Women: Best Questions to Ask Your Doctor
Doctor’s Visits Still Important in Midlife and Beyond
Just because you’re through your childbearing years doesn’t mean you can stop seeing your gynecologist. Health screenings and preventive care are as important during and after menopause as they were when you were young.
It’s imperative that you find the right doctor. While the ob/gyn who delivered your children may have a special place in your heart, he or she may or may not be as knowledgeable about the issues you are facing during midlife and beyond, including menopause. Don’t be afraid to ask if your doctor has additional training or is credentialed by the North American Menopause Society (NAMS). Taking control of your health means choosing a specialists who can provide the support and treatment options you need during each phase of your life.
Be wary if your health care provider imparts absolutes. Women’s health issues are never black and white. Every woman needs individualized options, education and support. If your doctor gives you simplistic answers, move on. You deserve better.
Routine Tests and Screenings
When caring for a woman at midlife, a physician should perform a number of tests and screenings on a regular basis. If you have chosen a new physician, getting what are called baseline scores on these tests will allow him or her to establish what is normal for you. Knowing your scores allows the doctor to track any improvements or declines over the months or years between visits.
Important tests include:
- Yearly mammogram to screen for breast cancer
- Bone density assessment
- Colonoscopy to screen for colon cancer by age 45
- Yearly blood pressure reading
- Periodic blood tests for cholesterol and fasting blood sugar
- Thyroid stimulating hormone (TSH) test every 5 years
- Periodic pap smear and pelvic exam
After baseline testing, your doctor will tell you when each of these tests should be repeated.
Health Issues Can Sneak Up on You
Risks of dangerous health problems, including cardiovascular disease; breast cancer and other cancers; and stroke actually increase with age. Regular visits to a physician will help to identify problems like high blood pressure, pre-diabetes, and breast or skin changes early, when they are easier to treat. The loss of estrogen during menopause is linked to a number of common health problems. After menopause, women are more likely to suffer from osteoporosis, changes in bladder function, loss of skin elasticity, decreased muscle tone, changes in vision and weight fluctuations because of a slower metabolism.
Top Five Health Concerns for Women
You can be proactive about preventing some major issues:
1. Cancer
Breast cancer
Lower your risks by not smoking, exercising regularly, limiting alcohol use and controlling your weight. In your 20s and 30s, have clinical breast exams every three years, and at age 40, start getting yearly mammograms. You may need earlier, more frequent screening if you have breast cancer in the family or other risk factors. Be sure to ingest enough vitamin D.
Cervical cancer
Get your periodic Pap smear to screen for cervical cancer and ask about getting tested for HPV by age 30. If your pap is normal and you do not carry HPV, you can space out pap smears of the cervix to every five years.
Colon cancer
Start screening with a colonoscopy at age 45. It it’s normal, repeat every 10 years.
2. Cardiovascular disease/high blood pressure/high cholesterol
If cardiovascular disease runs in your family, or if your blood pressure or cholesterol levels are high, ask your doctor about taking medications to control blood pressure and cholesterol. Your doctor can also advise you on whether you’ll benefit from taking a daily aspirin. For women, this is usually by age 65.
3. Osteoporosis
To preserve bone mass, avoid all tobacco products, limit your alcohol intake, get adequate calcium and vitamin D, and do weight-bearing exercises such as walking. Risks of bone fragility are greatest after menopause, so supplement your diet with 1200 mg of calcium plus at least 1000 IU of vitamin D3 starting at age 50. Begin bone-mineral density screenings at age 65, or earlier if you have one or more risk factors (at age 50 if you’ve suffered a bone fracture.) Screening every two or three years will detect any bone-thinning, and you can take bone-building medications on a weekly, monthly or annual (intravenous) basis if needed.
4. Menopause treatment options
If lack of sleep, continuous hot flashes or severe mood swings are disrupting your life, consider menopausal hormone therapy. Your physician will guide you to the right hormone combination and best mode of administration. For many women, the benefits of hormone therapy outweigh the risks.
5. Weight management as you get older
Eat smaller portions and healthier foods, and exercise more as your metabolism slows down with age. This will help prevent type 2 diabetes, arthritis and other weight-related problems.
Many medical problems can be controlled with relative ease by eating well, exercising regularly, protecting the skin from sun damage, taking the right vitamins and supplements and staying actively involved in life as you work with your physician to design a personalized regimen.
For more information, visit Cleveland Clinic’s Center for Specialized Women’s Health.