How long has it been since your last doctor’s visit, dental checkup, eye exam or skin cancer screening?
For many women, the answer may be “circa 2019” — or before the coronavirus crisis forced Americans to put their lives on hold and skip routine health appointments. Even as clinics reopened, many families have been reluctant to leave their “bubbles.”
It’s a concern for doctors, who say the time to go is now. National Women’s Health Week, observed May 9-15, serves as a reminder for women and girls to take care of their health and well-being.
A telemedicine visit — perfected by medical staff during the lockdown — can be a start, but most physicians are back to seeing patients in person.
“People are starting to kind of wake up and understand that they have to schedule their preventative screening visits,” Dr. Mary Rosser, an OB-GYN and director of Integrated Women's Health at Columbia University Irving Medical Center in New York, told TODAY.
“Women have been so focused on their families… and their own careers and jobs they've been taking care of during this pandemic. It's really time to say, OK, please don't forget to focus on yourself.”
Rosser was particularly concerned about women putting off mammograms. The director of the National Cancer Institute has predicted the number of people who’ll die from breast or colorectal cancer in the U.S. will rise by almost 10,000 over the next decade because of COVID-19's disruption of screenings and treatment.
Other physicians were also worried about the toll skipped visits would have in the months to come.
“I have seen many patients coming to me with new dental disease that they didn’t have before the pandemic,” said Dr. Ruchi Sahota, a dentist in Fremont, California, and a spokesperson for the American Dental Association.
“If my patients aren’t coming in for their routine exams and cleanings, I am worried about them. I can’t help it.”
Here’s what women need to know about their preventive care, broken down by appointment type and age group:
Annual physical:
The once-a-year checkup has long been considered a standard of care, but there’s been debate over whether it’s really needed, especially for healthy adults under 50.
Prevention really works, said Dr. Nisa Maruthur, a primary care physician and associate professor of medicine at Johns Hopkins University in Baltimore, so she’s been concerned about the drop in preventive care since last year. Common chronic diseases that might be missed include high blood pressure and diabetes, which can be asymptomatic for a long time.
“Regular contacts with your primary care provider are extremely important,” she said. Check with your doctor to see whether you’re overdue for a visit and if you should come in person.
Routine blood tests and screenings can offer important clues about health and catch problems early.
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Annual well-woman exam:
A visit at the gynecologist’s office used to be synonymous with getting a Pap test and a pelvic exam, but women don’t need those two items every year, said Rosser, who served as chair of the American College of Obstetricians and Gynecologists’ Presidential Task Force on preventive health.
“But you still need to see your gynecologist every year to talk about your total health,” she noted. “Women look to us as their primary care physician, and I think that is why we are in a unique position as OB-GYNs to deliver comprehensive care, looking from head to toe.”
The well-woman visit will cover everything from breast health and reproductive issues to healthy lifestyle counseling and screening for anxiety and depression. Rosser also likes to discuss heart health since heart disease is the leading cause of death in women.
Dentist:
Dentistry is essential health care, with regular cleanings allowing a dentist to remove bacteria that sneaks its way underneath the gums and onto the bone, Sahota said. Problems in the mouth can also contribute to systemic health issues or may signal something larger going on with your overall health, she added.
Women should go to the dentist on a regular basis, though the ideal frequency can vary from person to person. It may be twice a year or more often. Sahota recommended asking your dentist about the ideal intervals.
“If you’ve skipped your checkup, go now. Hopefully, no damage is done,” she said. “(But) if we let a small cavity linger too long, it can result in pain, infection and even the loss of a tooth… going as soon as possible will help your dentist treat the cavity.”
More than 70% of dentists are seeing an increase in patients experiencing teeth grinding and clenching, which are associated with stress, a recent survey by the American Dental Association Health Policy Institute found.
Regular checkups can help prevent dental health problems or spot them early when treatment is likely to be simpler and more affordable.
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Skin check:
Your dermatologist will determine how often you need a skin exam to detect cancer based on risk factors such as skin type, history of sun exposure and family history.
People with a history of melanoma should have a full-body exam by a dermatologist at least once a year, the American Academy of Dermatology noted.
“I am amazed and inspired by patients' willingness and insistence to come into to the office for their annual screening,” said Dr. Adam Friedman, professor and chair of dermatology at the George Washington School of Medicine and Health Sciences.
“With May being Skin Cancer Awareness Month, there’s no better time to have a skin cancer screen than now if you have put it off for more than a year.”
At his practice, dermatologists are now predominantly seeing patients in person, though they’re still offering telehealth visits that allow them to see suspicious spots via video.
Eyes:
The frequency of eye exams depends on factors including a person’s age and medical history, according to the American Academy of Ophthalmology.
Healthy adults should get an eye exam at least every two years until age 64, and annually if they’re older, the American Optometric Association recommended.
In your 20s:
Start getting your cholesterol levels checked and initiate Pap testing for cervical cancer screening. There are vaccinations that may be due, Maruthur said.
Rosser encourages women to think about whether they’d like to have children and consider their options for starting a family. It’s also an opportunity to talk about sexually transmitted diseases and birth control.
When it comes to skin health, self-exams are encouraged, but prevention is the best medicine. “Invest in your future with sun protective measures including (applying) sunscreen SPF 30 or higher and broad spectrum to exposed areas, as well as (wearing) protective clothing, hats, sunglasses every day,” Friedman noted.
In your 30s:
Have your blood pressure checked and get other screenings that may be needed based on your family history or other personal risk factors. Watch for red flags of skin cancer, including the ABCDEs of melanoma.
In your 40s:
“This is a time where we really need to keep an eye on blood pressure, consider screening for diabetes and discuss breast cancer and colon cancer screening,” Maruthur said.
Rosser starts educating women about perimenopause, the period of time that leads up to menopause and can last four to 10 years.
At the dermatologist, consider field therapy and photodynamic therapy, which target sun damaged skin cells to hopefully prevent them from developing into skin cancer, Friedman advised.
In your 50s:
Regular mammography and colon cancer screening are recommended.
It's also a time for women to consider bone health. As estrogen drops after menopause, bones start to become compromised, Rosser noted, so it’s important to get adequate vitamin D to absorb calcium better and engage in weight bearing exercise for bone health.
Take extra good care of your skin: Aging skin inherently heals slowly, is thinner — especially in sun-exposed areas — and more susceptible to the harmful effects of ultraviolet radiation, Friedman said.
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In your 60s and beyond:
Discuss getting a bone density test to evaluate for osteoporosis. Pay attention to neurocognitive aging and tell your doctor about any issues like forgetfulness or not being able to think clearly.
If you bruise easily in sun exposed areas — an issue that’s further exacerbated by medications like blood thinners — ask your doctor for products that can help with this problem.
Bottom line:
“It's really important now for all ages to get connected with their health care professional,” Rosser said.
More resources: Women's Preventive Services Initiative’s well-woman chart.
