So many things are changing during perimenopause that it can be difficult to know what is normal and what is not. Every day can be a new experience – not necessarily a bad one. That is why it is so important to keep a close eye on your health. With so many years likely to be ahead of you, it’s much better to stay well than to get well.
Here are the 12 Tests you should check regularly:
1. Blood-glucose or Hemoglobin A1C test – to screen for diabetes, pre-diabetes or hypogly-cemia. Over 25 million Americans have it and of these, 7 million don’t realize that they do. The latest studies suggest that there are 79 million US citizens that are pre-diabetic. That means that their blood sugar levels are higher than normal but not yet high enough to have diabetes. Hemoglobin A1C does not have to be drawn after fasting. It gives an estimate of your blood glucose over the past few months and is an excellent screening test.
2. Blood-pressure test to screen for high blood pressure.
3. Breast exam each month by you and each year by your doctor. Mammograms every year after age 40, or sooner if a strong family history of breast cancer.
4. Vitamin D blood test – Low vitamin D levels are extremely common and may increase the risk for breast cancer, heart disease and osteoporosis (thinning of the bones). Anecdotally, I have had patients with Low vitamin D levels who have decreased hot flashes when their vitamin D levels are corrected.
5. Cholesterol profile to screen for a major risk factor for heart disease. High levels of cholesterol (above 200 mg/dL or 5.18 mmol/L), LDL or bad cholesterol (above 130) significantly increase the risk of heart disease.
6. Dental Care – It is important to have regular dental cleanings and exams, usually every 6 months. This will help prevent gum disease and will identify problems with your teeth and gums early. Flossing daily is also recommended and may lower the risk of heart disease.
7. Eye care – It is also important to have regular dilated eye exams on average about every two years. This is the best way to pick up silently developing diseases such as macular degeneration, cataracts, glaucoma and diabetic retinopathy. Talk with your doctor about the best frequency for you.
8. Colonoscopy after age 50 and every 10 years after that is an essential screening test for women without a strong family history of colon cancer. If you do have a strong family history for colon cancer, have inflammatory bowel disease or colon polyps, start having your colonoscopy earlier and more frequently to prevent colorectal cancer. Along these lines, women should also get an annual rectal exam to screen for fecal occult blood – a test for colon cancer. These tests cut the rate of colon cancer by 15 to 33%.
9. Bone Density at age 50 to screen for osteoporosis or osteopenia, which is thinning of the bones before it is great enough calcium loss to be osteoporosis. Some doctors recommend waiting until as late as 65 to get a bone density. I disagree. If you find thinning of the bones early you can treat it. Once the bones have lost a lot of calcium it is harder to get it to return. Finding it early is the best way to prevent a hip fracture when you are 70 or older.
10. Pelvic Exam– The recommendations for how often to get a pelvic exam by a gynecologist, skilled internist or family practitioner along with a pap smear to check for cancer of the cervix (opening of the uterus) has undergone some changes. A pelvic exam and pap smear can be done less often if you have no pelvic symptoms and have had three normal pap tests in a row and no abnormal results in the past 10 years. Thus far studies have not shown that getting an ultrasound of the ovaries to look for ovarian cancer saves lives. But with less often pelvic exams now becoming the norm, I think pelvic yearly exams and pelvic ultrasounds have to at least be considered if there is a family history of ovarian cancer. I would also recommend discussion with your doctor about an ultrasound of the ovaries if there is a strong family history of breast cancer because there can be a genetic link between breast cancer and ovarian cancer.
11. Skin cancer check looking at the skin of the entire body every year to screen for malignant melanoma – the deadliest form of skin cancer as well as other problems. People with a family history of skin cancer and those who have a lot of moles, or a history of blistering sunburn as a child are at increased risk.
12. Immunizations are recommended every 10 years for tetanus and diphtheria, and flu shots are recommended every year. Ask about herpes zoster and meningitis immunizations and make sure you are up to date on your other immunizations.
Getting tested regularly is essential for the prevention of some major health problems. Remember, it’s much better to stay well than to get well.