By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
As a cardiologist who emphasizes prevention, I know from first-hand experience what happens when people put off routine checkups or ignore symptoms. Should you make an appointment to have any or all of these critical health tests done?
Is It Time for a Check-Up?
- Is your waistline expanding past 34 inches? You may need these tests.
- Is an annual mammogram right for you?
- When was the last time you had a pap smear?
- Could bacteria in your mouth be affecting your heart? Learn more about the importance of dental exams
- Worried about colorectal cancer?
- Are you letting your eyesight go?
- And last, but DEFINITELY not least, do you need these Must-Have Cardiovascular Tests? >
Women: Always Caring for Others.. Don’t Forget to Care for Yourselves!
Although men typically do so more than women, both sexes tend to put off check-ups because, frankly, they are busy with the minutia and routines of daily life. Family. Work. Caring for others. Time is a premium.
If they have some symptom, they will naturally think (or hope) “it will get better.” It may not. I very often had to treat procrastinating patients and patients-in-denial in the emergency room or critical care unit.
The lesson for everyone is this: Sure, time is a premium in all our busy lives. But you better make time for your health. That’s the REAL premium. You can lose time. You don’t want to lose an ounce of your health.
Generally speaking, women are natural nurturers and caregivers. Their DNA leads them to care for family and friends, often to the degree that they neglect themselves and their own care. During my clinical days, I used to worry about the toll on patients, most often women, who were caregivers. I often had to treat them for rising blood pressure. Frequently the caregiver undergoes much more stress than the person being cared for.
About 33 percent of women have high blood pressure, a significant risk factor for cardiovascular disease. What’s more, according to the U.S. Centers for Disease Control, about 36 percent of women are obese and almost 14 percent are considered to be in just fair to poor health. So there could be a lot of health problems waiting in the wings if you wait too long to address them.
For your own sake, make it your priority to see a health professional for routine preventive checkups. Below you will find a handful of important tests you need to have done at different times in your life.
And should you develop symptoms, get checked out right away, even if you have no insurance and the money has to come out of your pocket. From the doctor’s angle, it’s always easier to remedy a problem early on than resorting to serious interventions down the line when some condition has developed significantly and damaged organs.
Be smart and love yourself and take care of yourself. Make the time! If you don’t, who will do it for you?
Key Tests for Women
1. Metabolic Syndrome and/or Blood Pressure Tests
Get checked out by your regular doctor (family doctor or internist) for metabolic syndrome, a symptomless condition at epidemic levels that leads to diabetes and cardiovascular disease. If you are well overweight, and have a belt size of 35 inches or more, you likely have metabolic syndrome and need to do something about it. Here are the tests you need:
- Glycohemoglobin (HbA1c) measures the amount of blood sugar (glucose) bonded to hemoglobin, the red blood cell pigment that carries oxygen. The test is an effective indicator of the average glucose level over several months and is a primary tool in monitoring diabetes management. A normal level is below 5.7 percent; pre-diabetes below 6.4; and diabetes 6.5 and above. A routine blood glucose test is useful for measuring glucose control on a day-to-day basis. Get that test as well.
- Blood lipids, including LDL and HDL cholesterol, and triglycerides, a type of fat found in the blood. I don’t like the standard testing for total levels of cholesterol, LDL, and HDL. They are almost meaningless for identifying risk and best treatment options, in case your numbers are off. Doctors typically will recommend a statin drug to lower your cholesterol if it comes out a bit on the high side. You may not need a drug. You need to ask your doctor to order one of the new generation of advanced blood lipid tests that break down cholesterol elements into percentages based on particle size – are they dense and potentially dangerous, or large and harmless? With the added information, your doctor can more accurately determine whether there is reason for concern or not. These tests also cover triglycerides that is a risk factor. Ideally you want a level under 100 mg/dL.
- Blood pressure is an important reading to know, particularly because chronic stress can raise your levels and, because high blood pressure has no symptoms, you may not be aware that you have a problem. I like to see numbers at 120/80 and below. If you have higher numbers, you can usually lower them by practicing healthy lifestyle habits.
I have written a lot about this subject because high blood pressure is considered a silent killer – a leading risk factor for cardiovascular disease, the number one cause of death in both men and women. The big thing for a woman to understand is this: According to the American Heart Association, nearly half of all adults with high blood pressure are women, and beginning at age 65, after the onset of menopause, women are more likely to have this condition than men; high blood pressure is not just a man’s thing, as many women think.
As a cardiologist, I feel compelled to address blood pressure testing in this list of women’s health tests, though there’s lots of other pages at HMDI about heart health. Click here to learn more about women and heart disease. Please also visit this page to download my Must-Have Cardiovascular Tests for Men and Women and learn more about what I call “the dirty dozen risk factors for heart disease.” Lastly, here’s a simple questionnaire you can take to help assess your relative risk of heart disease.
2. Breast Exams
According to the U.S. Centers for Disease Control and Prevention, breast cancer is the leading form of cancer affecting women and the second deadliest, after lung cancer. Breast cancer affects approximately one in every eight women and will cause an estimated 40,000 deaths in 2014. While early detection can help reduce risk of breast cancer mortality, screening via mammogram is often a double-edged sword. Not only is getting a mammogram uncomfortable for most women and often results in false positives; it also can be an unnecessary source of additional ionizing radiation, which can accumulate over several exams and actually increase a women’s risk of breast cancer.
Whether or not to get an annual mammogram – and starting at what age – is an individual decision each woman needs to make with the help of her doctor. My suggestion is that women empower themselves by learning as much as possible about mammogram screening from a variety of sources. Know the benefits; know the risks – this article is a good place to get started, as well as get prevention tips. I highly encourage annual breast exams at the doctor’s office, as well as regular self examinations; if anything is out of the ordinary (e.g. you find a mass, have a lesion or sores that don’t heal, or experience nipple discharge), see a doctor for follow up, and request thermography. If you have a positive family history of breast cancer, you may want to have gene analysis done.
3. Pap Smears
According to the American Cancer Society (ACS), cervical cancer was once one of the most common causes of cancer death in American women. Then, between 1955 and 1992, the cancer death rate declined by about 70 percent due to increased screening via Pap testing.
Women over 21 years of age should have a Pap smear (done in a doctor’s office) every 1 to 3 years. Through this procedure, cells are scraped from the opening of the cervix and then examined under a microscope for abnormal cells. The cervix is a canal between the vagina and uterus. Another useful test is for the human papilloma virus (HPV), a pathogen that can lead to cancer of the cervix.
With normal readings, and in the absence of HPV, women over the age of 30 can generally have Pap smears done every 3 to 5 years. As cervical cancer usually afflicts women between the ages of 20 and 50, most women can stop having Pap smears after 65, or after a total hysterectomy if they have had a clean gynecologic history; approximately 20 percent of cervical cancer cases do occur in women over 65, though, so continuing to get Pap smears every few years is not a bad idea. Best to consult with a trusted gynecologist for your individual situation.
4. Colorectal Cancer Screening
While this is not a must-have, in my opinion, screening is a good idea if you are 50 or over. Cancer of the colon and rectum is the third leading cancer killer in the United States for women (and men), after lung and breast cancer. You are also considered more at risk if you have a family history of colorectal cancer, have precancerous polyps (abnormal growths), ulcerative colitis, Crohn’s disease, eat a lot of meat, or smoke. Screening can identify the presence of precancerous polyps—abnormal growths in the colon or rectum—so they can be removed before turning into cancer.
5. Eye Exams
You might not think about having a routine eye examination, but good sight is an important, but (pun intended) overlooked aspect of overall health. Today, the combination of a toxic environment and eye-related problems as we get older makes it imperative to see an ophthalmologist (eye specialist) every few years. You may need glasses as well, and an eye doctor can test you when he does an examination. Common eye disorders include glaucoma (pressure within the eye) and age-related macular degeneration. Both can seriously affect your vision, and ability to carry out your daily routines. Early detection and treatment can make a big difference.
6. Dental Exams
Lack of proper oral care – brushing after meals and getting routine dental checkups – is a ticket for gum disease and loss of teeth. Don’t kid yourself. Local infections, such as in the gums, can spread bacteria throughout the whole body. In 1998, the American Academy of Periodontology issued a strong warning that gum infections raise the risk for heart disease and stroke. Gum disease is an infectious inflammatory condition caused by bacteria. According to the Centers for Disease Control, half of American adults have it to one degree or another. Regular dental checkups and thorough daily cleaning routines are musts.
What to do for Unexplained Symptoms Your Doctor Can’t Figure Out
For problems that a conventional medical doctor cannot figure out or help you with, I strongly suggest you see an alternative health professional – a naturopath, a chiropractor, or a physician trained in environmental medicine (http://www.aaemonline.org/). They often have the diagnostic skills and natural remedies to find root causes of illness.
References and Resources:
- Vaidya V, et al. Gender differences in utilization of preventive care services in the United States. J Womens Health (Larchmt). 2012; 21(2):140-5.
- Women’s Health Statistics, 2014, U.S. Centers for Disease Control and Prevention, published online at http://www.cdc.gov/nchs/fastats/womens-health.htm
- High Blood Pressure and Women. The American Heart Association, published online at http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/High-Blood-Pressure-and-Women_UCM_301867_Article.jsp
- Menopause and Heart Disease. The American Heart Associatio, published online at http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Menopause-and-Heart-Disease_UCM_448432_Article.jsp
- Cancer Among Women, 2014, U.S. Centers for Disease Control and Prevention,
published online at www.cdc.gov/cancer/dcpc/data/women.htm
- What are the key statistics about cervical cancer? American Cancer Society, published online at http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-key-statistics
- What are the risk factors for cervical cancer? American Cancer Society, published online at http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-risk-factors
- Colon Cancer. The Mayo Clinic, published online at http://www.mayoclinic.org/diseases-conditions/colon-cancer/basics/definition/con-20031877
- CDC: Half of American Adults Have Periodontal Disease. U.S. Centers for Disease Control and Prevention,
published online at http://www.perio.org/consumer/cdc-study.htm
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