Recently in preparing for my monthly appearance on KTHV’s “Medical Monday”, I came across this list of tests that “every woman needs”. Some of them were no surprise to me – tests I talk with my patients about every day – pap smears, mammograms, colonoscopies, cholesterol and blood sugar levels, and bone density scans. These are certainly life-saving and quality of life improving tests. There were a few things listed that I have to admit I don’t think about, or counsel my patients about as often – (and by the way, several of these apply to men too!)
Did you know that?
People who have many moles (we call them hyperpigmented lesions or nevus) and people who are fair complected, blonde or redheaded should have a skin check every 6 months?
If you are noticing ringing in your ears, you should have an audiogram?
Even if your eyesight is good, you should have an eye exam at 40?
And let’s not forget our oral health – we should be sure to see our dentist every six months. Good oral health is not just for pretty smiles and fresh breath. It actually can increase our life span.
I have summarized a list of tests that women (and several of them that men) need and when they need them. Some of them are tests we all should be getting and some are based on personal risk factors. Make it a goal this year to make sure you are taking advantage of these important tests. Then… if you do find you have a problem – whether it be gum disease or high cholesterol, blood sugar or body mass index – I challenge you to do what it takes to improve your health!
For YOUR health,
- Bone Mineral Density test – to determine if you are at risk for osteoporosis, have a screening DXA (dual energy X-ray) at 65 and then every 2, 5 or 10 years depending on the results. If you have risk factors for osteoporosis – such as weight less than 127 pounds, a smoking history, a history of nontraumatic fractures as an adult, or family history of osteoporosis – the test should be done at the onset of menopause.
- Clinical Breast Exam and Mammogram – to screen for breast cancer begin having a yearly clinical breast exam by your doctor at age 20. Then at age 40, add a yearly mammogram. (Some guidelines recommended getting them every 2 years between 40 and 50, but data indicates that this decreases the sensitivity of screening overall).
- Pap smear – to detect and prevent cervical cancer. Screening should begin at age 21. If you have had several normal results and have had a negative HPV (human-papillomavirus) test, you may have it repeated every other year. If you are a smoker, have multiple sexual partners, began having intercourse at a young age, are HIV positive or have a sexually transmitted disease, have a pap annually. If you are 30 or over, ask your doctor for an HPV test.
- Sexually transmitted disease screening – Women who are trying to get pregnant or have a new partner, or who experience unusual vaginal discharge, irregular bleeding or pain with intercourse should be screened. Screening can include a cervical and/or vaginal swab for Chlamydia, Gonorrhea, or trichomonas and blood tests for HIV, herpes, syphilis, and hepatitis. American College of Obstetricians and Gynecologists recommends that all sexually active women under the age of 25 be screened yearly for Chlamydia and that all women be screened for HIV yearly.
- Colonoscopy – to detect colon cancer before symptoms occur. In the absence of a family history, screening should begin at 50. If there are no abnormalities found, a colonoscopy is usually recommended every 10 years. If there is a family history or polyps are found, it may be repeated every 3-5 years.
- Dental Screening – to screen for oral cancer (one of the six most common cancers), and prevent gum disease, tooth loss and tooth decay. Twice a year teeth cleanings and checkups should begin 6 months after baby teeth appear and continue throughout your life. Women who have more than 1-2 drinks per day or who smoke are at higher risk for gum disease and oral cancer.
- Heart Health Test – to ensure you are not at risk for heart disease, your blood pressure, pulse and BMI (body mass index) should be assessed yearly starting at age 20. Your doctor will also listen for any heart murmurs or irregular beats as well as assess any symptoms and perform further testing as indicated.
- Lipid Profile – also to assess heart disease risk. This test to check cholesterol and triglyceride levels should also be done starting at age 20. If normal, it should be repeated every 5 years until age 45. If you are 45 or over, have a family history of heart disease or have a total cholesterol over 200, have it checked annually.
- Diabetes screening – to detect diabetes or pre-diabetes. American Diabetes Association recommends that anyone (any age) who has a BMI over 25 and additional risk factors for diabetes such as high blood pressure, sedentary lifestyle, heart disease, high cholesterol, family history of diabetes, polycystic ovarian syndrome, diabetes in pregnancy, having a baby who weighed over 9 pounds at birth should be screened for diabetes. Those who are without risk factors should begin screening at age 45 and then repeat every 3 years. Screening tests can include random or fasting blood sugar tests or a hemoglobin A1C (gives an estimate of the average blood sugar over the last three months).
- Thyroid testing – to detect thyroid disorders. People with a family history of thyroid disorders or who suddenly suffer from fatigue, weight gain (or loss) or depression should be screened with a blood test (TSH – thyroid stimulating hormone) initially and then every 3-5 years. Even asymptomatic women with no family history should have a blood test done at age 65 and then every 2-5 years. An elevated TSH indicates an under-functioning thyroid and a low TSH indicates an over-functioning thyroid.
- Mole Screening – to detect skin cancer as early as possible. Melanoma, the deadliest form, is the second most common cancer among women in their 30s. By age 30, begin to have an annual skin check. This can be done by your primary care physician or dermatologist. Repeat twice a year (preferably by a dermatologist) if you are high risk – i.e. have already been diagnosed with a skin cancer, have a family history of skin cancer, have many moles or have fair skin, red or blonde hair, or freckles.
- Comprehensive Eye Exam – to detect eye health problems from loss of vision to cataracts or glaucoma. Even if your vision is good, and you have no risk factors like diabetes or family history of glaucoma, you should get a basic eye exam at age 40 and then every 2 years until 65. At 65, start getting them yearly.
- Audiogram – To prevent worsening of hearing loss, schedule and audiogram if you think you may not be hearing as well, notice ringing in your ears or have a strong family history of hearing loss.
- Lung Cancer – smokers who at least one pack of cigarettes a day or who have a recurring cough or wheeze and also former heavy smokers should be screened. Tests may include a breathing and lung capacity test, followed by a CT scan of the lungs if there are abnormalities in the initial tests.
- Ovarian Cancer – Women who have a family history of ovarian cancer or ongoing pelvic pain should have a vaginal (pelvic) ultrasound to check for any growths or cysts on her ovaries. It should be repeated based on your doctor’s recommendations.