Lambeth Hochwald
September 09, 2001

Most women wouldnt dream of skipping their annual pelvic, Pap, and breast exams. But when was the last time you had a head-to-toe checkup—or took stock of other tests you probably need but cant find time for? “For most women, a checkup just isnt on any to-do list,” says cardiologist Nieca Goldberg, MD, chief of womens cardiac care at Lenox Hill Hospital in New York. “We have to take the kids to the pediatrician, our moms are sick, our husbands need to go to the cardiologist.” The irony, of course, is that you cant do all that unless youre taking care of yourself, too.

Heres a quick rundown of 20-plus tests that experts recommend for women—dont worry, you dont need them all at once. But get to know them, and your body will thank you.

Musts: Annual screenings, preferably by an ophthalmologist, although you should feel free to see an optometrist. Also, a glaucoma and cataract screening at age 50 and beyond, or earlier if youre diabetic or if youre experiencing double vision, blurriness, or headaches. (African-American women should begin glaucoma screening at age 40 because their risk is higher.)
Maybe: Glaucoma screening in your 30s if you have a family history of early glaucoma.

Next Page: Ears [ pagebreak ]Ears
Musts: At age 40, a baseline audiogram (which measures your ability to hear sounds at different pitches) done by a licensed audiologist.
Maybe: An audiogram at any age if youre experiencing hearing loss—if you ask people to repeat themselves, for instance, or if you feel as if your ears are always plugged.

Musts: Annual screening for depression by your primary care physician. It could be a simple two-question test: 1) In the past two weeks, have you been feeling down, depressed, or hopeless? 2) Have you lost interest in things you used to enjoy? Answer yes to either or both, and depression is a possibility.

Musts: At age 50, a thyroid test every five years. The screening checks for an underactive or overactive thyroid.
Maybe: The same test when youre younger if you have inconsistent periods, unexplained weight gain or loss, heart palpitations, difficulty getting pregnant, or a sluggish postpartum feeling.

Musts: Twice-a-year checkups by a dentist to screen for cavities and gum disease, and a visual check for oral cancer. If you have red or white lesions that arent canker sores, then theres a chance youll be referred to an oral surgeon for an inner-cheek-swab cancer test.

Musts: Annual full-body visual scan by your primary care physician to check for skin cancer—or by a dermatologist if you have fair skin or a family history of skin cancer.

Musts: Baseline bone density scan, or DEXA, at age 65 to see if youre at risk for bone loss (its OK to be tested in your 40s or 50s if you or your doctor is concerned). Do it at age 35 if you weigh less than 127 pounds, have a family history of osteoporosis, take corticosteroids for a condition like asthma, or have a history of unexplained fractures.

Musts: Annual breast exam by a doctor beginning at age 18 and annual mammograms beginning at age 40. Formal self-exams? Experts dont agree about their value. Many recommend just touching your breasts regularly so youre familiar with any changes.
Maybe: If you have first-degree relatives who had or have breast cancer, talk to your doctor about starting screening earlier than normal, and about MRI and gene tests, too.

Musts: Yearly blood pressure check and physical exam, including checks for murmurs (sounds that may indicate a narrow or leaky valve) or for an irregular heartbeat. Cholesterol tests (including HDL, LDL, total triglycerides, and total cholesterol) beginning at age 20 (if normal, repeat every five years). And a blood-glucose test to screen for diabetes at age 45, repeated every three years.

Next Page: Abdomen [ pagebreak ]Abdomen
Musts: At age 50, a colonoscopy (a full examination of the colon) to screen for colorectal cancer; if normal, repeat exam in 10 years.
Maybe: An upper endoscopy (in which a video camera looks inside your esophagus) if you suffer from chronic heartburn (or if food routinely feels stuck after youve swallowed it) to screen for Barretts esophagus, a precursor to cancer.

Musts: An annual pelvic exam, including manual tests of the uterus and ovaries. If youre 30 or older, a Pap smear with a human papillomavirus (HPV) test to screen for cervical cancer; if normal, repeat in three years if you dont change sexual partners or havent had any abnormal Paps in previous years. Also, a digital rectal exam every five to 10 years beginning at age 50.

3 Tests You Dont Need
Biophysical 250
A blood test ($3,400; that scans for more than 200 potential signs of disease, including heart disease and cancer. “This test isnt ready for prime time,” explains Nieca Goldberg, MD, a heart specialist at Lenox Hill Hospital in New York and author of The Womens Healthy Heart Program.

A blood test ($159 to $200; that the manufacturer claims will measure heart-protective omega-3 fatty acids (EPA and DHA) in red blood cells. The results are touted as better predictors of risk for sudden cardiac death than LDL and HDL cholesterol levels. “In theory, an omega-3 index is useful, but there are no large-scale trials that have looked at this. So, in truth, no claims can be made. On the other hand, omega-3s are critically important to health, and supplementing with fish oils makes a lot of sense,” says internist Marie Savard, MD, author of The Body Shape Solution to Weight Loss and Wellness.

AntiOxidant Check
A urine test ($65.95; promising to measure your levels of antioxidants—which protect cells from unstable, unhealthy molecules (a.k.a free radicals). Savard: “This test is completely unfounded. Theres just no data at all to support it.”

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