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Regular medical exams are just as important to a woman's health after menopause as they are before. Some women still mistakenly believe that because they no longer menstruate, some of the screenings they used to get - mammograms and Pap smears - are no longer needed. But they are. The 40 million American women today who are postmenopausal still need to be screened for cervical cancer and breast cancer.
It's important to get other regular screenings too. Ask your doctor what kinds of tests and how often you should get them for:
- Blood pressure
- Cholesterol
- Colon cancer (including sigmoidoscopy or colonoscopy)
- Diabetes (blood sugar levels)
- Bone density
Mammograms
Make sure to get regular mammograms. Both the National Cancer Institute (NCI) and the American Cancer Society recommend that a woman have a breast exam by a doctor and a mammogram every one to two years starting at age 40. Ask your doctor how often you should have a mammogram. A woman's chance of getting breast cancer increases with age. By age 50, one of 50 women will have breast cancer. By age 60, one out of 24 will have it. For women age 50 to 69, having mammograms on a regular basis reduces breast cancer deaths by 25 percent to 30 percent.
A study in The Journal of the American Medical Association points out that menopause hormones increase breast density, making mammograms more difficult for doctors to examine and detect early signs of breast cancer.
According to the Women's Health Initiative study, hormone therapy (HT) increases the risk of breast cancer. That is why women should always tell their doctor or radiologist if they are on HT when they have their mammogram.
Pap smears
Pap tests are important even after menopause because they screen for precancerous conditions of the cervix. The Pap test can detect the human papilloma virus, which causes abnormal tissue growth and is often associated with some types of cancer, such as cervical cancer.
The NCI has established guidelines on how often women should be tested for cervical cancer. These guidelines state:
Cervical cancer screening should begin approximately three years after a woman begins having sexual intercourse, but no later than at 21 years old.
Women should have a Pap test at least once every three years.
Women 65 to 70 years of age who have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years may decide, upon consultation with their healthcare provider, to stop cervical cancer screening.
Women who have had a total hysterectomy (removal of the uterus and cervix) do not need to undergo cervical cancer screening, unless the surgery was done as a treatment for cervical precancer or cancer.
Women should seek expert medical advice about when they should begin screening, how often they should be screened, and when they can discontinue cervical screenings, especially if they are at higher than average risk of cervical cancer due to factors such as HIV infection."
Although the disease is most often found in younger women, older women are more likely to die of cervical cancer. That's because their cancer is usually diagnosed at a more advanced stage. According to the NCI, more than 50 percent of women who develop invasive cervical cancer have never had a Pap test.
Bone mineral density testing
Another invaluable screening is a bone mineral density test, or BMD, for osteoporosis. Dual energy x-ray absorptiometry (DEXA) is an x-ray technology used to detect low bone density. The lower the density of the bone, the higher the risk of fractures. Painless, noninvasive and safe, it evaluates the probability of a fracture and the need for treatment by scanning a patient's wrist, spine or hip for signs of mineral loss or bone thinning. DEXA can make repeated measurements to track bone loss over time. In addition, the scan determines the rate of bone loss and assesses the effectiveness of osteoporosis treatment.
According to the United States Preventive Task Force, all women age 65 and older should have a bone mineral density scan for osteoporosis and starting at age 60 if there is a risk for fracture. Ask your doctor when and how often you should have a DEXA scan.
This article was reviewed and updated June 2007.
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