A Preview of the Well Woman Exam in 2013

This year, when you go for your annual, well woman exam, you’re going to notice some changes, the result of new screening guidelines and new insights about the safety of hormone therapy that go beyond what was gleaned from the Women’s Health Initiative (WHI) Study more than a decade ago. Here’s a preview.

Don’t Expect a Routine Pap Test Every Year

The U.S. Preventive Services Task Force updated their guidance on when and how often women should receive a Pap Test for cervical cancer screening. (See my earlier blogpost that provides details on these new guidelines). If you’re between the ages of 30 and 65, you’ll have a choice of every three years with a traditional pap test or every five years if you also have an HPV test at the same time.

Hormone Therapy May Be Safer Than We Thought, But Not For All Women

When you ask your physician about the safety of hormone therapy (HT), she or he might cite the initial findings of the Kronos Early Estrogen Prevention (KEEPS) study, announced in Oct. 2011. The researchers reported that HT, when started within three years of the onset of menopause, “appears safe and relieves many of the symptoms menopausal women face as well as improving mood and markers of cardiovascular risk.”

These findings are consistent with the 2012 Hormone Therapy Position statement of The North American Menopause Society, thatalso stresses the importance of considering a woman’s individual risk factors when determining whether the quality of life benefits of HT outweigh a woman’s personal risk factors. In other words, when it comes to hormone therapy, there isn’t a simple answer. It’s not for everyone.

Are Your Breasts Dense? 

You may not know it, but you could have dense breast tissue, which makes it hard to detect a small breast cancer on a mammogram. Until fairly recently, doctors and radiologists weren’t required to inform patients if this was the case. But now, in seven states, including California, it’s the law.

The good news is that women now have more control over their care. The bad news is that this piece of information may lead to unnecessary, costly tests. After all, who doesn’t want to make absolutely sure that there’s nothing to be concerned about.

The need for additional testing may depend in part on where you live. If your mammography screening is done at a major hospital center that can afford the most sophisticated digital screening equipment, the radiologist may tell you that they’re confident they got a clear image to evaluate, despite the dense breast tissue. If not, your physician might recommend a second screening procedure, such as an ultra sound.

With this in mind, it’s a good idea to have your mammography screening ahead of your visit with your doctor so you can discuss the results and possible next steps during your office visit. For more information, visit the “Are Your Dense” website.

RX: Exercise

menopausal weight gain, depression, belly fatIn study after study, researchers have come to the same conclusion: aerobic exercise can alleviate many of the conditions that women complain about during menopause such as depression, weight gain, insomnia, and foggy brain. In fact, many physicians I’ve spoken with have told me that exercise is the single best thing you can do to improve your quality of life and reduce or prevent most ills. So, this year, don’t be surprised if your doctor hands you a prescription for 20 minutes of aerobic exercise rather than an anti-depressant or sleep aid. It’s certainly worth a try.