Medical checks women need in their 20s, 30s, 40s to nip health issues in the bud
The best defence for your health is regular screening. Here's a look at the yearly checks you should go for.
In partnership with UOB.
You schedule medical appointments for your loved ones, accompany them to said appointments and make sure they take their medicine in a timely manner.
As adept as many women are at taking care of others, there is one important area that has become a blind spot – your very own health. Take, for instance, health checks. How long have you been postponing yours?
Ask any doctor and he or she will tell you that it is important to go for regular check-ups. Cancers that are deadly are treatable when detected early. Even niggling issues such as low energy or heavy periods could be linked to a thyroid problem and they can be treated when picked up – but only if you have yourself tested.
To give you a better idea what those yearly contributions of blood, urine and other bodily fluids are for, CNA Lifestyle checks in with the doctors.
Here’s a look at the tests you need, depending on your age.
IN YOUR 20S
You’re young and there’s nothing wrong with you. So why do you need to get tested? Because many conditions such as hypertension, diabetes, and hyperlipidaemia (high levels of lipids in the blood) are “silent”, said Dr Chan Wan Xian, a cardiologist from Gleneagles Hospital.
It is a good idea to have your blood sugar level, cholesterol levels and blood pressure measured, especially if you have a family history of “diabetes, hypertension, hyperlipidaemia and cardiovascular diseases, including heart diseases and stroke", said Dr Chan.
But hold off on the breast ultrasound scans and mammograms for now as “it is extremely rare” to develop the disease at this age decade, said Dr Andrew Lee, a general surgeon from Gleneagles Hospital. In most cases, the lumps are benign and do not evolve into breast cancer, he said.
There’s another reason why the breast scans aren’t quite necessary at this stage: “When a young woman with no personal health insurance is found to have such lumps, she will have problems finding insurance coverage for her breasts,” said Dr Lee.
“My advice for any women is for them to have their personal health insurance first before contemplating breast screening.”
If you have a family history of breast cancer, you might want to consider insurance policies that cater to such health concerns. For instance, PRUCancer 360 from UOB offers a 100 per cent payout for all cancer stages and covers a wide range of cancer, including breast and ovarian.
TESTS YOU'LL NEED IN YOUR 20S
Blood test: The diabetes and hyperlipidaemia that Dr Chan mentioned can be screened out with a simple blood test. Here are the healthy numbers you should be aiming for when it comes to your post-fasting blood glucose and cholesterol levels:
- Glucose level: Below 6.1 mmol/L (prediabetic: 6.1 mmol/L to 6.9 mmol/L; diabetic: 7 mmol/L or higher)
- Total cholesterol: 200 mg/dL or below
- Triglycerides: Less than 149 mg/dL
- LDL (bad) cholesterol: Less than 100 mg/dL
- HDL (good) cholesterol: 50 mg/dL or higher
Besides cholesterol and glucose levels, a blood test can also check if your organs such as the liver, kidney and thyroid are humming along fine. Pick up your anaemia or a low haemoglobin count if you often feel faint, said Dr Derek Koh, the head of Medical Heath Screening at Thomson Wellth Clinic.
Furthermore, a blood test can screen for sexually transmitted infections (STIs) and is encouraged in the following scenarios, advised Dr Susan Logan, a senior consultant at National University Hospital’s Department of Obstetrics and Gynaecology:
- You've had a new partner in the past three months
- You've had more than a partner within 12 months
- You did not use barrier protection
- You have a previous history of STI
Blood pressure test: This screens for hypertension; a healthy reading is below 130/80mmHg.
Pap smear: Cervical cancer is caused by the human papilloma virus or HPV. The Pap smear (age 25 onwards, or younger if you're sexually active) can detect precancerous cells caused by the virus, said Dr Cindy Pang, an obstetrician and gynaecologist from Mount Elizabeth Novena Hospital.
Not only that, it can also screen out fungal or bacterial infections, said Dr Koh.
Urine test: This tests for blood, protein and infection, said Dr Pang. “It can sometimes pick up conditions such as kidney stones and kidney problems that cause leaking protein.”
Thyroid test: This is done through a simple blood test to detect abnormally low or high thyroid hormone levels (see below) – common in women – which could explain your “vague symptoms of tiredness, bowel habit changes or temperature intolerance”, said Dr Pang.
Unusual thyroid levels can cause “very light or very heavy menstrual flow, very irregular periods, or absent menstrual periods”, she said. Doctors can then determine if there is a need to test for further gynaecological problems like fibroids.
- Normal: 0.5 to 4.1 mU/L
- Low: Lower than 0.5 mU/L
- High: Higher than 4.1 mU/L
If you're worried about the cost of these tests, there are ways to get around it. The UOB Lady's Savings Account, for instance, offers complimentary health screening.
It also provides free cancer coverage of up to S$200,000 for six female cancers, including breast, cervix, uterus, fallopian tube, vagina/vulva and ovary.
IN YOUR 30S
The 30s are the reproductive years, so the health checks will often be about maximising fertility, said Dr Logan, who is also a co-lead for Women's Health at Alexandra Hospital.
Pre-conception checks can include testing your female hormone profile to assess if your hormonal levels are optimal (for instance, for stimulating the growth and release of eggs from the ovaries). Mums-to-be may also want to be screened for blood-borne viruses, thyroid function, ovarian reserve and thalassaemia. This is an opportunity to check your vaccination status for hepatitis, varicella and rubella as well.
While you may be in a committed relationship now, it doesn't hurt to test for STIs either. Herpes, for instance, is life-threatening to newborns; gonorrhoea can cause miscarriages and preterm labour.
To guard against cervical cancer, you may want to consider an HPV test in addition to a Pap smear for more thorough screening against cervical cancer.
TESTS YOU'LL NEED IN YOUR 30S
Blood test: The cholesterol levels aside, you'll want to test for diabetes and/or heart disease, polycystic ovary syndrome and gestational diabetes mellitus, especially if you have a strong family history, advised Dr Logan. "Annual glucose screening should be undertaken in women who had gestational diabetes in a previous pregnancy."
Blood pressure test: See In Your 20s.
Urine test: See In Your 20s.
Pap smear: See In Your 20s.
HPV test: While the Pap smear detects abnormal cells that could turn into cervical cancer, the HPV test can tell the presence of two strains of HPV, which is responsible for about 70 per cent of cervical cancer cases.
Mammogram: "If there is a strong family history, mammograms may be recommended to start five years earlier than the earliest age of diagnosis in a close family member," said Dr Logan. Otherwise, stick to your regular breast self-examination, she said.
Liver function test: Get yourself tested if there are symptoms such as jaundice or risks like congenital Hepatitis B, said Dr Logan.
Thyroid test: See In Your 20s.
IN YOUR 40S
Numbers that shouldn’t rise (weight, cholesterol and glucose levels, blood pressure, etc) will start to climb and can lead to issues such as diabetes and hypertension.
Due to the prolonged exposure to oestrogen, women in this age group are also at a higher risk of breast cancer. According to a 2010 study on Singaporean women, the highest rates are reported between the ages of 45 and 49.
Optional tests to consider can include a bone density test to detect early osteoporosis, especially if you hadn’t been paying attention to your calcium requirements during your childbearing and breastfeeding years as both events tap on your calcium reserves.
Thyroid checks are prudent to get as well. Symptoms that you think are related to impending menopause may be caused by a thyroid disorder instead. In fact, the condition is often diagnosed between the ages of 45 and 55, according to Mayo Clinic.
TESTS YOU'LL NEED IN YOUR 40S
Blood test: See In Your 20s.
If you were born in the 70s or 80s, some of your vaccination jabs may no longer be effective. For instance, diphtheria, pertussis and tetanus (aka DPT), require booster shots every 10 years. A blood test can test determine if you still have the antibodies.
Blood pressure test: If the reading is persistently elevated (it should be less than 140/90mmHg for this age group), you may need to tweak your lifestyle, including exercising more, losing weight and reducing your salt intake, said Dr Koh. “When lifestyle modifications fail, medication may be needed.”
Urine test: See In Your 20s.
Pap smear: See In Your 20s.
Mammogram: In addition to regular breast self-examination, you should also schedule yearly mammograms once you reach 40. “Breast cancer is the No 1 female cancer, so this is an important screening test for women,” said Dr Koh.
Stool test: This checks for blood in your stool, which can be traced to a problem in your digestive system, including polyps, haemorrhoids, ulcers and colorectal cancer. If blood is detected, it often entails a referral to see a specialist for a colonoscopy and other follow-ups, said Dr Koh.
Tonometry: It can be done in a few ways; the least invasive method involves puffing air onto your eye. This tests for glaucoma by measuring eye pressure; a high reading (normal eye pressure range is 10 mmHg to 21 mmHg) may mean that the optic nerve is damaged by this eye disease.
Thyroid ultrasound: Other than the thyroid function test (a blood test really), there is also a thyroid ultrasound scan that can catch what the blood test misses, said Dr Koh.
HPV test: See In Your 30s.
Pelvic ultrasound: Uterine and ovarian growths, including fibroids, ovarian cysts and cancer, are fairly common, said Dr Koh. “The ultrasound scan provides a visual overview to exclude such pathologies.”
Bone density test: Osteoporosis leading to fractures is a common cause of disability and death later in life, cautioned Dr Koh. “It is important to pre-empt the situation by doing a bone density test.”
Scans are usually done on the hip and spine as these areas are the most likely to fracture. According to the World Health Organization, the results are reported in T-scores – the higher, the better.
- Normal: -1.0 or above
- Low bone density: -1.0 and -2.5
- You have osteoporosis: -2.5 or below
Your doctor can advise you on further tests or actions to take should your test or scan results show abnormalities.
For more great ideas for you and your money, visit www.uob.com.sg/women.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.