January / 2001
Your Health

Women's health checklist
by: Elizabeth Wade Hall

An ounce of prevention truly is worth a pound of cure. "It sounds clichéd, but it's true," says Deborah G. Kwolek, M.D., medical director of the University of Kentucky Women's Health Center and an assistant professor of internal medicine in the UK College of Medicine.

"Women need to make caring for themselves a priority. Women often put themselves last. If you can prevent a medical problem you are far better off than getting treatment for a medical problem."

Women can start taking better care of themselves by following this preventive health checklist:

1. General medical exam. An annual physical is a good time to check blood pressure, blood sugar, cholesterol, thyroid, heart (heart disease is the number-one killer among women), lungs, vision, and hearing. A good time to do this is when you feel fine.

2. Pelvic exam and Pap test. During a pelvic exam, the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum are examined for abnormalities. The Pap test- a way to examine cells from the cervix and vagina-can show the presence of infection, inflammation, abnormal cells, or cancer. Women who are or have been sexually active, or have reached age 18, should have Pap tests and physical exams regularly.

3. Breast self-exam and mammograms. Breast cancer is the second leading cause of cancer death among women. Women should do a breast self-exam monthly. Menstruating women should do so right after their period ends, and women in menopause should use their calendars as a reminder and do their exams the first of every month. The current recommendations are for women between the ages of 40 and 50 to get a mammogram every one to two years, and for all women over 50 to have a mammogram annually.

4. Colonoscopy. Colon cancer is the third leading cause of cancer among women. Women who have a family history of colon cancer should be screened regularly, and women age 60 or older should have a colonoscopy.

5. Bone density screening. Women should receive a baseline bone density screening at age 35. Menopausal and post-menopausal women should be screened every other year. To prevent osteoporosis, women should take 1,200 milligrams a day of calcium and 400 IUs of vitamin D. Post-menopausal women who are not on estrogen need 1,500 milligrams of calcium per day.

6. Depression screening. Up to one quarter of all women are depressed, and 30 percent have anxiety, Kwolek says. "Some tend to think of women's health in terms of gynecology and we shouldn't," Kwolek says. "We need to look at the whole woman."

7. Exercise regularly and maintain your ideal weight. Women should participate in weight-bearing exercise-such as walking, running, or weightlifting-at least three times per week.

8. Quit smoking. Smoking is the number-one cause of cancer death among women, and women are more susceptible to lung cancer than men.

9. Minimize alcohol consumption. Women should have no more than one glass of wine per night.

10. Get plenty of sleep. If you're having trouble sleeping-whether it's caused by pain, hot flashes, or another problem-see your doctor.

11. Reduce stress. This is especially crucial for women in their 40s, which often is referred to as the "crunch decade," when women often have demanding careers, children in school, aging parents, and fluctuating hormones.

12. Keep immunizations current. All women should have a tetanus shot every 10 years. Women ages 65 or older or those who have asthma or chronic health conditions should have a pneumonia vaccination every five years and a flu shot annually. Women who work in health care or are in a high-risk group should have the hepatitis B vaccine. Those born between 1958 and 1968 should be re-immunized for measles, mumps, and rubella (MMR) because the vaccine given during that decade didn't take.

For more information about the Women's Health Center, visit the Web site at http://www.mc.uky.edu/whc.

Elizabeth Wade Hall is publications manager with the University of Kentucky Chandler Medical Center, Office of Public Relations.