May 11, 2009, is National Women’s Check-Up Day in the US. The US Department of Health and Human Services initiative was conceived to encourage women to schedule annual check-ups with their doctors. Ladies, why not make it a point to schedule your own appointments on and around this day as well?
TWO things will keep a woman healthy throughout her life: regular checkups and effective lifestyle management, says consultant obstetrician and gynaecologist Datuk Dr Nor Ashikin Mokthar.
When it comes to checkups, “regular” means once a year. The nature and scope of these checkups will change over time to accommodate changes in your body.
For young girls, Dr Nor Ashikin urges mothers to introduce their daughters to a gynaecologist once they experience their first menstrual periods and to continue having routine annual checkups that include a pelvic ultrasound examination. “ This is the age when some hormonal-related diseases can occur. Also, a woman’s (reproductive) structures are in the pelvis. You cannot see them, you cannot feel them. By the time you can feel something in your abdomen, it’s been there for a few years. 75% of ovarian cancers are detected at a late stage.
“In these last five years or so, I’ve seen younger and younger girls with huge ovarian tumours, which, from my medical undergraduate understanding, occur only in older women. I had a 19-year-old with a huge ovarian tumour, bigger than a coconut. If she came to see me sooner, she wouldn’t have had to lose an ovary.
“So yes, I would definitely encourage all young girls to have that assessment because it’s just once a year to check that her ovaries and uterus are fine.”
For women in their 20s to 30s, it’s time to begin a series of annual tests.
Continue annual pelvic examinations and begin clinical breast examinations.
Pap smears or tests (to screen for cervical cancer) should be done two years after a woman is sexually active and every one to three years after the age of 21 (consider asking your doctor about the cervical cancer vaccine).
Blood tests (for lipid profiling and blood sugar estimation) can be done every two years.
For women in their 40s:
Continue pelvic examinations, Pap tests and blood tests annually.
Begin having mammograms annually as well.
Many women with families tend to put their personal healthcare needs last, which Dr Nor Ashikin cautions against.
“If you love your family, you have to love your health. This is not about being selfish, this is about knowing your priorities. For you to give more, you yourself need to have more – more good health, more strength. Whatever you want for them is what you should have for yourself first. That means you must be in excellent health,” she says.
For menopausal women, other concerns like a marked increased risk of heart attacks, strokes and osteoporosis come into the picture, possibly due to the drop in oestrogen a woman experiences at this time.
Continue pelvic examinations, Pap tests, blood tests and mammograms
Begin annual bone density tests.
Consider doing having an ECG (electrocardiogram) and chest X-ray.
Consider screening for colorectal cancer from age 50 onwards. According to Dr Nor Ashikin, “Beyond menopause, women should still see their doctors annually. One common thing I hear is: ‘Oh I’m not having any more babies, I don’t need to see my gynae, I don’t need to do pap tests’. But changes are still occurring in your body – changes that we can address to slow down the ageing process and improve your quality of life.”
Other things to look out for include:
Depression – women are at a greater risk of depression at times of dramatic hormonal change such as at puberty, during and after pregnancy and during perimenopause. If you feel “down,” sad, or hopeless over two weeks or more or feel little interest or pleasure in doing things, you may be depressed and should talk to your doctor.
Chlamydia and other sexually transmitted infections (STIs) – have a test for chlamydia if you are 25 of younger and sexually active.
HIV – have a test if you are have had unprotected sex with multiple partners, have used or now use injection drugs, or are being treated for STIs. Managing your lifestyle, on the other hand, is as simple as keeping good habits.
Eat a well-balanced diet and maintain an ideal body weight; don’t deny yourself adequate nutrition eg by putting yourself on a high-protein, no-carbohydrate diet. Dr Nor Ashikin says: “If you eat sensibly, you will maintain a sensible weight.”
Get regular exercise; try walking 30 minutes three times a week.
Drink enough fluids. “Your body weight divided by 30 will give you the number of litres you should drink in a day. So for example, if you weigh 60 kilos, you need two litres of water a day,” advises Dr Nor Ashikin:
Get enough sleep. According to Dr Nor Ashikin, “Some cancers, particularly breast cancers, are associated with women who sleep less than six hours a day. When you sleep long enough, preferably in a dark room, you release melatonin – a hormone with anti-cancer properties.”
Don’t smoke. “There’s nothing cool about smoking. It’s the passport to early menopause, premature ageing, and it’s definitely associated with higher risks of cancers, whether it’s breast, cervical or oral cancers. Smoking also, in the long term, can (adversely) affect libido,” notes Dr Nor Ashikin.
De-stress, not distress. Dr Nor Ashikin emphasises that “A little stress is good, but know how to de-stress yourself, whether it’s through prayer, dancing, swimming, or games.”
Information partly sourced from the US Department of Health & Human Services. You can print off a women’s health checklist to bring along to your check-up from the HHS Agency for Healthcare Research & Quality at http://www. ahrq.gov/ppip/healthywom.htm
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