Check Out These Checkups

by Molly M. Ginty

Feeling physically fit (or phhhht) this New Year’s? Now’s the best time to make health resolutions — and check into medical checkups.

"Health screenings can prevent problems before they happen, and catch them early if they do," says Dr. Lynne Shuster, director of the Women’s Health Clinic at the Mayo Clinic in Rochester, Minn. "What checkups you’ll need depends not only on your personal and family history, but on the latest science, so discuss your needs with a doctor who is not only accessible and easy to talk to, but whose expertise and professionalism you trust."

The consensus is that most women need:
• A dental exam at least once a year to ward off cavities, gum disease, and oral bacteria that can migrate to the heart valve and spur heart disease, the number one killer of U.S. women.
• Immunization against tetanus (lockjaw), pertussis (whooping cough), and diphtheria (severe infection of the nose, throat, and airway), once as a combined shot, then as booster shots against tetanus and diphtheria once per decade afterward.
• Regular gynecological checkups every three years — or once a year if you have irregularities or change sexual partners.

"Ask for blood pressure tests and other routine screenings so your gynecological exams double as regular checkups and protect you from common health problems," says Dr. Mina Ma, an assistant clinical professor at the David Geffen School of Medicine at UCLA.

• An annual flu shot — especially if you have chronic disease, are in the second or third trimester of pregnancy, work with children, are employed in health care, or are over 50.

Aside from these recommendations, what screenings you’ll need — and how often — depends upon your age.

In your 20s
• If you’re under 26 and not sexually active, consider getting vaccinated against strains of the human papillomavirus (HPV) that can lead to cervical cancer.
• If you are sexually active, talk to your doctor about tests for sexually transmitted infections (especially chlamydia, which may have no symptoms and can lead to infertility). Since it’s possible you could get pregnant, from now through menopause, take a daily multivitamin with 400 mcgs of folic acid to prevent neural tube birth defects.
• Think breast cancer only strikes older women? Think again. It affects 1 in 12 women of all ages, so get a clinical breast exam every three years.
• After bone mass peaks in your mid-20s, bones start to break down faster than they rebuild. Maintain strong bones by getting at least 1,200 mg of calcium and 400 IUs of vitamin D daily through adulthood.
• If you have eyeglasses, contact lenses, or vision problems, get an eye exam every

year. If not, have at least one checkup between now and age 40.

• If you haven’t discussed your heart disease risk with your doctor yet, now is the time. "A check of your cholesterol levels and blood pressure is recommended every five years starting in your mid-30s, more often if you’re at increased risk of heart disease," says Dr. Shuster.

• The eyes have it! Since nearsightedness, presbyopia, and other vision problems often develop in your 40s, start getting an eye exam every two to four years.
• Also on your checklist? Cancer screening. The American Cancer Society recommends that women over 40 get a clinical breast exam and mammogram yearly. "To screen for uterine and ovarian cancer, start having a pelvic exam once a year," says Dr. Ma. "If you’re at risk for skin cancer, get a skin exam annually."
• Diabetes compromises the body’s ability to process sugar and can damage the heart, kidneys, and other organs, and affects 9 percent of American women. "After 45, get a fasting glucose blood test to check for diabetes, and repeat this test every three to five years, more frequently if glucose is elevated," recommends Dr. Shuster.

In your 50s
• "The average age of menopause is around 51," says Dr. Shuster. "If you’re having hot flashes or other troublesome menopausal symptoms, discuss hormone therapy or alternative treatments with your doctor."
• After menopause, levels of the female hormone estrogen can drop 90 percent, making you more susceptible to osteoporosis, bone thinning that boosts the risk of fracture and affects more than half of women over 50. Increase your nutrient intake to 1,500 mg of calcium and 800 IUs of Vitamin D per day. If you have a family history or other risk factors for osteoporosis, talk to your doctor about having a bone scan now.
• Starting at 50, check for colorectal cancer. "Try to get a colonoscopy every decade after 50," says Dr. Ma. "Or talk to your doctor about getting fecal occult blood tests and flexible sigmoidoscopy."
• Your overall risk of chronic health problems is higher than it was before menopause, so have a physical, get your vision checked, and get a flu shot once a year.

In your 60s and beyond
• According to the National Osteoporosis Foundation, all women should get a bone density scan for osteoporosis at age 65. And according to the Mayo Clinic, they should get a baseline hearing test by age 60.
• Start getting an annual pneumonia shot — and keep eating well and exercising regularly to maintain optimum health.

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

For more information: Agency for Healthcare Research and Quality "Women: Stay Healthy at Any Age" www.ahrq.gov/ppip/healthywom.htm

Article published in Lutheran Woman Today, January/February  2008