Genetic testing for women: what your DNA can and can’t tell you

By Shweta Arora, MD, board-certified physician · Medically reviewed by Robin Arora, MD · Updated October 2026

At-home DNA kits and “personalized” gene panels promise a custom plan for your hormones, diet and supplements. The genetics that matter most for women in midlife are more specific, and they usually start with a conversation about your family.

Your family history is still your most useful “genetic test”

Before any kit, ask your relatives:

• Who had cancer, which kind, and at what age? Breast, ovarian, uterine, colon and pancreatic cancers matter most here.
• Who had a heart attack or stroke at a young age?
• Who had a blood clot in a leg or lung?

Write the answers down and bring them to your visit. They guide which tests, if any, make sense.

Hereditary cancer genes: BRCA and Lynch syndrome

• BRCA1 and BRCA2. According to the National Cancer Institute, more than 60% of women with a harmful BRCA1 or BRCA2 change will develop breast cancer in their lifetime, compared with about 13% of women overall. Ovarian cancer risk rises too.
• Lynch syndrome raises the risk of colon, uterine and other cancers. About 1 in 279 people in the U.S. carry a Lynch-related gene change.

The U.S. Preventive Services Task Force recommends that women with a personal or family history, or ancestry linked to BRCA changes, have a brief risk assessment and, if it’s positive, genetic counseling and possibly testing. Routine BRCA testing isn’t recommended for women without those risk features.

Heart risk written in your genes

• Lipoprotein(a), or Lp(a). About 1 in 5 people have high Lp(a). It’s mostly inherited, diet and exercise don’t lower it, and it isn’t part of a standard cholesterol panel. The American Heart Association recommends that every adult be tested at least once.
• Familial hypercholesterolemia affects about 1 in 311 people, according to the CDC. It causes very high LDL cholesterol from a young age, and without treatment about 30% of women with it have a heart attack by 60.

For the rest of your heart numbers, see midlife weight gain & heart health.

Clotting risk and menopause hormone therapy

Factor V Leiden is the most common inherited clotting tendency: about 3% to 8% of people of European ancestry carry one copy. Estrogen, whether for birth control or menopause symptoms, raises clot risk further.

That’s why we ask about any personal or family history of blood clots before hormone therapy. A history of clots doesn’t automatically rule treatment out. The type of hormone therapy, the dose and whether it goes through the skin or by mouth all affect clot risk, so the plan can be tailored.

What at-home DNA kits and “nutrigenomic” panels can’t tell you

• They can miss what matters. The National Cancer Institute notes that some consumer tests don’t check every harmful BRCA change, so a “clear” result isn’t the whole story.
• Raw data can be wrong. In one study, 40% of gene changes reported in consumer raw data were false alarms when retested in a clinical lab.
• Common variants are overinterpreted. MTHFR is a good example. The CDC says people with common MTHFR variants can process all types of folate, including folic acid, so it isn’t a reason to avoid folic acid.
• Gene-matched diet and product plans aren’t supported by major medical guidelines.

Any result that could change your care should be confirmed in a clinical lab and reviewed with a clinician or genetic counselor.

Genes load the dice. Lifestyle still matters

Your genes aren’t your destiny. Strength training, vegetables and fiber, enough protein, less alcohol, good sleep and not smoking help across almost every genetic background. See strength after 40.

How we approach genetics at Serene

We review your personal and family history, order evidence-based tests such as Lp(a) when appropriate, refer you to certified genetic counselors when your history calls for it, and coordinate with your OB-GYN or primary care clinician.

Every plan is individualized, and treatment is recommended only when it’s right for you after your consultation.

Related reading: Midlife weight gain, blood sugar & your heart · Do I need my hormones tested? · Perimenopause: symptoms, diagnosis and treatment. Browse the full Women’s Health Library.

See us in person or by video

Visit our physician-led team at our Hudson, Ohio or Barboursville, West Virginia office, or meet Dr. Robin Arora by telehealth from anywhere in Ohio, West Virginia, Kentucky or Florida.

Sources: National Cancer Institute, BRCA gene changes fact sheet; U.S. Preventive Services Task Force, BRCA-related cancer risk assessment (2019); MedlinePlus Genetics, Lynch syndrome and Factor V Leiden thrombophilia; CDC, familial hypercholesterolemia and MTHFR gene variants; American Heart Association, Lipoprotein(a); Tandy-Connor et al., Genetics in Medicine 2018; The Menopause Society 2022 hormone therapy position statement. This page is general education, not medical advice.