As seen in the Odessa American “Medical Matters”.
by Dr. Avelino Garcia
Many women feel that there is no longer a need for a gynecologist after childbearing. For women over the age of 50, yearly exams are encouraged and very important. Even if a yearly pap smears are not needed, pelvic and breast exams can give your doctor information to keep you healthy.
Getting a yearly physical exam is so much more than just a pelvic exam and breast exam. A general physical exam begins with a detailed health history, including family history and any health changes that may have occurred. An examination of vital signs, including blood pressure, pulse and oxygen saturation, is also included with a yearly examination. Measurements of your height and weight combine to create your Body Mass Index, or BMI. These numbers can tell a doctor a lot of helpful information regarding your current health.
A pelvic exam can evaluate the condition of your vaginal tissues, cervix, uterus, ovaries and rectum. Even if you no longer have a uterus, a yearly pelvic exam is still encouraged to evaluate vaginal anatomy and pelvic health. If you have a cervix, a pap smear with screening for Human Papilloma Virus (HPV) is collected. A positive HPV test could mean that you are a carrier of the HPV virus and therefore at increased risk of cervical cancer. If your pap smear shows abnormal cells in conjunction with the HPV virus, further testing and treatment may be required. If both pap smear and HPV screenings are negative, it is safe to have a pap smear collected every two to three years. Just as a reminder, even if a pap smear is not required, a yearly pelvic exam still needs to be performed.
Even though it is uncomfortable, a rectal exam is encouraged to check for masses or lesions. A check of your stool for blood can also be done at the same time. Baseline screening colonoscopies are encouraged after the age of 50. However, if there is blood in the stool, a visit to the gastroenterologist is imperative for evaluation of your colon health. Screening colonoscopies are recommended earlier than the age of 50 if there is a history of cancer or colon problems in the family.
A yearly breast examination is performed to evaluate breast health. This examination includes the doctor looking at your breasts and nipples for leakage, lesions, redness, dimpling or other signs that there could be a problem present. The provider then does a manual examination, feeling the breast tissues and the under arms for lumps or masses. A yearly mammogram is recommended after the age of 40, unless a close family history of breast cancer is present. This includes mother and/or sisters with breast cancer. If there is a close family history, yearly screenings may begin earlier, based on the age of diagnosis.
Bone Density, or DEXA scans, help the provider evaluate your bone health. These tests are generally recommended for those aged 65 or over. These tests are encouraged every two years. It is important to keep bones healthy with Vitamin D and Calcium supplementation as well as regular weight bearing exercise.
Screening blood work can be completed by your primary care provider or your gynecologist. Yearly testing to check iron levels in the blood, cholesterol levels, thyroid levels, and blood sugar levels are some recommended testing. Further blood work can be completed to check for hormone imbalances. The provider may also check your Vitamin D and Calcium levels to help evaluate bone health.
Last, but certainly not least, it is important to discuss required immunizations with your provider. A yearly flu shot is encouraged, especially over the age of 50, unless there is a contraindication. A TDaP (Tetanus/Diptheria/Pertussis) vaccine is required every 10 years. After the age of 65, a one-time pneumonia vaccine is recommended. The CDC recommends that anyone over the age of 60 receive the Shingles vaccine.
It is time to put your health first and get your yearly examination.