Dear Dr. Dave & Dr Dee,
I'm 51 years old, and haven't seen a doctor in over three years and I am uncomfortable with pap smears in particular and wondered if maybe that is why I am reluctant to go to the doctor? I have always had a normal exam and feel healthy, so how much longer can I wait to have a check-up?
Signed,
Reluctant patient
Dear Reluctant patient,
Regular physical exams are important in order to stay healthy and to prevent problems from becoming worse. For example, age 50 and above is the recommended age for colon cancer screening, and you are overdue for your clinical breast exam and mammogram. Many diseases, if caught early, can be treated and cured.
Some women feel more comfortable seeing a female physician for physical exams and pap smears. Your health insurance company can give you recommendations for female gynecologists or family physicians in your area.
A Pap test is recommended every three years, but is only one of many important health screening exams for women. In brief are health exams for women as outlined by the U.S. Department of Health & Human Services.
12 IMPORTANT HEALTH SCREENINGS & IMMUNIZATIONS FOR WOMEN (http://www.womenshealth.gov/screeningcharts/general/)
These are guidelines only. Your doctor will personalize the timing of each test immunization to meet your health care needs.
1. BLOOD PRESSURE age 18 on up:
a. Get tested at least every 2 years if you have normal blood pressure (lower than 120/80).
b. Get tested once a year if you have blood pressure between 120/80 and 139/89.
c. Discuss treatment with your doctor or nurse if you have blood pressure 140/90 or higher.
2. BONE MINERAL DENSITY TEST (OSTEOPOROSIS SCREENING)
Beginning at age 50, discuss with your doctor or nurse if you are at risk for osteoporosis. If age 65 or older, then get tested at least once. Talk to your doctor or nurse about repeat testing.
3. BREAST CANCER SCREENING (MAMMOGRAM)
Beginning at age 40, discuss with your doctor or nurse. Starting at age 50, get screened every 2 years. Get screened every 2 years through age 74. Age 75 and older, ask your doctor or nurse if you need to be screened.
4. CERVICAL CANCER SCREENING (PAP TEST)
a. Age 21-64: Get a Pap test every 3 years if you have had vaginal sex, and have a cervix.
b. Age 65 and older: Ask your doctor or nurse if you need to get a Pap test.
5. CHLAMYDIA TEST
a. Age 18-24: Get tested for chlamydia yearly through age 24 if you are sexually active or pregnant.
b. Age 25-39, get tested for chlamydia if you are at increased risk, pregnant or not pregnant.
c. Age 40-49: Get tested for chlamydia if you are sexually active and at increased risk, pregnant or not pregnant.
d. Age 50 and older: Get tested for chlamydia if you are sexually active and at increased risk.
6. CHOLESTEROL TEST
Starting at age 20, get a cholesterol test regularly if you are at increased risk for heart disease. Ask your doctor or nurse how often you need your cholesterol tested.
7. COLORECTAL CANCER SCREENING
Age 50-75: Starting at age 50, get screened for colorectal cancer. Talk to your doctor or nurse about which screening test is best for you and how often you need it.
8. DIABETES SCREENING
Age 18 on up: Get screened for diabetes if your blood pressure is higher than 135/80 or if you take medicine for high blood pressure.
9. GONORRHEA TEST
a. Age 18-39: Get tested for gonorrhea if you are sexually active and at increased risk, pregnant or not pregnant.
b. Age 40 on up: Get tested for gonorrhea if you are sexually active and at increased risk.
10. HIV TEST
a. Age 18-39: Get tested if you are at increased risk for HIV. Discuss your risk with your doctor or nurse. All pregnant women need to be tested for HIV.
b. Age 40 on up: Get tested if you are at increased risk for HIV. Discuss your risk with your doctor or nurse.
11. SYPHILIS TEST
a. Age 18-39: Get tested for syphilis if you are at increased risk or pregnant.
b. Age 40 on up: Get tested for syphilis if you are at increased risk.
12. IMMUNIZATIONS
a. Influenza vaccine: age 18 and older every year.
b. Tetanus, Diphtheria, Pertussis (Td/Tdap) vaccine: Tdap vaccine once, then Td booster vaccine every 10 years for ages 18-64. For age 65 and over, Td/Tdap for adults who have contact with babies less than 1 year old.
c. Varicella (Chickenpox): 2 doses
d. HPV Vaccine for Women: 3 doses if age 19-26.
e. Zoster (Shingles): starting at age 60, one time only.
f. Measler, Mumps, Rubells (MMR): 1 or 2 doses
g. Pneumococcal (Pneumonia): Age 19-64 1 or 2 doses if high risk for serious illness discuss with doctor); age 65 or older one dose.
h. Meningococcal vaccine: 1 or more doses if high risk for serious illness, discuss with doctor.
i. Hepatitis A: 2 doses if high risk for serious illness, discuss with doctor.
j. Hepatitis B: 3 doses if high risk for serious illness, discuss with doctor.
For more information, go to http://www.womenshealth.gov/screeningcharts/general/