Medical Tests for Women
15 Medical Tests Every Woman Should Have
Medical screening tests are a great way to stay on top of your health. Think of them as basic maintenance, just like checking the oil and tire pressure to keep your car gunning down the highway. To help make it simple, we've compiled a list of the most important medical tests every woman should have -- along with what age to start and how often to repeat. Here's to routine maintenance for your health.
1. Cholesterol screening/lipid profile
Cholesterol is a type of fatty protein in your blood that can build up in your arteries, so knowing how much cholesterol is present is a good predictor of your risk for heart disease. And women need to pay close attention to cholesterol levels, because they tend to rise after menopause. If you were already high or borderline before or at menopause, there's cause for concern.
There are two kinds of cholesterol: HDL, or high-density lipoproteins, and LDL, or low-density lipoproteins. Confusingly enough, HDL is "good" and protects against heart disease, and LDL is "bad" and poses a risk to your heart. Your total cholesterol reading combines the measures of both and is used as an overall reading. The profile also measures triglycerides, which are fats in the blood; you want your triglycerides below 150 milligrams per deciliter.
What it is: A blood test for cholesterol, measured in milligrams per deciliter of blood (mg/dl); usually measures triglycerides as well
When to start: Age 20
How often: Every five years. If testing reveals your levels are high, your doctor will recommend retesting every six months to one year. If you have risk factors for heart disease in your family, the regular cholesterol test may not be specific enough; ask your doctor for an additional test called the lipoprotein subfraction test. It's more sensitive and checks the size of the cholesterol particles as well as the amount.
2. Blood pressure check
It seems simple, but checking your blood pressure regularly is one of the most important things you can do to protect your health, present and future. Many people make the mistake of thinking men are at more risk for high blood pressure, but actually half of the 75 million people who have it are women! And ever since the stress scales started to tip back in the 1980s, more women than men have died of heart disease every year.
When your blood pressure readings are higher than the cutoff of 140/90, it puts stress on your heart, leaving you at risk for heart attack and stroke. Many experts believe 120/80 is a healthier target to shoot for.
What it is: A physical reading using an arm cuff
When to start: Any age; best to begin during childhood
How often: Once a year if readings are normal; your doctor will recommend every six months if readings are high or if you're taking medication to control hypertension.
3. Diabetes screening
To check your risk for diabetes, doctors check your tolerance for glucose absorption, which means how readily your body digests sugar. Diabetes puts a unique burden on women: Many women get diabetes while pregnant, and it's dangerous for both mother and baby. And although gestational diabetes goes away in most cases, it raises the risk that you'll develop regular (type 2) diabetes later in life.
What it is: A blood draw performed after drinking a sugary drink; a fasting glucose tolerance test requires you not to eat for nine hours prior to the test.
When to start: At the start of pregnancy or at age 45 if you have no risk factors or symptoms. If you're significantly overweight, have high blood pressure, or have other risk factors for diabetes, such as family history of the disease, it's a good idea to get tested younger. If your insurance doesn't cover it, free testing is available at most major chain drugstores.
How often: Every three years
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4. Bone density test
About 80 percent of the ten million people afflicted with osteoporosis are women, according to the National Osteoporosis Foundation, so it's a serious concern. Osteoporosis happens when minerals such as calcium begin to leach from bones, thinning and weakening them. In women, this often happens as a result of low estrogen levels after menopause.
What it is: A specialized X-ray called a DXA (dual-energy X-ray) screens your spine, hips, and wrists as you lie on a table.
When to start: At age 65, when all women should have a DXA. But if you've had a hysterectomy or have reached menopause and have risk factors for bone loss such as being thin or having a history of fractures, you should talk to your doctor about being screened now.
How often: Every five years
5. Vitamin D test
Recently, doctors have realized that vitamin D is a key nutrient that helps maintain strong bones and protect against cancer and infection. Yet many women have low levels of vitamin D and don't know it. This is important because women are at such high risk for osteoporosis; 80 percent of those with bone loss are women.
A simple blood test can measure the level of vitamin D in your blood to see if you're getting enough sun exposure and if your diet provides you with enough vitamin D. If not, your doctor will recommend taking a vitamin D supplement.
What it is: A blood test to check the level of vitamin D in your blood. You want your reading to be between 30 and 80 nanograms per milliliter; some experts advocate 50 as the lower limit. Many experts recommend the 25(OH)D3 test as providing the more accurate measurement.
When to start: Age 40; sooner if you have signs or risk factors for osteoporosis. As we age, our bodies become less efficient at synthesizing vitamin D from the sun, so after age 40 it's more likely that you'll become D-deficient. Also, if you have any signs of low bone density, such as a fracture, your doctor will want to test your vitamin D along with your bone density.
How often: Although vitamin D testing isn't yet required or listed on the official schedule of recommended tests, more and more doctors are recommending it as an annual test after age 45, along with diabetes screening.
6. Colonoscopy or sigmoidoscopy
Colorectal cancer, which is cancer of the lower part of the intestines, is curable in 90 percent of all cases -- as long as it's caught early. And screening tests that look inside the colon, called colonoscopy and flexible sigmoidoscopy, are the secret to catching it early.
Unfortunately, this still isn't happening as often as it should, especially in women. Many people mistakenly think of colon cancer as a man's disease, although it strikes women equally with men. And despite Farrah Fawcett's well-publicized death from anal cancer, women are still less likely to be screened and more likely to have advanced disease once it's caught.
What it is: An examination of your colon using a tiny scope and camera, which are inserted through the rectum. A colonoscopy can see the whole colon, and a sigmoidoscopy can see only the sigmoid, or lower section of the colon.
When to start: Age 50 for those with no risk factors. If, however, you have a first-degree family member who's had colon cancer before the age of 50, begin colonoscopy screening when you're ten years younger than the age at which your family member was diagnosed. If a family member was diagnosed at 45, for example, you should have your first screening at 35.
How often: Flexible sigmoidoscopies should be repeated every five years, and a colonoscopy should be repeated every ten years. A computerized imaging technique called virtual colonoscopy is gaining popularity at some medical centers, but many doctors still consider it experimental and some insurers, including Medicare, don't cover it.
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7. Fecal occult blood test (FOBT)
Although it sounds otherworldly, the word occult simply refers to the fact that this test checks for blood in the stool that's not visible to the eye. This test is considered key to catching colon cancer early; currently more women than men are diagnosed with colon cancer that's already at an advanced stage. An FOBT is used to check for intestinal conditions such as Crohn's disease and ulcerative colitis.
What it is: A chemical solution is used to test a stool sample for the presence of invisible blood. Three stool samples are collected on consecutive days, since cancer and other conditions may not bleed consistently.
When to start: At age 50; your doctor may suggest it earlier if there's cause for concern about intestinal conditions.
How often: Yearly after age 50
8. Skin cancer screening
Skin cancer, while less deadly than some, is the number-one cancer diagnosed among Americans. And one type of skin cancer, melanoma, is deadly. Younger women in particular need to be educated about skin cancer; many women mistakenly believe men are more likely to get skin cancer, but the rise in popularity of tanning beds and some outdoor activities has caused skin cancer rates to rise among younger women. The number of women under age 40 with basal cell carcinoma, one type of skin cancer, has more than doubled in the last 30 years and women under 39 are almost twice as likely to develop melanoma as men. Skin cancer is relatively easy to detect as long as you bring any suspicious areas to the attention of your doctor.
What it is: An examination of your skin, particularly moles, lesions, or other areas that are changing or growing
When to start: Any age
How often: Experts recommend conducting a personal "mole check" once a month in the shower to look for unusual growths or changes to existing moles. If you notice anything unusual, call your doctor. Many communities offer free skin cancer screenings, usually held at drug stores or clinics. They're often held in May, just as the summer season begins and people start to expose more skin.
9. Eye exam and vision screening
Whether you have problems seeing at a distance or close up, you need regular eye exams as you age to check the overall health of your eyes. Women are at a slightly higher risk of developing age-related macular degeneration, one of the most common eye health problems.
What it is: A vision screening tests how well you can see; an eye exam checks for glaucoma, macular degeneration, retinopathy, and other eye diseases. Make sure you're having both kinds of exams.
When to start: Age 18
How often: Every one to three years between the ages of 18 and 61, says the American Optometric Association; after that, as often as your doctor thinks is necessary depending on what's happening with your vision. If you have diabetes, you're at much higher risk for eye problems and should be checked more often.
10. Hearing test (audiogram)
Fourteen percent of adults between ages 45 and 64 have hearing loss, and by the age of 60, one in three adults is losing hearing. Yet many people go years before getting tested, primarily because hearing tests are voluntary. Although men are more likely to develop hearing loss in general, certain conditions that are more common to women, such as lupus and other autoimmune diseases, raise the risk of hearing loss.
You and your doctor have to decide that you need a hearing test and request one. If you notice problems following conversations, missed social cues, or an inability to distinguish people's speech from background noise, ask for a referral to an otolaryngologist to check the condition of your ears and to an audiologist to check your hearing.
What it is: A series of tests to assess different aspects of hearing. Tone tests are used to measure your overall hearing; additional tests evaluate your ability to register speech and check inner and middle ear function.
When to start: When you or others notice problems
How often: Hearing tests are voluntary, but the American Speech-Language-Hearing Association recommends hearing tests every ten years for adults up to age 50. After that, experts recommend hearing tests every three years.
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11. Thyroid test
The thyroid, a small gland in your neck, regulates your body's metabolic rate. Women are at higher risk for most types of thyroid disease, probably because of hormonal factors. If your thyroid is overactive, a condition known as hyperthyroidism, your metabolic rate is too high. Symptoms include insomnia, weight loss, and overactive pulse. If you're hypothyroid, it means your thyroid is underactive and your metabolism will be slow and sluggish. This usually leads to fatigue, constipation, and weight gain.
What it is: The most common test, the TSH test, is a blood test that measures the level of thyroid-stimulating hormone. The desired level is between 0.4 and 5.5. However, many experts believe testing thyroxine (a hormone made by the thyroid) directly with what's called the T4 test is a more accurate way to assess thyroid function.
When to start: Age 35
How often: The American Thyroid Association recommends a thyroid test every three to five years after the age of 35. Other doctors don't recommend a thyroid test for midlife adults unless you have symptoms of hypothyroidism or hyperthyroidism. Many women begin to experience thyroid problems in their 40s and 50s, so if you have any question about whether your thyroid levels are normal, ask your doctor to order tests. After the age of 60, thyroid testing is usually conducted annually.
12. Screening for metabolic syndrome
Metabolic syndrome is a group of symptoms that put you at increased risk for both diabetes and heart disease. The screening involves checking for a list of issues and, if they're present, recommending additional tests. Doctors consider women to have metabolic syndrome if three of the following five risk factors are present:
Waist circumference for women greater than 35 inches
Low "good" cholesterol (below 50 mg/dL)
Elevated triglycerides (greater than 150 mg/dL)
Blood pressure higher than130/85
Fasting glucose above 100 mg/dL
If three or more of these apply, ask your doctor for an additional screening test called the C-reactive protein (CRP), which many experts think is the best way to monitor heart health risks.
What it is: A blood test that measures an inflammatory marker for plaque buildup
When to start: Age 50
How often: Every three to five years, along with cholesterol and diabetes screening
13. Pelvic exam and pap smear
Although many younger women are now being vaccinated against the HPV strain that causes cervical cancer, women who were past the age of 26 when the vaccine was introduced still need to be alert for this deadly form of cancer. (Current vaccine recommendations are for girls and women ages 9 to 26.) Sadly, cervical cancer remains the second leading cause of death from cancer for women worldwide, and the familiar pap smear remains the preventive screening test of choice.
What it is: A swab test in which a swab is inserted into the vagina to remove cells from the cervix; the cells are then examined in a laboratory for signs of precancerous or cancerous changes.
When to start: At age 21 or within three years of becoming sexually active
How often: Every year, although some doctors will allow you to go two to three years between exams if all your results have been normal.
14. Physical breast exam
Checking your breasts for lumps, thickening, skin changes, and nipple discharge is the best way to be vigilant about preventing breast cancer. You can do this exam at home in the shower, but doctors also recommend having breast checks performed by an expert as well.
What it is: Palpation of the breast and underarm area looking for lumps, dimpling, pain or tenderness, inflamed skin, and any other breast changes; also a nipple exam checking for discharge, crustiness, or blockage
When to start: Age 20
How often: Experts recommend home breast exams once a month; it's usually best to do them just after your period ends, when breasts aren't as tender or sore. Women over age 18 should have a doctor perform a breast exam once a year; this is usually done along with the pelvic examination.
Breast cancer is the most common type of cancer in women, and the mammogram remains the most basic tool used to screen for tumors, aside from physical examination of the breasts.
What it is: A specialized X-ray of the breast. Some hospitals now use digital mammograms; others continue to use film. Both are effective, but research shows that digital mammography is significantly better for women who are younger than age 50 or have very dense breasts, according to the National Cancer Institute.
When to start: Age 40; however, if your mother or sister was diagnosed with breast cancer, especially if she was younger than 40, experts recommend starting mammograms five to ten years earlier than the age at which your relative was diagnosed.
How often: Every year. (Disregard recent controversy over mammogram frequency until final recommendations are issued.)