Published: May 28, 2014
The Visit to the Doctor: Top Mistakes Women Make
You’re smart and educated, you visit the doctor yearly, you’re healthy- so what’s the big deal? Many women commonly write off their annual exam when receiving a perfect bill of health. They leave the office as unassuming and unquestioning individuals.
Well, maybe it’s time to think twice about our gynecological visit. This does NOT necessarily mean your doctor or health care practitioner is NOT doing his or her job. They are most likely very valid, logical claims that you are a healthy individual. On the contrary, we need to do better jobs as patients in their offices. Everyone should be aware of common flaws women make when visiting the doctor.
There is no better time than menopause for understanding your visits to the doctor.
By knowing what to expect, hopefully you will find appointments to flow much smoother and question-asking will be easier.
First, it is imperative that you choose a doctor you can talk to and trust. If your doctor doesn’t seem to be concerned about your menopausal issues, or tells you it’s all in your head, consider getting a second opinion.
The North American Menopause Society, www.menopause.org, can provide you with names of doctors and allied healthcare professionals in your area who are qualified to treat patients going through menopause.
Your medical agenda should include a visit to your physician on a yearly basis and adhere to a schedule of examinations and medical tests he/she may recommend.
The first step in assuring a smooth visit to your medical provider is to know which tests you should be receiving and why you are taking them.
If you’re not sure why you’re being tested for something, speak up! You have the right to ask questions. Expect a combination of physical tests and blood tests when going to the doctor for menopausal symptoms.
You should have a complete physical once a year which includes a blood pressure test, a test for diabetes, vision and hearing test, blood work-up, and cholesterol screening.
You should have a gynecological exam once a year. Your doctor will perform an internal exam with a speculum to visualize your cervix. Physical tests include the popular, highly anticipated pelvic examination (usually with a Pap Test). During this test, your health care provider looks for any internal or external abnormalities of reproductive organs including STDs (sexually transmitted diseases), cysts, tumors and cancers.
A Pap test detects any precancerous or cancerous changes of the cervix or vagina. These should not be new tests for the menopausal woman. Pelvic exams and pap smears should be on your “yearly list of tests”. Unfortunately, between 60% and 80% of American women with newly diagnosed invasive cervical cancer have NOT had a Pap smear in the past 5 years (American Society of Colposcopy and Cervical Pathology, 2005). A common misconception for postmenopausal women is they no longer need to be screened. Hysterectomy-induced menopausal women should discuss the frequency of this test with their doctor because they may be unnecessary.
The Mammogram is another common, important test that screens for breast cancer. We all need to be concerned about breast cancer and aware of ways to detect it. Our October 2004 issue of the Menopause Minute discusses breast health in detail. There is no arguing the importance of this test.
The National Cancer Institute (NCI) suggests a mammogram every year. There are many mistakes women make when considering a mammogram. Common myths deter women from having this screening. The mammogram is the single best way to detect breast cancer at an early age. It is a common misconception among women thinking mammograms do more harm than good. Although there are limitations to the test (they miss 10-15% of breast cancers and they can result in false-positives), it can find cancer before any lump can be felt. Another common misconception is if you don’t have a family history of breast cancer, you don’t need to have a mammogram. The mistake in assuming this is the majority of breast cancers occur in women who have no known risk factors1. Long term studies have shown that the mammography actually reduces deaths from breast cancer among women. Makes sense! Another myth is that having a mammogram will tell you everything you need to know for a year (until your next screening). This is not true. You still need to check for breast cancer with breast self-exams monthly. Discuss this with your health care provider and they will tell you how to recognize any abnormal changes. Make sure your doctor is checking you properly during your breast exam2 and if you feel a lump that your doctor doesn’t feel is suspicious, question it. Also question the results of your mammogram if you feel something abnormal but it didn’t pick it up. Ask for a sonogram. Sonograms will detect whether a lump is a cancerous solid mass.
The FSH (Follicle Stimulating Hormone) test helps determine whether a woman is in menopause. FSH levels can be tested with blood or urine. High levels of FSH are expected in perimenopausal or menopausal women because it is a hormone (that’s secreted by your pituitary gland in the brain) in response to low levels of estrogen. Women commonly misunderstand this test and think it is the black and white answer for whether they are in menopause. This just simply isn’t the case. When women have the first symptoms of menopause, they want to take this test. The problem with this is menopause can go in and out of our bodies like waves. There’s no way to test for a hormonal imbalance when everything is normal one second and out of whack the next. Ask your doctor about getting a hormonal profile to test for levels of estrogen, progesterone, testosterone and other hormones. Another mistake women make is thinking estrogen is the only hormone level that changes during menopause. In fact, all hormone levels change.
Improving and maintaining healthy bones during menopause is important. Refer to this issue and the December 2004 issue of the Menopause Minute for more information on osteoarthritis. In “A Report of the Surgeon General; Bone Health and Osteoporosis” (a 2004 publication from the US Surgeon General Richard H. Carmona), stated that by 2020, half of all Americans older than 50 will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken by individuals at risk, doctors, health systems and policymakers. Osteoporosis is the most common bone disease affecting over 10 million people in the United States. It is estimated that 34 million are at risk for developing osteoporosis. The common misconception about this disease is that only our grandmothers had to worry about it. Bone health affects everyone from older women to young men. Another common myth is thinking you don’t have to worry about osteoporosis until after menopause. The good news is maintaining healthy bones can start right now. It is never too early or too late to take the proper preventative measures against bone disease. Adequate calcium intake and healthy lifestyle habits are something you have control over. Don’t think you are too old to do anything about osteoporosis. Talk to your doctor about getting a bone density test. The test will diagnose osteoporosis and/or can tell you if you are at risk. It is an easy, painless test that is common procedure for doctors.
Lastly, blood pressure tests and cholesterol levels are important screenings for cardiovascular disease. The myths: young women don’t have coronary disease; symptoms are the same for women and men; women should be more concerned with breast diseases than heart diseases; menopause is followed by an increase in the risk of heart attack and coronary death in women. The latest statistics from the American Heart Association show that in every year since 1984 cardiovascular disease has claimed the lives of more females than males. More than 500,000 American women die from these diseases yearly. The fact is that women need to talk to their doctors about heart disease. Ask the questions so you know how to take care of the risks associated with aging and heart problems. What is my risk of heart disease? How can I take preventative measures against cardiovascular diseases? Should I have my cholesterol checked? The fact is that women generally underestimate their risk for heart disease.
Make sure you are getting the appropriate, thorough care from your healthcare provider. Ask the appropriate questions and raise the correct concerns. Your doctor will most likely be impressed by your knowledge if you come with some good, suitable questions.
1 The Mayo Clinic: www.mayoclinic.org
2 www.webmd.com for what to expect from a doctor’s breast exam