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How healthy are you?

A checklist to help women stay in good health over the decades.
/ Source: Weekend Today

For women, the aging process can be difficult as they see wrinkles appear, their waistline expand and their biological clock ticking faster. But there are important steps you can take to help you live a longer and healthier life. Liz Vacariello, executive editor of Fitness magazine, shares a checklist on staying healthy.

Major physical changes of women in their 30s and 40s
The most obvious is your metabolism slows down and excess pounds won’t come off as quickly. Starting at about age 25, a person s metabolism declines approximately 5 percent every decade. You lose lean muscle mass: Between the ages of 30 and 50, a woman can drop up to 10 pounds of lean mass.

Infertility: A woman’s fertility declines with age because the quantity of her eggs is drastically reduced.  All women run out of good eggs at some point and that point varies by the individual. By age 30, a woman has a one in seven chance of infertility. By age 35, one third of females will experience infertility, and by age 37 that number rises to one half.

A greater risk of heart disease: This is the time in your life when you’re balancing work and your kids and husband; you may also be caring for aging parents. All this stress increases your risk for heart disease.

Perimenopause: The time when your body begins its transition into menopause. The levels of your reproductive hormones — estrogen and progesterone — rise and fall unevenly during this time, and menstrual cycles gradually lengthen. Perimenopause begins at around age 35. This leads to increased weight gain, particularly in the abdomen.

Breast cancer: More than 11,000 women under age 40 will be diagnosed with breast cancer this year. They tend to have more aggressive cancers (and lower survival rates) than older women.

Test women should have in their 30sPap smear for cervical cancer: A pap test checks for changes in the cells of your cervix, the lower part of the uterus that opens into the vagina. This test can tell if you have an infection, abnormal cervical cells or cervical cancer. All women should have this test cause it could save your life and find the earliest signs of cervical cancer. The test is simple and quick. The doctor uses an instrument called a speculum into your vagina. He will remove a few cells inside and around the cervix. The cells are then placed on a glass slide and sent to the lab for examination.

It’s important to get this test annually. You can start in your 20s or even earlier if you’re sexually active. However if you’re over 30, and have had three normal pap tests for three years in a row, you should talk to your doctor about spacing out the tests every two-three years.

Pelvic exam by Ob/Gyn for reproductive cancers (uterine and ovarian): A regular pelvic exam is your first line cancer screening for almost all gynecological cancers. The most common form of reproductive cancer occurs in the lining of the uterus. Treatment for this type of cancer is usually a hysterectomy, followed by radiation or chemotherapy, and survival rate is quite good. The American Cancer Society recommends that all women be informed about the symptoms of uterine cancer like abnormal bleeding or spotting, pain in the pelvis or back of legs, unusual weight loss, and changes in bladder habits — and to see a doctor immediately if these symptoms do occur.

Ovarian cancer begins in the ovaries, the area that produces eggs for reproduction. The eggs travel through the fallopian tubes into the uterus where the fertilized egg implants and develops into a fetus. Cancer beings in the tubes and the ovaries are the main source of female hormones estrogen and progesterone. Symptoms of this cancer include pelvic discomfort, back or leg pain, bloating, fatigue, gastrointestinal symptoms, nausea and unusual vaginal bleeding.

Blood pressure, cholesterol tests for heart disease, diabetes: It’s important to measure you blood pressure and get a cholesterol blood test to detect any heart disease or diabetes.

High blood pressure or hypertension will increase your risk of heart disease, heart attack and stroke. If you’re obese, smoke or you have high blood cholesterol levels along with high blood pressure, your risk of heart disease or stroke greatly increases. Blood pressure can vary with activity and with age, but a healthy pressure reading should be between 120 and 130, and a diastolic pressure reading between 80 and 90 (or below).

Cholesterol is a fat-like substance carried in your blood. It’s found in all of your body’s cells. Your liver produces all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals (meats, eggs and dairy products). We often blame the cholesterol found in foods that we eat for raising blood cholesterol, but the main culprit is saturated fat in food.

Heart problems are the leading cause of death among people with diabetes, especially in the case of adult-onset or Type II diabetes (also known as non-insulin-dependent diabetes). The American Heart Association estimates that 65 percent of patients with diabetes die of some form of cardiovascular disease.

Test women should have in their 40s
Mammogram for breast cancer:
Mammograms is an x-ray of the breast. It’s the probably the most important tool doctors use to diagnose and evaluate women for breast cancer. Leading experts, the National Cancer Institute, the American Cancer Society and the American College of Radiology, now recommend annual mammograms for women over 40. These exams can reduce your risk of dying from breast cancer by 63 percent.

There’s a lot of confusion out there about when and how often to get a mammogram. For now, the recommendation is that women get a mammogram once a year, beginning at age 40. If you’re at high risk for breast cancer, with a strong family history of breast or ovarian cancer, or have had radiation treatment to the chest in the past, it’s recommended that you start having annual mammograms at a younger age (often beginning around your 30s). This, however, is something that you should discuss with your health-care provider.

Rectal exam for colon cancer: Colon cancer is one of the leading and most common forms of cancer in the U.S. One screening method is a digital rectal exam — that’s when the doctor checks the rectum for polyps and any cancers. Since this is one of more treatable cancers, it’s important to catch it early when chances of a cure are greatest. You can also lower your risk of colon cancer by the following: proper exercise, weight control and avoid becoming obese, giving up smoking and changing your eating habits to low-fat, high-fiber foods.

“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 50sMeasure 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.

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 60sDetermine 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.

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