormonal health in context with other risk factors — providing more holistic, personalised care.

But there are potential concerns.

There has been no clear commitment to additional training, extra time, or increased resources for the staff delivering these checks. These appointments are already time-pressured. Without proper support, there is a real risk of this becoming a tick-box exercise, failing to identify those with less recognised symptoms or those with premature ovarian insufficiency (POI).

We must also remember that not all women will be invited for an NHS Health Check, including those already living with high blood pressure, and those who cannot attend due to caring responsibilities. Everyone deserves the same proactive, thoughtful conversations about menopause — yet menopause questions are not currently proposed for other routine checks, such as hypertension reviews or carers’ health checks.

Beyond the Health Check: A Cultural Shift

Over the last few years, I’ve been leading a women’s health education programme for primary care clinicians across Bristol, North Somerset and South Gloucestershire— running sessions for GPs, pharmacists, practice nurses, and non-medical colleagues like social prescribers covering menopause, PMDD, endometriosis, menstrual health and more.

What’s become clear is that we need a broader cultural shift.
We should be asking about the menstrual cycle as routinely as we ask about anything else, and as often as we check blood pressure — at GP appointments, during screening programmes, and in public health initiatives.

Without this, too many people will continue to experience unrecognised hormonal issues, with potential lasting impacts on their long-term health.

Final Thoughts

Including menopause in NHS Health Checks is a welcome step forward — but it should be just the beginning.

Let’s use this as a springboard to build better awareness, better conversations, and better training across the healthcare system.
Because when we talk openly about hormones, we improve health outcomes for everyone.

Resources

NHS tool – calculate your heart age

British Heart Foundation – Bias and biology