Guest blog by Elizabeth Stein, CNM, MSN, MPH
NYC practice Ask Your Midwife, PC.
1. Gynecology - Women should see their midwife or physician routinely for a Pap smear, pelvic exam, pelvic sonogram, breast exam, STD screening, pregnancy planning and birth control. In addition, blood pressure and weight should be recorded at each visit. For many women, their gyn provider is also their primary care provider. This visit should include a complete interval history, which is the history from previous visits to the current visit. This includes medical problems, medications including over the counter medications and herbs, sexual activity, lifestyle which includes smoking, drinking, drugs and exercise.
2. Breast Health - A breast self-exam should be done every month for the women's entire life. Mammograms should start at age 40. They can be scheduled earlier if there is a close family member with breast cancer.
3. Cervical and STD Screening - Though not standard of care, HPV testing should be done in combination with the Pap smear. STD cultures include gonorrhea, Chlamydia, trichomonas. Other cultures include bacterial vaginosis (BV), yeast, and group B strep. STD blood screenings include HIV, syphilis, hepatitis B, and herpes 1 and 2.
4. Heart Health - Heart disease is the number one cause of death among older women in the United States. Blood pressure, weight, nutrition, activity level, lipid profile (cholesterol, triglycerides, HDL, LDL) and diabetes screening are all factors that affect heart health and should be discussed regularly. Obesity, diabetes and high blood pressure increase the risk of cardiovascular disease and stroke. Women may want to consider taking a baby aspirin (81 mg) daily to decrease their risk of heart attack and stroke.
5. Colon Health - Women should have a colonoscopy at age 50 and repeated every 10 years. Women with a personal history may start screening earlier and more frequently than every 10 years.
6. Bone Health - Osteoporosis is a condition that causes bone deterioration and mainly affects women. Women should have a bone density test near the onset of menopause. Estrogen prevents bone loss. Weight-bearing exercise and diets rich in calcium and vitamin D will help to keep bones healthy.
7. Perimenopause Health - The transition into menopause can last anywhere from 2-8 years. Menstrual history should be reviewed because the first symptoms of menopause are often changes in the menstrual cycle followed by hot flashes. Hormone tests can also determine if a woman has entered perimenopause and include follicle-stimulating hormone (FSH), estrogen and thyroid levels.
8. Postmenopausal Health - The average age for menopause is 51+ years. The average lifespan for women is currently nearly 80 years. Women may want to discuss a wellness plan with their provider as most will live another 25 to 30 years in the postmenopausal period.
9. Vaccinations - An HPV vaccine (Gardasil®) is available and strongly recommended. Women should also consider a flu vaccine annually.
10. Other Annual Screenings - See your dentist and eye doctor yearly.
11. Be Proactive. Review all results and make a healthcare plan with your provider.