As a family medicine physician, I want to write this to give moms a concise guideline of what is recommended to keep you healthy for your families. The medical world can be difficult to navigate, so my goal is to give you a snapshot of what you need to do to make sure you are up to date! To be able to take care of your family, you’ve first got to take care of yourself!
Pap smears: Everyone woman’s favorite exam. So there have been a lot of changes to this over the years, but if you have never had an “abnormal pap”, there’s good news! We recommend a Pap smear every 3 years between ages 21-29 (you should still see your doctor yearly to discuss risks and screening for sexually transmitted diseases) and once you get to 30, if you have co-testing for HPV (the virus that causes cervical cancer and is sexually transmitted) you can lengthen this to a Pap every 5 years if your results are normal! Once you reach 65, if you’ve had at least 2 normal Paps with negative HPV within the last 10 years, you no longer need cervical cancer screening.
Mammograms: Controversial! According to which source you follow, the USPSTF (US preventative services task force) recommends beginning screening at age 50 every 2 years with mammography, until the age of 75. They state that women should discuss with their doctor between 40-49 the benefits and risks of early screening, especially when there is a family history of breast cancer (parent, sibling, child). The ACOG (American college of gynecology) recommends yearly screening starting at age 40. So in the end, have a discussion with your doctor regarding the benefits and risks. I follow the ACOG guidelines on this one typically and offer/recommend yearly mammography. After the age of 75, it is particularly important to talk to your doctor about the risks and benefits of continued screening, as women diagnosed with breast cancer in this age group tend to have slower growing disease that may not cause significant health problems, and if they have other severe chronic illnesses, it may cause more harm to screen/find cancer. I’ve seen this firsthand several times in my practice, and always have a candid discussion with patients over 75 before ordering a mammo for this reason.
Bone density testing: DEXA scans are a tool we use to determine a person’s bone thickness. These typically start at age 65, unless you have other risk factors for early bone loss such as a family history of osteoporosis, long term steroid use, or other medications known to thin the bones, smoking and heavy alcohol use, and several other risk factors. As women our bones naturally start to thin after age 30, so it’s important to get enough calcium (1200-1500 mg daily) and vitamin D- at least 1000 IU daily but many sources recommend more, as well as weight bearing exercise to keep your bones strong!
- Vaccines: We recommend a TDaP with each pregnancy in the third trimester to protect against pertussis, and if you have chronic lung disease, diabetes, or other conditions that may make your immune system not work at its best, you should talk to your doctor about a pneumonia shot as well. And of course, the newest CDC guidelines recommend a flu shot for everyone 6 months and older.
Hopefully these are helpful tips! Is there anything you’d add to the list?