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What your doctor doesn’t know can hurt you

Think medical-history forms are a bore? Think again, says Dr. Judith Reichman — not completing them could put your health at risk.

Q: I hate those long medical-history forms you fill out at the doctor’s office. They seem to ask for information that seems irrelevant to my situation. Are they really necessary?

A: Yes — they are essential. You should fill out those forms thoroughly and update them every time you see the doctor.

Although most doctors do their best to keep up with your medical history, you cannot assume that this is the case (or that he or she even reviews that all-important first page of your chart). And with doctors busier than ever, you cannot always rely on them to ask all the questions that may be relevant to your health.

Worse, changes in insurance plans sometimes mean changes in doctors, and the “getting to know you” phase must be repeated each time.

In either case, if the doctor does not have a complete and updated medical-history form, you are putting your health at risk.

I’m glad when a patient comes to her appointment with a list of medical-history information and of questions. All too often, important issues arise from a “by the way” comment as the patient is about to exit the exam room. Then there are those who call later, saying, “I forgot to tell you….” These are not the best ways to get timely diagnosis and therapy.

The following information should be included in your medical history:

GYNECOLOGICAL HISTORY
Since this is a women’s health column, I’ll begin with gynecological topics.

When did your period start? The earlier it starts and the later it stops (in other words, the longer you have had periods), the greater is your risk for breast and ovarian cancer.

Are your cycles regular? Missed periods could indicate too little estrogen — a cause of osteoporosis. Irregular cycles could signal polycystic ovary syndrome (PCOS), a condition often accompanied by acne and weight gain. PCOS may increase the risk for infertility, uterine cancer, hypertension and heart disease.

How long, heavy or painful are your cycles? Severe pain or heavy bleeding may indicate endometriosis, uterine fibroids or ovarian cysts.

If you have premenstrual symptoms, how severe and long-lasting are they?There is no reason to suffer PMS in silence — it can be treated. In addition, a determination needs to be made to separate its effects from underlying clinical depression.

How many times have you been pregnant, and how many deliveries, C-sections, miscarriages or terminations have you had? Multiple deliveries could increase your risk of pelvic support problems. A history of miscarriages could indicate an autoimmune disorder. Also, having a large baby (more than 9 pounds) may mean you are at risk for diabetes.

Do you have a history of infertility? An inability to conceive — as well as the use of infertility therapies — could increase your risk for ovarian cancer.

What have you used for contraception? The use of birth-control pills decreases your risk for ovarian and uterine cancer.

Do you feel that your sexual desire or pleasure are diminished or absent?
This can be due to hormonal, physical or emotional problems. Your doctor can help you diagnose the cause and find appropriate treatment.

Have you had a sexually transmitted disease?
If you have had genital warts, chlamydia, pelvic inflammatory disease, trichomonas, herpes or a previous abnormal pap smear, you should maintain a rigorous schedule of pap smears.

Are you menopausal and do you have distressing symptoms? Hot flashes, mood swings, vaginal dryness and sleep disturbances are treatable. Very early menopause — before age 40 — puts you at risk for osteoporosis and coronary disease.

GENERAL MEDICAL HISTORYThe above questions relate only to your gynecological history. There is, of course, other background information that your doctor should know. This includes:

Past illnessesRheumatic fever in childhood, for example, can lead to mitral valve prolapse, meaning you must take antibiotics before dental work to guard against a heart infection called bacterial endocarditis.

Blood transfusionsIf you have received blood, your doctor may want to test for Hepatitis C. Transfusions in the 1980s could have put you at risk for HIV infection.

Family historyThis is revealing of your genetic risk. You share half of your genes with each parent and sibling, and a quarter of your genes with each grandparent. A family history of heart disease, diabetes, stroke, osteoporosis, arthritis, Alzheimer’s and many cancers can increase your risk for these diseases and warrant specific testing (and, in some cases, behavior modification).

MedicationsYour doctor should know what medications you are taking. This includes any over-the-counter drugs, vitamins, minerals and herbs. (Just because something is labeled “natural” does not mean that it does not have potential harmful effects and/or interactions with other medications.)

Health habitsSmoking, alcohol consumption, diet and exercise — own up to what you are (or aren’t) doing.

Sleeping patterns and energy levelsFatigue may be due to inadequate sleep, stress or an underlying disease.

Drug allergiesWhenever you get a new prescription, remind your doctor about previous drug allergies. Many medications share a similar chemical structure that will renew old allergic reactions.

Recent foreign travelMore and more people are traveling the globe — and are exposed to new viruses, bacteria and parasites. Keep your doctor informed.

Finally, ask your doctor whether you are due for screening tests or immunizations. Depending on age and risk factors, you should be given a schedule for your mammogram, pap smear, blood tests, colon testing and bone-density test.

Dr. Reichman’s Bottom Line: What your doctor doesn’t know can hurt you. It’s important to keep those forms at the doctor’s office complete and current.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," published by William Morrow, a division of .

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.