How healthy are you?

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“The Middle Years”
This is the stage where women experience enormous physical changes because of estrogen decline and aging. One of the most obvious changes is menopause. But there are other big health issues like arthritis, osteoporosis, heart disease, breast and cervical cancer. So medical checkups, exams and testing are important at this age. Schedule the following tests to stay healthy, strong and vital:

General physical exam
This includes taking a detailed history to learn all about you and your family history and a head-to-toe physical exam including an exam of your skin, eye, ears, nose throat, lymph nodes, chest, breast, abdomen, rectum and extremities. Make sure you get a breast exam and rectal exam and stool check for blood by your family doctor if you are not examined yearly by a gynecologist.

Tests for women in their 50s
Measure waist circumference: Women with increased waist circumference (WC) are at increased risk of metabolic syndrome, diabetes, heart disease and cancer of breast and uterus. Checking your body mass index or BMI (measure of height and weight) is a much less reliable estimate of future health risk than WC and body shape.

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Get a colonoscopy: Talk to your doctor about colon cancer screening at the age of 50 — or sooner if colon cancer, colon polyps, inflammatory bowel disease or other cancers such as breast, ovarian, endometrial or prostate run in your family. At the least, you should have an annual rectal exam and check of the stool for occult or hidden blood. Ideally you should also have a look inside of your entire colon once at age 50 (called a colonoscopy) and if it is normal, perhaps this test could be repeated no more often that once every 5-10 years depending on your history.

Need mammogram tests: A mammogram is an x-ray that can detect breast cancer early; often before a lump can be felt. It is best to schedule this test a week after your period, a time when your breasts will be least tender and glandular. If you are taking hormone therapy after menopause your breasts may appear more glandular or dense from the hormones. Ask your doctor about stopping the hormones a few weeks before the scheduled test. Women over 50 should have this test yearly. (Women at high risk for breast cancer should ask about a digital mammogram and an MRI.)

Tests for women in their 60s
Determine your bone density for risk of osteoporosis: At this stage, you gradually lose bone mass, but after menopause, the rate of bone loss increases significantly. An estimated 20 percent of women in their 50s already have osteoporosis. Make sure your diet is rich in calcium, engage in regular weight-bearing exercises (walking and dancing) and strength-training (lifting weights) to help keep your bones strong. Studies show that even gardening can help prevent bone loss in older women.

Bone density test uses the DXA scan. The lower your bone density, the greater your risk for bone fractures. (There is also a much less accurate heel ultrasound test that does not diagnose osteoporosis but merely tells your doctor whether you are at risk and should have the more complete x-ray DXA scan test.) The DXA scan is considered the gold standard for the diagnosis of osteoporosis. The most important score or result to check is your T-score. The T-score tells you how your bones compare to that of a healthy 35-year-old woman. If your T-score falls between -1 and -2.5 then you have mild bone loss called osteopenia. If your T score is -2.5 or lower, than you have osteoporosis and a significant increased risk of fractures. You can also look at your Z-score, which tells you how you compare to a similarly matched group of women your age and ethnic background. It is not unusual for an 80-year-old woman to have a normal (for her age) Z-score but have severe osteoporosis (her T-score could be much lower than -2.5). I often hear women tell me their DXA scan is normal yet when I got the actual report I found that their Z-score was normal for their age but their T-score was low and they needed counseling about prevention for further bone loss. I can’t say it enough, “Get a copy of your report and learn what your results mean for you.”

Eye exam for glaucoma and cataracts: Everyone should have their eyes checked on a regular basis. This exam can check for vision, cataracts and even glaucoma. Patients with metabolic syndrome or diabetes should also have an annual exam by an ophthalmologist to check the retina as well.

For more information, visit http://www.drsavard.com/ and http://www.applesandpears.org/.

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How healthy are you?