From Health magazine
Sure, your to-do list is probably longer than the Great Wall of China, so you may be tempted to let your annual mammogram or cholesterol test slip. But don’t let that happen: Studies show that regular checkups and screenings can help keep you out of the doctor’s office the rest of the year. Here, we lay out the essential medical tests you need in your 30s, 40s, 50s, and up, according to top women’s-health experts. In most cases, these should be covered by insurance—but be sure to ask first.
In your 30s and up, get a …
Full gynecological check
Your gyno will perform manual pelvic and breast exams, plus a Pap smear (during which cervical cells are collected with a swab). You may also receive an HPV (human papillomavirus) test to detect strains of the HPV virus that are responsible for most cervical cancer cases.
Why you need it: A pelvic exam checks for abnormalities such as growths. A breast exam will identify any suspicious lumps, dimpling, rashes, and nipple discharge. And the Pap smear and HPV test are important screenings for cervical cancer.
How often you need it: All women 30 and older need annual pelvic exams (a breast exam is typically included). The exception: You may be able to skip a year or two if three consecutive, annual Pap tests come back normal or if you have both the Pap and HPV tests and both are regularly normal.
Tip: For the most accurate Pap results, avoid having sex or using vaginal medications (such as anti-yeast creams) one to two days before your appointment, says Mary Marnach, MD, an assistant professor of obstetrics and gynecology at the Mayo Clinic in Rochester, Minnesota. And at home, many experts say, it’s smart to perform monthly breast self-exams (manual checks for lumps), despite debate about whether these exams help prevent breast cancer deaths. Do them about a week after you start your period, when breasts tend to be less swollen and tender, Marnach says.
Heart-health check
Your doc will check your blood pressure and administer a lipid profile, a blood test that checks for LDL (bad) and HDL (good) cholesterol, triglycerides, and total cholesterol levels. If you have a family history of heart disease or other risk factors, she may recommend a high-sensitivity CRP test (hs-CRP), which measures inflammation, an indicator of heart health. If you have a history of depression, you may have increased levels of inflammation.
Why you need it: These tests help determine your level of risk for heart disease (the number-one killer of women) and stroke.
How often you need it: If your blood pressure is normal—120 over 80, or less—get rechecked every two years. Have your cholesterol checked every five years. (After age 45, you’ll need both tests annually, as your risk rises with age.) Talk to your doctor about how often to retake the hs-CRP test, if this applies to you.
Tip: A lipid profile is best done after fasting for 9 to 12 hours, so book a morning appointment and skip breakfast. If your blood pressure reading seems unusually high, try again a few minutes later or at the end of the visit.
Next page: Skin check
Comments (35)
Awareness, precaution and prevention is a good idea!! A must do!
I had to find another heart doctor in Austin Texas after he told me the CRP test is not important.
Leave any doctor behind in the dust who argues with you about monitoring the CRP levels….Dr. OZ from the Oprah show even says it is an important test.
My C-reactive protein reading is off the chart at 18.94 but neither my internist nor cardiologist (I have A Fib) are concerned. Maybe I should see another cardiologist but this one is supposedly the best on the east coast, especially for a-fib.
My wife had fibroids in her uterus for at least 20 years. She was careful about her health. Had all the tests recommended on this list of topics. She had multiple OB/GYNs (some retired, some moved) all of whom we considered to be “good doctors.” When my wife would ask about having a hysterectomy so as not to have the fibroids (which they could palpate), she was told by all OB/GYN doctors that “fibroid are always benign and surgery has inherent risks, so don’t go that route (could have problems with anesthesia, infection, etc). So, over all those years, she lived by the doctors advice. In 2006, my wife once again was told the same. There were no changes across the years in how she felt, but this time she said she was tired of being told the same thing and she wanted the hysterectomy. Multiple pre surgical tests were conducted – PAP smear, hysteroscopy, MRI and all results came back as “no cancer and no medical reason to avoid the surgery.” Up until a few days prior to the scheduled elective surgery, the doctor made additional efforts to discourage the procedure. So, being my wife was in good health, the surgery was to take place. She was told to expect three days in the hospital and then back home. On the day of the surgery, I was in the waiting room when, in less than an hour of the beginning of the surgery, I was called to the desk to speak with the surgeon who told me that “one of the fibroid tumors on the outer surface of the uterus was cancerous and a gynecological oncologist had been called in to complete the surgery. The surgeon was confident of his surgery, but admitted that such cancers are hard to treat and do not have a good prognosis. We were told that, as a precaution, my wife would have 6 months of chemo to catch any cells that might have been missed or spread. Chemo was administered twice a week for what turned out to be 8 months and not 6 months. At the end of the 8 months of chemo (with the typical side effects) my wife died of her cancer. She died because she had been told for 20 years that “surgery as too many risks, so just ‘live with them’ and you will be okay.” Well, if anyone wants to go online and research this situation, you will find that approximately 30,000 women die, as my wife did, from fibroid tumors that became cancerous. Sad. My wife was in good health and she died at 63, which in this day and age with good health care, is young. This is just a word to the wise. Don’t always accept what you are told. Do your own research and then make up your own mind about risk factors. Thank you for reading. Tom
I can’t find a doctor who agrees with this either.
They say that the CRP tests don’t really show heart disease.
What the heck are patients supposed to believe?
I am so sorry for your loss Tom–more often than not–surgeons suggest surgival procedures and non-surgeons do everything to dissuade–it isn’t a science but we have not found a better alternative.
I have changed my physicians to younger ones–who I hope to predecease—-because many are more knowledgable about the newest research and what needs to be–every single test necessary for women (and I am a female) I have had done and with a high CRP-he suggested a Calcium CT Scan–which showed no indication of calcium deposits–an even better indicator of heart health, but not covered by any insurance.
I’m sorry for your loss, Tom. In sharing your experience, you may have saved the lives of many women. Thank you.
Sorry for your loss TOM but you helped me coz i am having so many health issues and Doc. are redicule as well one called me i am depress other called me i am too fat and one who didn’t had any answer called me i am hypercondriac finally i am with auto-immune thyroide with cyst in my overies just growing and have celiac .I was dismissed due to my age and with an excuse being a women .
I AM SORRY FOR YOUR LOSS
Tom,
Thank you for your poignant story. I am very sorry for your loss. I am a cancer survivor because I did not take the advice of my first doctor, who told me I was terminal. My advice for all women is to your own advocate. Educate yourself to the best of your abilities. Ask questions. Get the emotions out of the room if at all possible and make decisions based on facts as much as you can. If you don’t trust your doctor, find another one. I will no longer ever have another male OB-GYN. I’m sure there are some good ones out there but I have had bad experiences and I will only trust a woman from now on. I know my body. I know when something’s not right. I keep lists of questions to ask. I interview doctors when I move into a new city before I choose which one will take care of me or my family. I do not blindly accept anything a doctor tells me; I get second opinions (and sometimes even 3rd!). No doctor worth her/his salt will mind this. Exercise, take care of yourself, and be your own best advocate. It can be the difference between life and death. I’m here 19 years later as proof of that.
If you can’t ask your doctor for tests,explanations or anything,put the thought in your head you’re saving a life;your own . Some people just can’t verbalize their concerns and questions for being ridiculed the only dumb/stupid questions are those unasked .Sometimes I’ll get the doc who doesn’t believe in Fibomyaglia,by the time I leave their office I’ve given them names of doctors,websites and diagnostic tools to diagnose fibromyaglia. They need to learn too.
I am sorry for your loss, Tom. Your heartfelt advice is here to help others and that is what you are doing. My own mother died at age 51 from cancer – she had been to OB/GYN with a heaviness in her breast – he told her to wear a bra to bed. One comment that I have with regards to this post of yours is that we are all UNIQUE – never listen to a doctor who says such a thing as “all fibroid tumors are benign” for instance. They might be benign in 75% of patients, but not in you! We are individual creatures with individual needs and should be treated as so! I appreciate all the wonderful comments and advice here; I see that many are waking up to this so-called healthcare system and taking their health into their own hands!
In response to Beth’s comment above, I would like to note that 2 of the 4 OB/GYNs that my wife had were women. The OB/GYN that did the work-up on my wife, but still advised her not to have the surgery, was also a woman doctor. She, too, told Jennifer that her opinion was “no surgery” right up to the week before the scheduled surgery. When she knew she was out of her league facing the fibroid cancer, she called for a (male) gynecological oncologist to do the surgery and administer the chemotherapy treatments. So, two male doctors and two female doctors sought to convince my wife, Jennifer, that she ought to “live with the fibroids, because they are always benign.” It is the ALWAYS that bothers me the most. No woman should be told that. Every woman should be told that, while uncommon, fibroids can manifest cancer. Then the woman in question can make her decision – or research the facts, etc. Tom
I am so sorry to learn of your loss. My mother died at the age of 54 due to a malignant fibroid tumor rupturing. She had it for many years and was “watched for growth” but never encouraged to have it removed – because “99.9% of the time it is benign” according to her doctor. I listened to my ob/gyn and took HRT for 12 years – only to get breast cancer. I’ve learned by these experiences to be my own advocate and to research and educate myself about risks and get second opinions!
I didn’t mean to imply that women doctors don’t make mistakes. I just made a personal decision to only interact with women doctors. I grew up in the South and got very tired of not being listened to by male doctors. I have found that women seem to listen better. However, if a doctor doesn’t listen, I’m not going to be her patient for long.
Thank you for sharing your wife’s story so that other women can learn to be their own advocates and do their own research and DEMAND better health care. Doctors work for us not the other way around.
Tom,
Fibroids are all too common these days. According to Dr. John R. Lee (author or PreMenopause and menopause books), the problem is often caused by too much estrogen. Progeserone cream have been used to eliminate fibroids and menopausal symptoms, etc.
I know how important these tests are. Unfortunately, my insurance (Blue Cross) doesn’t seem to think so, therefore, they don’t cover most of them. I pay $540.00 a month for coverage and they don’t believe in preventative care. Unbelievable!
Some of these insurance companies will pay for surgeries but not preventive care. I think those sky high salaries have taken oxygen fro their brains. I know a lot of people are scared of Nationalized medicine,but just think all insurance would be the same ,prescriptions would be available to the masses.It would be a while before all the kinks are worked out. $540.00 a month for insurance that doesn’t cover preventative care is irresponsible .
I just completed a yearly physical and am so thankful for my insurance. I have a wellnes policy called True Blue thru Blue cross for people on medicare. Otherwise, I would not beable to afford eye, ear, skin, and all the blood tests that I just pay a co-pay. It’s a great time to be over 65.
Thanks for the article. I have had many of the tests, but I would like to comment on the importance of the DEXA bone scan. My mother was diagnosed with severe osteoporosis (including 5 fractures in her back that needed fusion) when I was 43. I had the scan to see where my levels were and was diagnosed with osteopenia in both the hip and spine. I take calcium with D twice a day and was prescribed Actonel. That was two years ago and I recently went for a follow up DEXA scan and my levels are now in the normal range. However, I will continue to take the Actonel as bone loss is more frequent in your 50’s. It is important to catch this early as it can be reversed.
I have had high cholesterol, trygliceride, and CRP levels when tested. My CRP had ranged anywhere from 7.5 – 18 which is quite high. My doctor had me take supplements to lower my levels. I currently take fish oil (use enteric coated – no taste) twice a day, an 81 mg aspirin, and folic acid. Along with a lower-fat diet you can lower your levels naturally without medication. My CRP still scares me, but there is only so much you can do. I also saw an endocronologist who also has me taking CQ10 and Alpha Lipoic Acid as supplements. It is my opinion the CRP shouldn’t be ignored
Tom, I can’t imagine how you must feel. I am so sad to hear this happened to your family. Thank you for sharing your story.
15 years ago I was misdiagnosed and was told to just watch the lump on my neck. That didn’t sit well with me. I got a second and third opinion; they removed the lump and I was told I had thyroid cancer that had spread to my lymph nodes. I beat the cancer and can’t express enough how everyone needs to get second and third opinions… or until they find a doctor they can trust; go with your gut feeling.
I have now been told I have large fibroids on the outside of my uterus. Everyone says they’re nothing to worry about, but Tom your story will make me insist that they remove these fibroids and I pray for good results. My Mother was also recently misdiagnosed and was told her back pain was muscle tightness and was seeing a chiropractor. We took her to the Mayo clinic and she is now being treated for non Hodgkin lymphoma. It is so important to find the best healthcare. I believe in – getting several opinions; you know your body, find a doctor you feel comfortable with, research on your own, vitamins and herbs, prayer, and keeping a good attitude. Thank you and God bless.
I had a history of kidney infections, so my doctor said just call the office and they would order a perscription for antibotic. He said it was customary to do this. I did this for 20 years. Well, it is not a good idea. I went to a new doctor and was sent to the emergency room. I had a very large maligant tumor on my kidney. I lost the kidney, but if I had not had it checked, I would have died of kidney cancer. So don’t ever let a doctor take kidney infections too lightly.
My mother had good insurance and spent a lot of time in the hospital before she died. Her doctors were consistently wrong about what was wrong with her. In retrospect, I wish we had taken her to Mayo, or someplace where the treatment was more holistic. She had good doctors, with good credentials, but they totally missed the boat, and she died at 63, of a stroke. Five years later, I cannot tell you how much I miss her. Doctors do not always know what they do not know.
It should be noted that one should take Vitamin D3 (Cholecalciferol) instead of D2 (ergocalciferol)which has lower bioactivity, poorer stability, and shorter duration of action, resulting in approximately 33% lower potency compared with vitamin D3” as stated in ‘The Value of Vitamin D3 over Vitamin D2 in Older Persons’ Barbara J. Zarowitz PharmD, FCCP, BCPS, CGP, FASCP
Re bone density tests–anyone with osteopenia should definitely be tested for gluten sensitivity as this has become one of the main reasons a person suffers with bone loss. Having the genes that make one sensitive to gluten or maybe even having Celiac Disease is a major cause of malabsorption of calcium which leads to bone loss. It is sad that many medical doctors do not even have knowledge of this and it is the Functional Medicine doctors who are normally out of network with most insurance plans that people have to go to in order to be tested for this intolerance if they want it covered by their insurance. Anyone seeking to learn more can Google Enterolab, which is located in Plano, TX and owned by a Gastroenterologist, Dr. Fine. He has a wonderful website on the subject. You can order the test yourself and they will even go over the results of the test with you.
I, myself found out that I had 2 genes that make me sensitive to gluten and was having loads of problems. On doing mega research to understand gluten sensitivity (which is genetic), I also realized that 3 of the 4 girls in my family have osteopenia. My having 2 genes means that I got one gene from each of my parents and would have given one to each of my daughters. I have been on a gluten free diet for over a year and am doing so much better. I really believe that gluten sensitivity is a “silent epidemic” and wish to make others aware of the havoc it can cause in one’s life if left untreated.
If one is sensitive to gluten and continues to eat it they run the risk of aquiring any of a number of autoimmune diseases to include fibromygalia, MS, Sjogrens, non-Hodgkins Lymphoma, Type 2 Diabetes, plus dementia, and Alzheimers to name just a few.
Sheryl.
You probably have what is called dense breast tissue. Have they done an ultrasound? or a fine needle biopsy/? Find a teaching hospital in your area,trust me these residents want to learn and earn praise from the patient and the doc they’re training under.
I can’t even go to a doctor anymore. They all seem like they don’t really know much at all about the human body, nutrition, or about people. It’s all a gamble. Last time I had a breast mammography tey took films over and over and then switched to digital and when they sent my report it said it was inconclusive and that I should come back for more pictures WTF????
I do not trust the medical community AT ALL. The whole healthcare, big pharma, insurance system is a fraud and the fact that it is a for profit system makes it much worse. Ethics? Forget about it.
For those of you reporting unusually high CRP levels – when I had my CRP checked over my doctor’s protests that it was not reliable, it was very high. My doctor told me that suggested a possible infection somewhere in the body, so he conducted further tests of the liver, kidney, etc. and they were fine. So he told me not to worry about it since all other heart indicators were good as well. Since my dad died of a heart attack, I was unwilling to let it go so I did my own research. I found that the birth control pill can make it go up, usually only slightly, but I went off it anyway, and sure enough, my levels went down to normal. Just to make sure it was the pill, I went back on the pill for three months and it shot right up again! So ladies, if you’re on the pill with a high CRP, try this! I don’t know if it even signified anything was wrong with me physically – it may just be that the pill creates a false reading for CRP, but I wasn’t taking any chances and have been off it ever since.
I have been refused health insurance for at least 6 years. I take 4 medications for blood pressure due to kidney diease I had about 12 years ago. I go once a year to get my prescriptions renewed. Preventative testing? Who can afford that out of pocket. Also what if they find anything,? No health insurance means one cannot afford any treatment, even if they found something. So what’’s the point.
My sister had mammograms with breast ultrasounds every year. 6 months ago she was diagnosed with breast cancer that had spread to her lymph nodes. They said it had been there at least 2 years, despite no one seeing it on the mammograms or ultrasounds. She has had 7 months of chemo and now 6 weeks of radiation. That’s what “preventative checkups” did for her, missed 2 years of a growing breast cancer.
I urge women not to pigeonhole the idea of thyroid problems as something that only affects women in their 50s. There are MILLIONS of women in the U.S. who have thyroid conditions in their 20s, 30s, and 40s. Undiagnosed thyroid conditions can cause weight changes, fatigue, anxiety, depression, infertility, recurrent miscarriage, premature delivery, difficult menstrual periods, difficult menopause, hair loss, high cholesterol, and a host of other health issues and problems. It is frequently MISdiagnosed as everything from anorexia, to depression, and it’s thought that majority of thyroid patients haven’t even been diagnosed yet. So as a thyroid patient advocate, I urge women to get tested if they are experiencing any of the above symptoms, and also, if they have a family history of thyroid or autoimmune disease. Also, it’s controversial, but some experts advocate testing for all women early in pregnancy. (I think it should be part of the pregnancy workup for all women!)
I highly recommend a transvaginal ultrasound. I was almost religous about my gyn appts. Every year I had my pap smear, mammogram. I decided to add a colonoscopy when I turned 50, and during the pre-exam, it was suggested that I have a Transvaginal ultrasound first…..I was diagnosed with stage 3 ovarian cancer. Please, ask your gyn to add this test to your yearly exam, it will save your life.
I read with interest the many and varied comments regarding people’s experiences in health care. Personally , I feel one must remember that health care practicioners are people FIRST; it is the PRACTICE of medicine after all. Know thyself and listen to what your body is telling you. It’s not gonna lie to you. Found this out the hard way!
Tom,
I too had fibroids for 20 years. A wonderful Dr.
advised me to have them removed if only for my peace
of mind. I had the surgery and am grateful.
I’m so sorry for your lost.And I’m advising all
women to be their own advocate for health.
I just came home from my doctor’s visit and am outraged at the outcome! I am a military family member with full coverage insurance. This is the time of year when I schedule my annual gyno exam but at 32 I’ve never had my cholesterol or skin checked. I decided to change that after reading this article. My insurance required me to get a referral to see a dermatologist so I went in today to do just that. Unfortunately, when I told the doctor that I wanted a referral for a preventative screening, he nearly laughed at me and said “no dermatologist will see you unless you already have an identifiable skin issue.” He then went on to say that he had NEVER had a patient request to see a dermatologist for preventative reasons. I am new to this area and to this doctor’s office, so I know for sure he did not have my medical history, yet, he still did not ask any questions about my background or why I might want the screening! He just said that if I have a particular mole I am concerned about they could look at it and then decide if I should see a dermatologist. I even used the analogy of going for a yearly gyno exam: even though I may not have an identifiable issue, it’s a preventative step. He just brushed me off saying it is not the same. I refuse to accept his ignorance as the final answer, even though I know it will mean a fight with my insurance and possibly paying for this out-of-pocket. The doctors response just really shocked me!
I too had my doctor do a C-reactive protein (CRP) blood test with the result being high. My doctor told me that any inflammation in the my body could alter the readings. He suggested that I have a NMR Lipoprofile blood test done. The test breaks down your VLDL, LDL, and HDL. It defines your risks of a heart attack or stroke. It was worth it to take the time to have this test done for the peace of mind I now have.