A woman’s health depends on a lot of factors.
Every woman should make time for healthy habits; regular exercise, stress management, eating the right foods, and she should also be scheduling routine health screenings so potential problems can be spotted early.
In this informative segment Sherrilyn Parrish, MD, obstetrician and gynecologist at Our Lady of Lourdes Medical Center, shares the five most important health screenings every women should have, and that regular health screenings can make keeping tabs on your health much more simple.
The Most Important Health Screenings Every Women Should Have
From the Show: Lourdes Health Talk
Summary:
Air Date: 11/24/17
Duration: 10 Minutes
Transcription:
Melanie Cole (Host): A woman’s health depends on so many factors. Every woman should certainly make time for healthy habits, regular exercise, stress management, eating the right foods; you know the drill. But she should also be scheduling routine health screening so that potential problems can be spotted early. My guest today is Dr. Sherrilyn Parrish. She’s an obstetrician/gynecologist with Our Lady of Lourdes Medical Center. Welcome to the show, Dr. Parrish. So, let’s just start with screenings that women should be getting in their even teens, 20’s, 30’s. Kind of work your way up and what do you think are the most important things we should start keeping a track of.
Dr. Sherrilyn Parrish, MD (Guest): So, first of all, I think that, you know, it’s very important for women to manage their health. A lot of times we get busy taking care of everyone else in the family, and we neglect our own health. Well, starting as early as 18, you could start screening for blood pressure, which elevated blood pressure can lead to heart disease and other changes in your vascular system. So, I recommend starting blood pressure screening at age 18, and then it’s often checked annually when you go in for a physical exam or gynecological exam or something like that. New blood pressure guidelines have been recommended, and they lowered the recommended blood pressure to be below 130/80, and then another thing that women should have checked is they should be screened for diabetes, and generally, we don’t screen for diabetes until about age 45 or older unless you have risk factors. So even as early as 30 years old we can screen for diabetes if you have a family history of diabetes. If you’ve had gestational diabetes when you were pregnant, if you delivered a baby that was over nine pounds, if your cholesterol is elevated—so all of these reasons we screen for diabetes earlier than age 45.
Melanie: What’s that screening?
Dr. Parrish: That screening would be a – there’s a couple of ways you could do it. You can drink a Glucola and have your blood drawn two hours later. You can have a hemoglobin A1C drawn to see if your blood sugars have been in good control over the previous three months.
Melanie: And what about cholesterol because as you’re speaking about diabetes and the risk for heart disease—
Dr. Parrish: Yes.
Melanie: –and obesity, which is an epidemic in this country right now—
Dr. Parrish: Yes.
Melanie: –what about cholesterol? Do young women need to worry about that?
Dr. Parrish: They do. Especially women that maybe smoke, women that may have diabetes, heart disease. We start screening for cholesterol as early as age 20. If, however, we have no risk factors, generally you don’t screen again until maybe age 45 and for men, a little sooner, but we do have a lot of women that have increased risk factors. So, we do recommend maybe even starting screening at age 20 if you have a family history of, members of your family that have heart disease, or elevated cholesterol at a younger age, definitely, they should be screened at an earlier age.
Melanie: What about pap smears and pelvic exams? How early do we bring in our daughters and what’s the relationship to HPV and now, Dr. Parrish, that our younger girls are getting the HPV/cervical cancer vaccine—
Dr. Parrish: Yes.
Melanie: —do they still need pap smears in their 20’s? Please speak about this controversy and clear up some of that confusion for us.
Dr. Parrish: Right. So, pap smears, we start at age 21, and from age 21 to 29, we do a pap smear every three years. We do not test for HPV until age 30. The reason being is because young, healthy women, if they are exposed to HPV, it can go away on its own, and so we don’t even start screening until age 30. It is recommended that all young girls between the ages of 9 and 26 do get the Gardasil or the HPV vaccine. It’s also recommended that young teenage boys also get this vaccine. So, this vaccine protects us against several different strains of the HPV virus, and the HPV virus is the most common cause of an abnormal pap smear, and it’s also the most common cause of cervical cancer. So, the thought is that if we can prevent the virus, then we can prevent cervical cancer. A lot of mothers and daughters are reluctant to get the vaccine because they think it’s too new, but it is recommended by the American College of OB/GYN. It’s recommended by the American Cancer Society, and it’s a great tool that we have to protect us against the HPV virus or at least the most high-risk types of the HPV virus, the ones that can potentially lead to cervical cancer.
Melanie: What about women who could not get that vaccine who are over—
Dr. Parrish: Right.
Melanie: —the age of 30, if it stops at 26?
Dr. Parrish: Right.
Melanie: Do then they need that pelvic and that pap smear on a regular basis or do they get checked for HPV and if they don’t have it then they don’t need that, you know, pap smear—every
Dr. Parrish: Right.
Melanie: —every year?
Dr. Parrish: So, starting at age 30, we do a pap smear every three to five years, and we check for the HPV virus every five years. And so that’s our way of checking for women over 30 to see if they’ve been exposed to the HPV virus, and to see if this exposure is leading to any abnormal changes on your pap smear. We stop doing pap smears at age 65 as long as they’ve always been okay.
Melanie: That’s great information. Clears up the confusion very well, Dr. Parrish. And what about mammograms and breast exams? How early do we get our first baseline mammogram and then again—
Dr. Parrish: Yes.
Melanie: —there’s some controversy on this? So, clear that up for us.
Dr. Parrish: Yes. So, the first baseline mammogram is at age 40. Again, we can always start earlier if there’s a strong family history, if there are younger women in the family that have been diagnosed with breast cancer, if a first degree relative, mother, sister, daughter, has been diagnosed with breast cancer, then you would start screening earlier, but typically mammograms start at age 40, and clinical breast exams should be done by a provider beginning at age 25. And the patient should be taught how to do a self-breast exam as well. Mammograms are done yearly, but there are some recommendations that may be every other year, but I follow and a lot of people follow the American College of OB/GYN which recommends mammograms yearly.
Melanie: Now, onto the one that people don’t like to think about or discuss because they’re so worried about the prep but it’s really—
Dr. Parrish: Right.
Melanie: —such an easy test. I myself have had a bunch of them so—
Dr. Parrish: Yes.
Melanie: —so colon cancer screening and colonoscopy. When do you start those and how often?
Dr. Parrish: Yes, colonoscopy starts at age 50, and then it depends on the findings. So, if they find a polyp, they may bring you back sooner in three to five years to repeat another colonoscopy. If they find nothing, and everything is clear, then you don’t go again for 10 years. If you have a family history of colon cancer, then you go every five years. So, there, you know, depends on what you find. Depends on your family history, but a routine screening colonoscopy with normal findings start at age 50 and go every 10 years.
Melanie: And they’re really so much easier than people realize, so it is so important for men and women—
Dr. Parrish: Yes.
Melanie: —to get that colonoscopy. Now, for women, we also hear and as you enter perimenopause and menopause that your bone density can go down—
Dr. Parrish: Yes.
Melanie: —as the decades increase. So, what do we do about bone density testing?
Dr. Parrish: So, there is something called a DEXA scan, and a DEXA scan screens for bone density. It screens for osteoporosis and the recommendation is to start getting a bone density test at age 65. Again, sooner if you have risk factors and those risk factors would be someone who has small build, someone who has had multiple fractures. Some women of Asian descent, Caucasian women that have a small frame—you may want to screen them earlier or generally we start screening at age 65.
Melanie: So, there’s just a few others that are pretty important for women—
Dr. Parrish: Yes.
Melanie: —and one of them is to take care of our skin. If you’re of a certain age, maybe you didn’t even think about it when we used to sit out in the sun—
Dr. Parrish: Right.
Melanie: —but how often should we see a dermatologist and kind of get that whole-body check?
Dr. Parrish: Yes. That should be done every couple of years, every two years you should probably follow up with a dermatologist to have your moles checked and make sure there’s no pre-cancerous lesions anywhere on your body, especially your face, you back, anything that has been exposed to the sun for a prolonged period of time.
Melanie: And the last one I’d like to ask you about, Dr. Parrish, is our eyes because people tend not to, you know, we know we have to go to the dentist and do certain things—
Dr. Parrish: Right.
Melanie: —but we don’t always go to the eye doctor.
Dr. Parrish: Right. Right, right, right. Yeah, the eye doctor, again, the recommendation is every one to two years to have your eyes checked, especially after the age of 40. That’s when we start noticing that you need to move the papers a little further so that you can see, and the bifocals come into view, but every one to two years you should have an eye exam and for people that have a family history of glaucoma, they should be screened more often and earlier.
Melanie: So, wrap it us for us with your best advice about all of these things. You’ve given such really great information—
Dr. Parrish: [laughs]
Melanie: —today and so succinctly put, what do you want women out there to know about taking care of themselves? In a sense putting on their own mask before they put the mask on of their loved ones because we are the caregivers of society, as you said, and if we don’t take care of ourselves, we’re not going to be able to take care of our loved ones.
Dr. Parrish: Exactly. Exactly. So, the best advice that I can give is that you start seeing your primary doctor, your gynecologist at an early age. Teenagers, I often have teenagers come in before they go to college, and even if we don’t do an exam, we talk, and, you know, explain changes that are happening and then start blood pressure screenings, cholesterol screenings starting as early as age 18, and then seeing the gynecologist starting again as a teenager, but starting to get the pap smears, talk about HPV, and STD screening, you know, before they go to college. Pap smears starting at age 21, every three years until age 30 and at age 30, start screening for the HPV. Mammograms starting at age 40. Cholesterol screenings, age 45. So, there’s milestones that we have to reach as we go through the different stages of our adult life and just, you know, trying to take care of ourselves so that we can take care of everyone else.
Melanie: Thank you so much for being with us today. What great information you’ve given us. This is Lourdes Health Talk. For more information, please visit lourdesnet.org. That's lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): A woman’s health depends on so many factors. Every woman should certainly make time for healthy habits, regular exercise, stress management, eating the right foods; you know the drill. But she should also be scheduling routine health screening so that potential problems can be spotted early. My guest today is Dr. Sherrilyn Parrish. She’s an obstetrician/gynecologist with Our Lady of Lourdes Medical Center. Welcome to the show, Dr. Parrish. So, let’s just start with screenings that women should be getting in their even teens, 20’s, 30’s. Kind of work your way up and what do you think are the most important things we should start keeping a track of.
Dr. Sherrilyn Parrish, MD (Guest): So, first of all, I think that, you know, it’s very important for women to manage their health. A lot of times we get busy taking care of everyone else in the family, and we neglect our own health. Well, starting as early as 18, you could start screening for blood pressure, which elevated blood pressure can lead to heart disease and other changes in your vascular system. So, I recommend starting blood pressure screening at age 18, and then it’s often checked annually when you go in for a physical exam or gynecological exam or something like that. New blood pressure guidelines have been recommended, and they lowered the recommended blood pressure to be below 130/80, and then another thing that women should have checked is they should be screened for diabetes, and generally, we don’t screen for diabetes until about age 45 or older unless you have risk factors. So even as early as 30 years old we can screen for diabetes if you have a family history of diabetes. If you’ve had gestational diabetes when you were pregnant, if you delivered a baby that was over nine pounds, if your cholesterol is elevated—so all of these reasons we screen for diabetes earlier than age 45.
Melanie: What’s that screening?
Dr. Parrish: That screening would be a – there’s a couple of ways you could do it. You can drink a Glucola and have your blood drawn two hours later. You can have a hemoglobin A1C drawn to see if your blood sugars have been in good control over the previous three months.
Melanie: And what about cholesterol because as you’re speaking about diabetes and the risk for heart disease—
Dr. Parrish: Yes.
Melanie: –and obesity, which is an epidemic in this country right now—
Dr. Parrish: Yes.
Melanie: –what about cholesterol? Do young women need to worry about that?
Dr. Parrish: They do. Especially women that maybe smoke, women that may have diabetes, heart disease. We start screening for cholesterol as early as age 20. If, however, we have no risk factors, generally you don’t screen again until maybe age 45 and for men, a little sooner, but we do have a lot of women that have increased risk factors. So, we do recommend maybe even starting screening at age 20 if you have a family history of, members of your family that have heart disease, or elevated cholesterol at a younger age, definitely, they should be screened at an earlier age.
Melanie: What about pap smears and pelvic exams? How early do we bring in our daughters and what’s the relationship to HPV and now, Dr. Parrish, that our younger girls are getting the HPV/cervical cancer vaccine—
Dr. Parrish: Yes.
Melanie: —do they still need pap smears in their 20’s? Please speak about this controversy and clear up some of that confusion for us.
Dr. Parrish: Right. So, pap smears, we start at age 21, and from age 21 to 29, we do a pap smear every three years. We do not test for HPV until age 30. The reason being is because young, healthy women, if they are exposed to HPV, it can go away on its own, and so we don’t even start screening until age 30. It is recommended that all young girls between the ages of 9 and 26 do get the Gardasil or the HPV vaccine. It’s also recommended that young teenage boys also get this vaccine. So, this vaccine protects us against several different strains of the HPV virus, and the HPV virus is the most common cause of an abnormal pap smear, and it’s also the most common cause of cervical cancer. So, the thought is that if we can prevent the virus, then we can prevent cervical cancer. A lot of mothers and daughters are reluctant to get the vaccine because they think it’s too new, but it is recommended by the American College of OB/GYN. It’s recommended by the American Cancer Society, and it’s a great tool that we have to protect us against the HPV virus or at least the most high-risk types of the HPV virus, the ones that can potentially lead to cervical cancer.
Melanie: What about women who could not get that vaccine who are over—
Dr. Parrish: Right.
Melanie: —the age of 30, if it stops at 26?
Dr. Parrish: Right.
Melanie: Do then they need that pelvic and that pap smear on a regular basis or do they get checked for HPV and if they don’t have it then they don’t need that, you know, pap smear—every
Dr. Parrish: Right.
Melanie: —every year?
Dr. Parrish: So, starting at age 30, we do a pap smear every three to five years, and we check for the HPV virus every five years. And so that’s our way of checking for women over 30 to see if they’ve been exposed to the HPV virus, and to see if this exposure is leading to any abnormal changes on your pap smear. We stop doing pap smears at age 65 as long as they’ve always been okay.
Melanie: That’s great information. Clears up the confusion very well, Dr. Parrish. And what about mammograms and breast exams? How early do we get our first baseline mammogram and then again—
Dr. Parrish: Yes.
Melanie: —there’s some controversy on this? So, clear that up for us.
Dr. Parrish: Yes. So, the first baseline mammogram is at age 40. Again, we can always start earlier if there’s a strong family history, if there are younger women in the family that have been diagnosed with breast cancer, if a first degree relative, mother, sister, daughter, has been diagnosed with breast cancer, then you would start screening earlier, but typically mammograms start at age 40, and clinical breast exams should be done by a provider beginning at age 25. And the patient should be taught how to do a self-breast exam as well. Mammograms are done yearly, but there are some recommendations that may be every other year, but I follow and a lot of people follow the American College of OB/GYN which recommends mammograms yearly.
Melanie: Now, onto the one that people don’t like to think about or discuss because they’re so worried about the prep but it’s really—
Dr. Parrish: Right.
Melanie: —such an easy test. I myself have had a bunch of them so—
Dr. Parrish: Yes.
Melanie: —so colon cancer screening and colonoscopy. When do you start those and how often?
Dr. Parrish: Yes, colonoscopy starts at age 50, and then it depends on the findings. So, if they find a polyp, they may bring you back sooner in three to five years to repeat another colonoscopy. If they find nothing, and everything is clear, then you don’t go again for 10 years. If you have a family history of colon cancer, then you go every five years. So, there, you know, depends on what you find. Depends on your family history, but a routine screening colonoscopy with normal findings start at age 50 and go every 10 years.
Melanie: And they’re really so much easier than people realize, so it is so important for men and women—
Dr. Parrish: Yes.
Melanie: —to get that colonoscopy. Now, for women, we also hear and as you enter perimenopause and menopause that your bone density can go down—
Dr. Parrish: Yes.
Melanie: —as the decades increase. So, what do we do about bone density testing?
Dr. Parrish: So, there is something called a DEXA scan, and a DEXA scan screens for bone density. It screens for osteoporosis and the recommendation is to start getting a bone density test at age 65. Again, sooner if you have risk factors and those risk factors would be someone who has small build, someone who has had multiple fractures. Some women of Asian descent, Caucasian women that have a small frame—you may want to screen them earlier or generally we start screening at age 65.
Melanie: So, there’s just a few others that are pretty important for women—
Dr. Parrish: Yes.
Melanie: —and one of them is to take care of our skin. If you’re of a certain age, maybe you didn’t even think about it when we used to sit out in the sun—
Dr. Parrish: Right.
Melanie: —but how often should we see a dermatologist and kind of get that whole-body check?
Dr. Parrish: Yes. That should be done every couple of years, every two years you should probably follow up with a dermatologist to have your moles checked and make sure there’s no pre-cancerous lesions anywhere on your body, especially your face, you back, anything that has been exposed to the sun for a prolonged period of time.
Melanie: And the last one I’d like to ask you about, Dr. Parrish, is our eyes because people tend not to, you know, we know we have to go to the dentist and do certain things—
Dr. Parrish: Right.
Melanie: —but we don’t always go to the eye doctor.
Dr. Parrish: Right. Right, right, right. Yeah, the eye doctor, again, the recommendation is every one to two years to have your eyes checked, especially after the age of 40. That’s when we start noticing that you need to move the papers a little further so that you can see, and the bifocals come into view, but every one to two years you should have an eye exam and for people that have a family history of glaucoma, they should be screened more often and earlier.
Melanie: So, wrap it us for us with your best advice about all of these things. You’ve given such really great information—
Dr. Parrish: [laughs]
Melanie: —today and so succinctly put, what do you want women out there to know about taking care of themselves? In a sense putting on their own mask before they put the mask on of their loved ones because we are the caregivers of society, as you said, and if we don’t take care of ourselves, we’re not going to be able to take care of our loved ones.
Dr. Parrish: Exactly. Exactly. So, the best advice that I can give is that you start seeing your primary doctor, your gynecologist at an early age. Teenagers, I often have teenagers come in before they go to college, and even if we don’t do an exam, we talk, and, you know, explain changes that are happening and then start blood pressure screenings, cholesterol screenings starting as early as age 18, and then seeing the gynecologist starting again as a teenager, but starting to get the pap smears, talk about HPV, and STD screening, you know, before they go to college. Pap smears starting at age 21, every three years until age 30 and at age 30, start screening for the HPV. Mammograms starting at age 40. Cholesterol screenings, age 45. So, there’s milestones that we have to reach as we go through the different stages of our adult life and just, you know, trying to take care of ourselves so that we can take care of everyone else.
Melanie: Thank you so much for being with us today. What great information you’ve given us. This is Lourdes Health Talk. For more information, please visit lourdesnet.org. That's lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
