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The Tests All Women Should Have

Everyone asks me “So what tests should I be having” There is no one answer. It depends on your age and personal circumstances.

Safe Sex:

Certainly as soon as a woman is contemplating becoming sexually active she needs to thinks about “Safe Sex” – both to prevent Sexually transmitted infections and to prevent an unwanted pregnancy. I would recommend seeing a Doctor to discuss this and to get advice on how to use condoms, and to discuss any other birth control that she may wish to use. It may even be worth attending with her partner to be screened together – and this should certainly happen with any new partner. If she has never been sexually active and has not been vaccinated against the HPV (Human papilloma Virus) this is the time to do it. HPV 16 and 19 causes 80% of Cervical Cancer and is sexually transmitted. By getting vaccinated we may be able to prevent a Cancer.

Cancer Screening:

I recommend annual smear tests from the age of 25. Any younger and unnecessary tests and treatment may be carried out. After than 3 yearly screening until age 50 when 5 yearly screens until age 64 will suffice. If she is 65 and older it is not necessary to continue unless she has never had a smear or if a recent one was abnormal.

Breast Cancer Screening is also important. Generally mammograms should start at age 45-50 depending on local policies and continue every 2 – 3 years until age 50-55. Sometimes people may need earlier screening if they is a strong family history of breast cancer at an early age or are known genetic carriers of genes that cause Breast Cancer.

Contraceptive Advice

All women should have a consultation about the different methods available to them. Gone are the days of just ‘The Pill” and “Condoms”. There are a whole range of other Long Acting reversible Contraceptives like the Mirena, the Depot injection and the IUD. Some methods may be more suitable that others for women with certain medical conditions or for those on certain medications. Women on the Pill should have a “Pill check” to check their blood pressure every six months

Antenatal Advice

It is a good idea to speak to your Doctor before trying to conceive to make sure all relevant vaccinations like Rubella are up to date. If a pregnant woman succumbs to Rubella, especially during the first trimester it can harm her unborn child. As the vaccine is live, it must be administered before pregnancy. It is important to take at least 400mcg (micrograms) of Folic acid prior to conception and during the first 3 months of pregnancy to reduce the risk of Spina Bifida.

Bone Health

Premature menopause, steroid use, alcohol use, being over or underweight and certain medical conditions like Coeliac Disease/Thyroid disease etc can increase the risk of Osteoporosis or “Thinning of the Bones”. This is especially important after the menopause. Osteoporosis is treatable but if not picked up it can lead to a fractured hip or spine from a relatively low impact fall! If you think you might be at risk it is worth seeing your Doctor to discuss screening and possibly investigation with a Bone Scan (DEXA scan)

The above list is not exhaustive and did not include more general tests like weight, cholesterol, Diabetes screening which also apply to men! The most important things you can do to keep healthy are to stop smoking, and have a healthy diet and exercise. Obesity has been linked to many cancers including Endometrial (womb), Breast and Bowel cancer!

Before sexual activity HPV vaccine, safe sex and contraception 25 – 49
Pap smear every 3 years
Mammogram every 2-3 years from age 45.
50 – 64 Pap smear every 5 years

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