Dr. Birdie on the New Women's Health Guidelines
By: Birdie Varnedore, M.D.,
SparkPeople Blogger
4/3/2012 6:00 PM
: 45 comments
: 10,760 Views
Being healthy is about far more than the number on your scale. Just because you lost weight and look fabulous does not guarantee you're healthy on the inside. As a physician, I have seen many people who are thin and look healthy, but are actually sicker than many overweight and obese people.
The best way to stay healthy for years to come is to prevent illness. Focusing on diet and exercise is an important part of being healthy and preventing illness, but there are other aspects of your health that can't be managed with diet and exercise alone. Some areas of your health require regular visits to a qualified medical professional, especially for women.
So, women of SparkPeople, when was the last time you visited your gynecologist?
Can I see a show of hands? Do you know how often you are supposed to get a Pap smear? How about a mammogram? You are probably thinking I’m trying to trap you into the wrong answer.
Of course, I am! Most of you probably said you need to get an annual Pap smear and an annual mammogram starting at age 40. Right? Not anymore.
The rules we've all heard have changed, and I'm here to explain the new recommendations for Pap smears, mammograms, and more.
For more information about the reasoning behind the changes, read this New York Times article.
Pap Smear:
Before: yearly between the ages of 21 and 65
Now: every 3 years
Why the change?
For years, we doctors have preached to women to get these tests done yearly, no matter what, between the ages of 21 and 65.
Cervical cancer is relatively slow-growing, and it can be caught in its early stages with screening every three years rather than yearly. When women are screened yearly, there is an unacceptable number of false-positive screening tests, leading to unnecessary procedures which can lead to harm such as infertility.
Mammogram:
Before: Yearly after age 40
Now: Every two years between the ages of 50 and 75
Why the change?
This is a very controversial issue. The United States Preventative Services Task Forces has recommended mammograms every two years starting at age 50 and stopping at age 75. Women at high risk (such as those with a family history of breast cancer) should start screening earlier.
Some groups, such as the American Cancer Society, still recommend yearly mammograms starting at age 40.
Why the difference? The reasons are similar to those for the change in the Pap smear recommendations. The risks (women harmed by invasive testing prompted by false-positive screening tests) outweigh the benefits (the number of deaths prevented by yearly testing is relatively low).
What should you do? How often you get screened should be a decision made between you and your physician.
If you are still confused about when to start mammogram screening--especially with high-profile women in their 40s getting diagnosed with breast cancer--I understand. Knowing your options empowers you to make a more informed decision about when to start your personal screening program.
Breast self-exams
Before: Monthly
Now: No need to do them.
Why the change?
I remember being reminded every year--and taught--how to do a breast self-exam by my own gynecologist. Self-exams are no longer recommended because they have not been found to reduce breast-cancer mortality.
So, what do these changes mean for you? Does this mean that you get to skip your annual physical?
No!
My intended message of highlighting these screening changes is to let you know what is currently recommended. I think we should use this discussion as an opportunity to question your relationship with your health-care provider and learn how to make that relationship more productive.
You still need to visit your primary-care physician regularly to monitor your overall health. The number one cause of death in America is heart disease, and you still need to monitor your risk factors and “know your numbers" in order to decrease your risk of heart disease and stroke.
I know you may be thinking that if your primary-care physician spends only about 5 minutes with you that they can’t possibly accomplish adequate preventative care. I am not denying that this is an issue. The current structure of the health-care system in the United States makes it difficult to receive the primary care that you deserve. Take charge of your own health and demand the care that you need. Know which screenings you need and when--and "know your numbers." Go to your primary-care physician prepared to ask for what you need. If your primary-care physician is threatened by your assertiveness, then you can exercise your right find another physician. A good physician will be supportive and impressed with your efforts to take charge of your health to prevent future disease.
So are annual physicals necessary and to they improve health outcomes?
I believe that preventing disease is one of the best gifts that you can give to yourself and your family. Keeping that once a year appointment can serve as a reminder of your commitment to your health and early detection leads to better outcomes. So, continue your annual physicals and continue to eat healthy, exercise, and enjoy your life!
What is the bottom line? Even though the latest recommendations allow for less vigorous screening for cervical and breast cancer it does not mean that you should stop seeking annual medical care. Keeping your yearly appointment is a commitment to preventing future disease and is a gift to all of those who love and depend on you!
Keep Sparking, everyone!
What do you think about the new recommendations?
Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider.
The best way to stay healthy for years to come is to prevent illness. Focusing on diet and exercise is an important part of being healthy and preventing illness, but there are other aspects of your health that can't be managed with diet and exercise alone. Some areas of your health require regular visits to a qualified medical professional, especially for women.
So, women of SparkPeople, when was the last time you visited your gynecologist?
Can I see a show of hands? Do you know how often you are supposed to get a Pap smear? How about a mammogram? You are probably thinking I’m trying to trap you into the wrong answer.
Of course, I am! Most of you probably said you need to get an annual Pap smear and an annual mammogram starting at age 40. Right? Not anymore.
The rules we've all heard have changed, and I'm here to explain the new recommendations for Pap smears, mammograms, and more.
For more information about the reasoning behind the changes, read this New York Times article.
Pap Smear:
Before: yearly between the ages of 21 and 65
Now: every 3 years
Why the change?
For years, we doctors have preached to women to get these tests done yearly, no matter what, between the ages of 21 and 65.
Cervical cancer is relatively slow-growing, and it can be caught in its early stages with screening every three years rather than yearly. When women are screened yearly, there is an unacceptable number of false-positive screening tests, leading to unnecessary procedures which can lead to harm such as infertility.
Mammogram:
Before: Yearly after age 40
Now: Every two years between the ages of 50 and 75
Why the change?
This is a very controversial issue. The United States Preventative Services Task Forces has recommended mammograms every two years starting at age 50 and stopping at age 75. Women at high risk (such as those with a family history of breast cancer) should start screening earlier.
Some groups, such as the American Cancer Society, still recommend yearly mammograms starting at age 40.
Why the difference? The reasons are similar to those for the change in the Pap smear recommendations. The risks (women harmed by invasive testing prompted by false-positive screening tests) outweigh the benefits (the number of deaths prevented by yearly testing is relatively low).
What should you do? How often you get screened should be a decision made between you and your physician.
If you are still confused about when to start mammogram screening--especially with high-profile women in their 40s getting diagnosed with breast cancer--I understand. Knowing your options empowers you to make a more informed decision about when to start your personal screening program.
Breast self-exams
Before: Monthly
Now: No need to do them.
Why the change?
I remember being reminded every year--and taught--how to do a breast self-exam by my own gynecologist. Self-exams are no longer recommended because they have not been found to reduce breast-cancer mortality.
So, what do these changes mean for you? Does this mean that you get to skip your annual physical?
No!
My intended message of highlighting these screening changes is to let you know what is currently recommended. I think we should use this discussion as an opportunity to question your relationship with your health-care provider and learn how to make that relationship more productive.
You still need to visit your primary-care physician regularly to monitor your overall health. The number one cause of death in America is heart disease, and you still need to monitor your risk factors and “know your numbers" in order to decrease your risk of heart disease and stroke.
I know you may be thinking that if your primary-care physician spends only about 5 minutes with you that they can’t possibly accomplish adequate preventative care. I am not denying that this is an issue. The current structure of the health-care system in the United States makes it difficult to receive the primary care that you deserve. Take charge of your own health and demand the care that you need. Know which screenings you need and when--and "know your numbers." Go to your primary-care physician prepared to ask for what you need. If your primary-care physician is threatened by your assertiveness, then you can exercise your right find another physician. A good physician will be supportive and impressed with your efforts to take charge of your health to prevent future disease.
So are annual physicals necessary and to they improve health outcomes?
I believe that preventing disease is one of the best gifts that you can give to yourself and your family. Keeping that once a year appointment can serve as a reminder of your commitment to your health and early detection leads to better outcomes. So, continue your annual physicals and continue to eat healthy, exercise, and enjoy your life!
What is the bottom line? Even though the latest recommendations allow for less vigorous screening for cervical and breast cancer it does not mean that you should stop seeking annual medical care. Keeping your yearly appointment is a commitment to preventing future disease and is a gift to all of those who love and depend on you!
Keep Sparking, everyone!
What do you think about the new recommendations?
Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider.
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Comments
Also, it is true that The U.S Preventative Services Task Force is the one putting out these standards, but you would be surprisied how much insurance money goes into their pockets. Don't fool yourself. This is ALL about money. - 4/10/2012 10:19:30 AM
As for pap smears, well I had a pap that came back abnormal, went for a colposcopy, turned out it was highly abnormal; had a cone biopsy, and have been clear ever since. If I hadn't had that original pap, I may not have known for 3 years, and then I would have had to wait even longer to get it dealt with, so I am totally against that reccommendation.
Granted, I live in Canada, and all these tests & procedures are paid for through my taxes so I don't have the financial issue to consider. However, just from personal experience, I will continue having paps on a regular basis, and when my dr reccomends it I will start having mammograms. - 4/9/2012 1:01:41 AM
Too many people take better care of their cars and their electronics than they do their own bodies. We should listen to our bodies when we see/feel something go wrong and learn about it instead of expecting overworked doctors who are humans that make mistakes to fix it with a little pill or a quick shot.
As for the guidelines, we should talk with our doctors about what the guidelines really mean and make informed choices. We are all unique - I'm one in more than a million - so guidelines are not law for any of us. - 4/6/2012 7:06:32 PM
So I am most glad that the monthly breast exams are KAPUT! Now we can focus on other helpful indicators for health concerns. And I am glad that the mammograms are scaled back. Not only were they costly, but traumatic for some.
Thanks so much for the updates! It will be nice when everyone is on board with the recommendations. - 4/6/2012 3:31:20 PM
Being on Spark these past six years has inadvertently led to my coming across a discussion on more than one team about "girl stuff".
Armed with some basic information, I went to the Internet for information. Why in blazes was none of this discussed in college level A&P classes?
Most guys are at least three years behind ladies in social training (and many Never catch up), and in some of that training we are encouraged not only to not ask questions, but to run, not walk, whenever anything even remotely associated with "girl stuff" is overheard in any conversation.
To guys, the words "pap smear" usually mean..... not much at all. I mean, it doesn't sound like 'kidney stones' or 'heart attack' or any other thing bad. It's just something girls do.
Likewise, the term 'mammogram' doesn't sound painful or uncomfortable at all. I assumed it was just some sort of x-ray, probably like a chest x-ray.
I now know what you ladies put up with, and think the innocuous term 'mammogram' should be replaced with something related to medieval torture devices.
I have apologized already to my DW (of nearly 41 years) about being so ignorant - and I apologize to you, too, just for guys in general.
BUT..... you need to help. Talk to your husbands and sons realistically and don't make it appear that your trips to your OB/GYN are just "routine" or "no big deal".
I know many young men, when asked by their wives to pick up feminine hygiene products while at the store, cringe and blush when they get to the counter and have to pay for them.
My wife is considered "low-risk" for breast cancer as there has been none diagnosed with cancer of any type going back 3 generations on her mom's side of the family and 5 generations on her dad's side.
Even at 66, she gets a breast exam much more often than once every month. - 4/5/2012 8:46:35 PM
I had my first and only mammogram then; I no longer have mammograms because I had a bilateral mastectomy without reconstruction.
Unfortunately though, my cancer returned in 2007, I'm now stage IV with bone mets. - 4/5/2012 1:37:54 PM
Insurance companies do offer coverage for birth control. Think of it like a menu. Employers look over the menu that is presented to them by the insurance company and decide what they are willing to pay for. If you do not have coverage for birth control talk to your employer.
- 4/5/2012 12:04:03 PM
*If you have insurance, consumer protections help you get the most out of your plan.
*If you need insurance or have been rejected for preexisting conditions, new programs may provide coverage.
*Medicare is strengthened, provides more access to preventive services and prescription drug discounts for seniors.
*Addresses the coverage gap know as the “donut hole” for prescription medicines for seniors 65 and older, and has already initiated a 50% discount for name-brand drugs in this category.
*Tax credits and new programs are available to small businesses to make health care more affordable for employers, employees, and early retirees.
*Insurance companies can no longer limit or deny benefits to children under age 19 due to a preexisting condition.
*Children can remain on their parents’ policy until age 26.
*Aims to reduce gender disparities in policy costs – women are currently overcharged compared to men.
*Breast Cancer Mammography screenings every 1 to 2 years for women over 40.
*Allow the woman and her physician to decide her contraceptive options – protect women from having these options decided by pharmacists, your boss, religious institutions or the government by having the insurance companies provide contraception coverage in their policies.
Contraception does NOT include abortifacient drugs, i.e. RU-486.
Access and use of contraception is practiced by 98% of women in this country at some time in their lives, and although no method is 100% effective having the choice reduces unintended pregnancies and therefore the decision of abortion in the first place.
Florida has already documented an increase in the deaths of women from ectopic pregnancies due to lack of access to health care and early diagnosis and treatment.
NOTE: THE REPUBLICAN PLATFORM SPECIFICALLY TARGETS THIS
AND WOULD COVER VIAGRA FOR MEN BUT NOT CONTRACEPTION FOR WOMEN.
So get the facts, people.
Without national health care, illness will bankrupt more and more families in this country.
With national healthcare, we can have a healthier, more productive workforce.
Here is the link for preventive care for women
www.healthcare.gov
- 4/5/2012 1:04:24 AM
Why?
BECAUSE SHE DID A BREAST SELF EXAM.
I don't *care* if it "doesn't reduce breast cancer mortality" - it saved my mother's life, who probably would NOT have been checked because of her lack of insurance. Advising women not to do breast self-exams, which are FREE and EASY to do is irresponsible, and likely would have KILLED MY MOTHER if she'd followed that advice.
As a fourth generation in a family of THREE GENERATIONS of breast cancer (my mother, grandmother, and great-grandmother) I WILL continue to do my breast exams... because doing saved my mother's life, and it could very well save mine.
Not everyone has insurance... not everyone can afford regular mammograms, nor has the access to low cost/free programs that offer them. For the million sof people who have no insurance, and those who have it but do not follow adequate preventative care for whatever reason, this is irresponsible advice, and I hope for those like my mom, they IGNORE IT. - 4/4/2012 6:47:22 PM
I had my yearly physical already this year, it is one of the things I always make sure to do early on so I don't put it off.
I am surprised that the breast self-exam has been nixed.
- 4/4/2012 11:50:03 AM
I completely disagree with the women on here saying they knew they didn't need it yearly and it's unethical for doctors to have "forced" us to have them. REALLY? Pap smears, as others have pointed out, are NOT just about cancer. There are a heck of a lot of conditions and illnesses that are found that way, some that can kill you and/or cause horrible deformities should you become pregnant and YES you CAN become pregnant ON birth control. Also CERVICAL IS NOT the ONLY cancer. They quote cervical but the instances of UTERINE cancer are much higher to MY EXPERIENCE. Number of women I know who've had cervical cancer? ZERO. Number of women I know who've had UTERINE cancer? Oh, lets seeee... about 7!!!! Including MY MOTHER. If my BFF hadn't been diagnosed when she was and my mother as well they'd have been dead. And they GOT YEARLY EXAMS. IMHO it's NOTHING but a money maker for a mysoginistic insurance system. - 4/3/2012 10:36:08 PM
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