10 Medical Tests Every Woman Should Have

No matter what your age, here's how to make sure you're in good health.

  • Lambeth Hochwald

Audiogram

Why you need it: To find out if you are one of the more than 28 million Americans with measurable hearing loss and, if so, to take steps to keep it from worsening.

When and how often: Schedule an audiogram if you have trouble making out what people are saying, hear ringing in your ears, feel a plugged sensation, or have a family history of hearing loss. Otosclerosis, a genetic disorder that prompts abnormal growth of the bone of the middle ear, is more prevalent in women and often surfaces when a woman is pregnant or between 15 and 30.

What to expect: You wear headphones while a licensed audiologist or ear, nose, and throat doctor has you listen to sounds. "We check for your ability to discriminate between tones of different frequencies," says David Fabry, Ph.D., a former president of the American Academy of Audiology.

What the results mean: If your audiogram is normal, you'll come back every two to five years for a follow-up test. If your audiogram shows you have high-pitch hearing loss, you may have more difficulty hearing certain voices and might need a hearing aid.
 

Bone-Mineral Density Test

Why you need it: To find out whether you're at risk for osteoporosis. This crippling weakness of the bones afflicts nearly 10 million older Americans, 80 percent of whom are women, according to the National Osteoporosis Foundation.

When and how often: Have your first DXA (dual-energy X-ray) test at age 65 and another every five years thereafter. Women can lose up to 30 percent of their bone mass in the five to seven years following menopause. Get tested at menopause if you weigh less than 127 pounds, have ever smoked, have a history of nontraumatic fractures as an adult, or have a family history of osteoporosis.

What to expect: The DXA test, the most accurate bone-density test, is safe and noninvasive: You lie fully clothed on a table while the X-ray machine scans your spine, hips, and wrists. If your bone density is low, your doctor may recommend the NTX test, a urine test that measures the rate at which you're losing bone mass; she may also want you to be X-rayed annually.

What the results mean: If your DXA shows you have osteopenia, a preosteoporotic state of low bone density, your doctor will recommend you consume at least 1,000 milligrams of calcium and 400 to 800 IUs of vitamin D daily without fail. (All women should get this amount, in fact.) She'll also suggest regular exercise. If you have osteoporosis, your doctor may give you a drug like Actonel or Fosamax.
 

Clinical Breast Exam and Mammogram

Why you need it: Both types of screening can detect breast cancer when it is confined to the breast. Ninety-seven percent of women diagnosed at this stage survive without a recurrence for at least five years, according to the American Cancer Society.

When and how often: Starting when you're age 20, your doctor should manually examine your breasts at your regular checkup. By age 40, you should have a mammogram (an X-ray of the breasts) once a year. "Schedule your mammogram right after your period," says Holly Thacker, M.D. "That's when the breasts are least tender."

What to expect: Mammograms are done by standard X-ray. "If you've had previous mammograms and you're now using a new facility, be sure the radiologist compares your old films with the current ones," says Suzanne Trupin, M.D., a clinical professor of obstetrics and gynecology at the University of Illinois College of Medicine at Urbana-Champaign.

What the results mean: If the mammogram picks up an abnormality, such as a small deposit of calcium or a mass, your doctor may ask you to undergo a breast ultrasound or in some cases a breast MRI. These tests can determine whether a lump is a solid mass and if a biopsy is necessary.
 

Colonoscopy

Why you need it: To detect colorectal cancer before symptoms occur. In Its early stage, this disease is more than 90 percent curable, says Bernard Levin, M.D., vice president for cancer prevention and professor of medicine at the University of Texas M.D. Anderson Cancer Center, in Houston.

When and how often: Doctors suggest you have your first colonoscopy at age 50. If a parent or sibling was diagnosed with colorectal cancer or polyps before 50, you are at higher risk and should get your first test 10 years before they were diagnosed and repeat it at least every five years. If no problems are found and you have no family history, testing can be limited to once every 10 years.

What to expect: For a colonoscopy, the gold-standard diagnostic test, your doctor uses a colonoscope, an instrument with a tiny video camera, to examine your large intestine for polyps and other growths.

What the results mean: If polyps are found, they will be removed and biopsied, says David E. Beck, M.D., chairman of the department of colon and rectal surgery at the Ochsner Clinic Foundation, in New Orleans. Depending on the results, you may need surgical treatment or additional testing within three to five years. 
 

Comprehensive Eye Exam

Why you need it: To catch any eye health problems, from vision changes and sties to cataracts and glaucoma. Glaucoma is highly treatable, and in most cases glaucoma-induced vision loss can be slowed with medication if treated early, according to Richard Bensinger, M.D., a spokesman for the American Academy of Ophthalmology.

When and how often: Even if your vision is good, you need a basic eye exam by age 40 and then every two years until 65. After 65 it should be done annually. Get exams before age 40 if glaucoma runs in your family; if you have a risk factor, such as diabetes; if you are African American; or if you use steroids. Contact-lens wearers should see a doctor annually.

What to expect: Your ophthalmologist will check the pressure in your eyes. Elevated pressure is a symptom of glaucoma. He will examine your eyelids, eye linings, and pupils for abnormalities; your optic nerve for signs of brain tumors; your corneas and irises for problems; your lenses for cataracts; and your retinas for signs of macular degeneration, a deterioration of retinal cells.

What the results mean: If your vision is poor, of course, your doctor will probably suggest glasses or contact lenses. If you have signs of glaucoma, treatment usually starts with eyedrops, followed by laser therapy and surgery if the drops are ineffective. Vitamins and laser treatments can slow the progression of macular degeneration.
 

Dental Screening

Why you need it: To rule out oral cancer, one of the six most common cancers among American adults, according to the Academy of General Dentistry, and to combat gum disease and treat any tooth decay.

When and how often: Twice-a-year teeth cleanings and checkups should begin six months after your baby teeth appear and continue for life. If you're pregnant or taking contraceptives, you may be more prone to gum inflammation. Smokers and women who have more than a drink or two a day are at a greater risk for gum disease and oral cancers.

What to expect: A dentist will take a close look at all your teeth, your tongue, the soft and hard tissues of your mouth and neck, and the area around your jaw to determine if there are any unusual changes in tissue.

What the results mean: If you have gum disease, your dentist may recommend that you return for cleanings more than twice a year. You may also have plaque and tartar scraped from above and below the gum line and rough spots on tooth roots smoothed. If you have abnormal tissue growths, your dentist may take a biopsy.
 

Heart-Health Test

Why you need it: To ensure that you're not at risk for heart disease, the number one killer of women. Sixty-four percent of women who die from sudden cardiac death have no previous symptoms of this disease.

When and how often: Annual exams starting at age 20. These are especially important if you have a family history of hypertension or premature heart disease, if you're 45 or older, if you're overweight, or if you are a smoker.

What to expect: At your annual checkup, your doctor will check your blood pressure and listen to your heart for murmurs or irregular heartbeats. If you have been experiencing chest pain, shortness of breath, and easy fatigue, your doctor may refer you to a cardiologist, who will order a stress test and an electrocardiogram to help evaluate your heart and future heart-disease risk.

What the results mean: If your doctor determines that you have an irregular heartbeat or if you're experiencing palpitations, this may indicate a cardiac rhythm disorder that requires medication. If your blood pressure is higher than 130/90, you may be developing hypertension.
 

Lipid Profile

Why you need it: One of the most effective ways to track your heart-disease risk is to check your cholesterol levels. Elevated cholesterol not only raises your odds of a heart attack or stroke but also has been linked to gallbladder disease.

When and how often: Schedule this test beginning at age 20, regardless of whether you have a family or personal history of heart problems. If your results are normal, get checked at least every five years until you reach age 45. If you are 45 or older, have a family history of heart disease, or have a total cholesterol level of over 200, get an annual screening.

What to expect: A comprehensive lipoprotein profile measures the total cholesterol in your blood, including "bad" LDL (low-density lipoprotein) cholesterol, "good" HDL (high-density lipoprotein) cholesterol, and triglycerides. If you're at risk for heart disease, some doctors may test your apoB levels, a measure of fat particles in the blood.

What the results mean: If your total cholesterol is over 200, your HDL is less than 40, or your LDL is over 130 (or over 100 if you're at high risk), your doctor may recommend diet changes, increased exercise, and weight loss to improve your cholesterol profile. Depending on your other risk factors, you may be prescribed cholesterol medication, such as Lipitor.
 

Mole Screening

Why you need it: To detect skin cancer as early as possible. Melanoma, the deadliest form, is the second most common cancer (after breast) among women in their 30s, according to the American Cancer Society. Basal-cell and squamous-cell carcinomas occur more frequently but are nearly 100 percent curable if caught early.

When and how often: By age 30 (earlier if you've had extensive sun exposure), you should begin to have an annual skin check. Repeat twice a year after that if you're at high risk - that is, if you've already had a basal-cell or squamous-cell carcinoma, you have a family history of skin cancer, you have many moles, or you have fair skin, red or blond hair, or freckles.

What to expect: A dermatologist will examine your body, head to toe - including your scalp, your ears, and the skin between your toes - checking freckles, moles, and skin growths. She may measure any large or unusual moles or even perform digital-imaging screening, a computer scan that provides a close-up view of your moles for future comparison.

What the results mean: Your doctor will take tissue samples from any suspicious-looking moles and send them to a lab to be examined. Depending on the results, surrounding tissue may be removed for further evaluation and treatment.
 

Pap Smear

Why you need it: It's the tried-and-true way to detect cervical cancer in time to treat it effectively. According to the American Cancer Society, over the past 50 years, the death rate from this disease has declined by more than 74 percent, thanks to the Pap smear, which was first introduced by the late George Papanicolaou, M.D.

When and how often: Beginning at least by age 21, If you've had several normal Paps in a row and a negative human-papillomavirus (HPV) test, get tested every other year. If you're a smoker, have multiple sexual partners, began having intercourse at a young age, are HIV-positive, or have a sexually transmitted disease, have a Pap annually. If you are 30 or older, ask your doctor to test for HPV.

What to expect: A Pap smear―a swab of cells from your cervix―is sent to a lab to be tested for any abnormalities. Ask your doctor if she's using the ThinPrep Pap Test, which obtains your sample using a brush and stores the cells in a liquid formula. The FDA considers this a more effective test than the traditional Pap.

What the results mean: If your Pap test shows you have abnormal cervical cells, your doctor may do an HPV test. If you test positive for HPV, then you will probably need a colposcopy, a procedure in which your doctor uses a special microscope to look for abnormalities in the vagina or on the cervix. If a colposcopy raises red flags, you may also need a cervical biopsy.

 

 

Consider the following special screenings:
 

Diabetes

Who needs testing? People who are obese or who have high cholesterol, hypertension, frequent thirst, frequent urination, fatigue, blurry vision, or a family history of diabetes.

What tests to expect: Your doctor will order blood tests to measure your blood glucose levels after fasting.

How often? Annually, if your first test results are normal.

Thyroid Problems

Who needs testing? People with a family history of thyroid disorders or those who suddenly suffer from fatigue, weight gain (or loss), and depression.

What tests to expect: A blood test that checks the levels of thyroid-stimulating hormone (TSH). Low levels typically indicate an overactive thyroid; high levels, an underactive one.

How often? Every five years or at your doctor's discretion.

Sexually Transmitted Diseases

Who needs testing? Women who are trying to get pregnant, who have a new partner, who engage in unprotected sex, or who experience unusual vaginal discharge, irregular bleeding, or pain during intercourse.

What tests to expect: Your doctor will do a DNA probe (a cervical swab similar to a Pap test) to check for gonorrhea and chlamydia. Blood tests screen for syphilis, hepatitis, and HIV.

How often? Annually; every three to six months if you have a new sexual partner.

Lung Cancer

Who needs testing? Smokers who go through at least one pack of cigarettes a day or who suffer a recurring cough or wheeze. Also former heavy smokers.

What tests to expect: You'll start with a test of your breathing and lung capacity. If the results are abnormal, your doctor may call for a chest CT (computed tomography) scan to detect any tiny malignancies, which may be treatable.

How often? As recommended by your physician.

Ovarian Cancer

Who needs testing? Women who have a family history of ovarian cancer or ongoing pelvic pain.

What tests to expect: A vaginal ultrasound, in which a baton-shaped ultrasound scanner is inserted into the vagina to look for any growths or cysts on the ovaries.

How often? As recommended by your physician.

Osteoporosis

Why you need it: To find out whether you're at risk for osteoporosis. This crippling weakness of the bones afflicts nearly 10 million older Americans, 80 percent of whom are women, according to the National Osteoporosis Foundation.

When and how often: Have your first DXA (dual-energy X-ray) test at age 65 and another every five years thereafter. Women can lose up to 30 percent of their bone mass in the five to seven years following menopause. Get tested at menopause if you weigh less than 127 pounds, have ever smoked, have a history of nontraumatic fractures as an adult, or have a family history of osteoporosis.

What to expect: The DXA test, the most accurate bone-density test, is safe and noninvasive: You lie fully clothed on a table while the X-ray machine scans your spine, hips, and wrists. If your bone density is low, your doctor may recommend the NTX test, a urine test that measures the rate at which you're losing bone mass; she may also want you to be X-rayed annually.

What the results mean: If your DXA shows you have osteopenia, a preosteoporotic state of low bone density, your doctor will recommend you consume at least 1,000 milligrams of calcium and 400 to 800 IUs of vitamin D daily without fail. (All women should get this amount, in fact.) She'll also suggest regular exercise. If you have osteoporosis, your doctor may give you a drug like Actonel or Fosamax.