Screening & Tests- 02

1- Your 20s and 30s: Jumpstart Healthy Living

2- Medical Tests in Your 20s and 30s
3- Your 40s and 50s: Managing Health Changes
4- Exams for Women Over 40

5- Health Checklist for Women Over 40
6- Your 60s and Up: Healthy Body, Sharp Mind
7- Testosterone and Estrogen Levels in Women
8- Estrogen Test

9- Progesterone Test
10- Breast Biopsy
11- What to Expect From an Ob-Gyn Visit
12- Hysteroscopy

13- Pelvic Exam
14- Pap Smear
15- What If My Pap Test Results Are Abnormal?
16- Vaginal Wet Mount
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5- Health Checklist for Women Over 40

Health Checklist for Women Over 40

Print out this list to keep track of tests and procedures you need after the age of 40 and take it with you to your next doctor's appointment.

Procedure/test: What it does: Starting at age: How often: Date performed/results: Mammogram Checks for breast cancer 40 (or earlier with certain risk factors) Every 1 to 2 years, depending on risk   Doctor's breastexam May detect breastcancers missed by mammography 20 Annually; Every three years for women 20-40

Cervical cancer screening (one of the following):

Procedure/test: What it does: Starting at age: How often: Date performed/results: Pap smear and pelvic exam Checks for cervical cancer 21 Every three years. Women older than 65 may be able to stop testing if your doctor says you're low risk.   Pap smear plus HPV DNA testand pelvic exam Some experts recommend as more precise means to check for cervical cancer 30 Every five years until age 65, or as recommended by your doctor. Women older than 65 may be able to stop testing if your doctor says you're low risk.

Colorectal cancer screening:

Procedure/test: What it does: Starting at age: How often: Date performed/results: Colonoscopy Outpatient procedure in which a doctor inserts a long, flexible instrument - about 1/2 inch in diameter - into the rectum to view the rectum and entire colon. Many experts say colonoscopy is the most accurate colon cancer screening 50 (or earlier with certain risk factors) Every 10 years, more often for those with risk factors, a family history or history of colon polyps.   Fecal occult blood test(FOBT) Stool is tested for blood -- a possible sign of colorectal cancer 50 Annually   Flexible sigmoidoscopy Outpatient procedure for examining the lower portion of the large intestine, called the sigmoid colon. A special instrument with a tiny camera attached is used. 50 Every 5 years   Air-contrast barium enema(for those who cannot undergo a routine colonoscopy) Barium is given as an enema, and then air is blown in to make the barium spread over the lining of the colon, producing an outline of the colon on X-ray. This helps to reveal any irregularities in the lining, such as a polyp. 50 Every 5 years   *Your doctor will pick which screening test is best for you. Your screening schedule may be different depending on your personal and family history.

Heart disease screening:

Procedure/test: What it does: Starting at age: How often: Date performed/results: Blood cholesterol test Measures amount of total cholesterol, "bad" LDL, and "good" HDL cholesterol circulating in the blood. Levels of triglycerides, another blood fat, are also usually checked. 20 Every 5 years, or at your doctor's discretion   Blood pressurecheck Measures blood pressure, an indicator of heart risk 18 At least every other year, more often if above normal   Fasting plasma glucose Measures blood sugar, an indicator of diabetes risk 45, or younger if you are overweight with BMI > 25kg/m2 and have other risk factors such as hypertension or high cholesterol Every three years if in normal range, or at your doctor's discretion

Bone Health:

Procedure/test: What it does: Starting at age: How often: Date performed/results: Bone mineral density test Used as an indicator of bone strength and osteoporosisrisk 65, or earlier for women with previous fragility fractures; a family history of osteoporosis; on medications that cause bone loss; or have problems with calcium absorption At your doctor's discretion

Sexual Health: 

If you are sexually active and have a higher risk for STDs, get tests for chlamydia, gonorrhea, and syphilis yearly. Take an HIV test at least once, more frequently if you’re at risk.

Vaccines/immunizations:

Procedure/test: What it does: Starting at age: How often: Date performed/results: Tetanus, diphtheria, pertussis(Td/Tdap) booster Restores protection against tetanus, diphtheria, pertussis (whooping cough) infection Varies. Recommended in the third trimester of pregnancy. One dose of Tdap as a booster, and then a Td booster every 10 years   Pneumonia vaccine Provides lifelong protection against pneumonia 65 or earlier in people with risk factors, such as heart failure, lung disease, alcoholism, and others Two shots if given at age 65 or later. May need to be repeated in people who have certain medical conditions who received it before the age of 65   Influenzavaccine Provides protection against common influenzastrains Everyone 6 months of age and older Yearly Zostavax To help protect against herpes zoster, or shingles 60 One dose

6- Your 60s and Up: Healthy Body, Sharp Mind

Simple Health Steps for Women in Their 60s and Up

If you're in your 60s or older, take a little time to keep your body healthy and your mind sharp. Try these easy tips that can make all the difference.

1. Use It or Lose It

As you get older, keep your thinking ability in good shape. A key part of this is to make sure your brain stays busy. Read, do crossword puzzles, socialize, try new hobbies, and start new adventures. Maybe it's finally time to learn French!

2. Strength Training: It's Never Too Late to Start

At 65, you may think the heaviest thing you should lift is the remote. Not true! You do lose bone mass and flexibility with age, but regular strength training and exercise can help keep you healthy. It will help keep your muscles from shrinking, and help you avoid falls and other accidents.

3. There's Still Time to Quit Smoking

If you've been trying for years to kick the tobacco habit, don't give up now. You can still repair or reduce some of the damage from smoking if you quit now.

For example, studies show that people who stop smoking at 65 cut their heart disease and lung cancer risks.

4. Don't Forget Key Screening Tests

Make sure to get your bone density screening test done when you turn 65, or sooner if you're at high risk for the bone-weakening conditions osteopenia and osteoporosis.

Many experts suggest you get a mammogram every 1 to 2 years to check for breast cancer when you're 50 to 74. Check with your doctor about what you should do if you're older than 74.

You may be due for another colonoscopy. It's a procedure that can find small growths called polyps that have the potential to turn into colon cancer. You should get the test every 10 years, or sooner if your doctor finds polyps.

To check for cervical cancer, ask your doctor if you need regular pelvic exams with Pap and HPV tests, and how often.

5. Immunizations

It's important to get a flu shot every year. Don't forget about other key vaccines, like the pneumonia shot, which you should get at 65.

Also get a shingles vaccine. Even if you've had the painful condition before, it may help prevent another bout, or if you do get shingles, it will be milder.

7- Testosterone and Estrogen Levels in Women

Normal Testosterone and Estrogen Levels in Women

It may surprise you to know that men don't have a monopoly on testosterone. Testosteronebelongs to a class of male hormones called androgens. But women also have testosterone.

The ovaries produce both testosterone and estrogen. Relatively small quantities of testosterone are released into your bloodstream by the ovaries and adrenal glands. In addition to being produced by the ovaries, estrogen is also produced by the body's fat tissue. These sexhormones are involved in the growth, maintenance, and repair of reproductive tissues. But that's not all. They also influence other body tissues and bone mass.

What are hormones?

A hormone is a chemical substance. It's secreted by one tissue and travels by way of body fluids to affect another tissue in your body. In essence, hormones are "chemical messengers." Many hormones, especially those affecting growth and behavior, are significant to both men and women.

The amount and levels of hormones change daily. The sex hormones, estrogen and testosterone, are secreted in short bursts -- pulses -- which vary from hour to hour and even minute to minute. Hormone release varies between night and day and from one stage of the menstrual cycle to another.

What is estrogen?

Estrogen is an entire class of related hormones that includes estriol, estradiol, and estrone.

Estriol is made from the placenta. It’s produced during pregnancy.

Estradiol is the primary sex hormone of childbearing women. It is formed from developing ovarian follicles. Estradiol is responsible for female characteristics and sexual functioning. Also, estradiol is important to women's bone health. Estradiol contributes to most gynecologic problems, including endometriosis and fibroids and even female cancers.

Estrone is widespread throughout the body. It is the main estrogen present after menopause.

Why do estrogen levels fall?

There are many reasons why estrogen levels fall, including:

• Hypogonadism
• Hypopituitarism
• Pregnancy failure (estriol)
• Perimenopause and menopause (estradiol)
• Polycystic ovarian syndrome (PCOS)
• Anorexia nervosa (eating disorder)
• Extreme exercise or training

Drugs that block estrogen include clomiphene, which  tricks the body into thinking it has decreased levels of estrogen. Also, women experience low levels of estrogen immediately after childbirth and also during breastfeeding.

Why are athletes at risk for low levels of estrogen?

Women with low body fat often do not produce sufficient amounts of sex hormones. This can be a problem for women such as athletes, models, and gymnasts. It can also be a problem for women with eating disorders. These women can experience a cessation of menstruation, known as amenorrhea. They may also develop osteoporosis -- thin bones -- and fractures as well as other conditions more common in older women after menopause.

Do estrogen levels fall at menopause?

Yes. Estrogen levels fall at menopause. This is a natural transition for all women between ages 40 and 55. The decline in estrogen can happen abruptly in younger women whose ovaries are removed, resulting in so-called surgical menopause.

Perimenopause is the period of transition before menopause. The first natural decline in estrogen levels starts during this phase. Other physiological changes also start. Women going through perimenopause may experience weight gain along with other menopause symptoms. For instance, there may be irregular menstrual periods, hot flashes, and vaginal dryness.

On average, menopause occurs at age 51. When it does, a woman's body produces less estrogen and progesterone. The drop of estrogen levels at menopause can cause uncomfortable symptoms, including:

• Hot flashes
• Night sweats
• Vaginal dryness or itching
• Loss of libido or sex drive

Some women experience moodiness. That may or may not be related to the loss of estrogen. Lower levels of estrogen may also increase a woman's risk for heart disease, stroke, osteoporosis and fractures.

Why do estrogen levels rise?

During puberty, it's normal for levels of estrogen to rise. That’s because this hormone fuels changes in a young girl's body. For example, it plays a role in the development of breasts, a more mature curved figure, fuller hips, and pubic and underarm hair.

In addition, high levels of estrogen are seen in women who are extremely overweight. Estrogen levels rise during a healthy pregnancy, and increased estrogen levels may be seen with tumors of the ovaries, testes, or adrenal glands.

Some drugs, such as steroid medications, ampicillin, estrogen-containing drugs, phenothiazines, and tetracyclines can increase estrogen levels.

What happens when testosterone levels rise or fall?

If your body produces too much testosterone, you may have irregular or absent menstrual periods. You may also have more body hair than the average woman. Some women with high testosterone levels develop frontal balding. Other possible effects include acne, an enlarged clitoris, increased muscle mass, and deepening of voice.

High levels of testosterone can also lead to infertility and are commonly seen in polycystic ovarian syndrome (PCOS). PCOS is an endocrine condition that is sometimes seen in women of childbearing age who have difficulty getting pregnant. Women with PCOS have symptoms similar to those produced by high testosterone levels. They include:

• Obesity
• An apple-shaped body
• Excessive or thinning hair
• Acne
• Menstrual irregularity

PCOS is associated with:

• Higher levels of circulating male hormones
• Insulin resistance
• Carbohydrate intolerance -- conditions that make you prone to gaining weight
• Low levels of HDL -- ''good'' -- cholesterol
• Elevated triglycerides
• High LDL -- ''bad'' -- cholesterol
• Obesity
• High blood pressure

As women with PCOS age, the presence of these risk factors increases their risk for heart disease.

At menopause, women experience a decline in testosterone. That decline may be correlated to a reduced libido. Some findings indicate that testosterone replacement therapy may benefit sexual function in certain perimenopausal and postmenopausal women. Testosterone replacementis unadvised in women with breast or uterine cancer. It also may increase the chances of cardiovascular disease or liver disease. So, experts are cautious about recommendations.

How do I know if my hormone levels are too high or too low?

Your doctor can do a physical examination and assess your health situation and symptoms to determine if further laboratory tests are needed to check hormone levels. Those tests may be important if you have a health condition such as PCOS or have stopped menstruating because of excessive athletic training or anorexia nervosa. If the tests show abnormal levels of hormones, your doctor can prescribe effective treatment.

8- Estrogen Test

What Is an Estrogen Test?

Doctors may use estrogen tests to help check on concerns with puberty, fertility, menopause, and other conditions.

You may know estrogen as the hormone that plays a key role in many aspects of a woman’s health, such as bone and reproductive health. But did you know there are several forms of estrogen?

If your doctor needs to check to see if you might have a condition caused by too much or too little of a particular estrogen type, she may recommend that you take an estrogen test. It’s a simple blood test, and it can measure up to three types of this estrogen.

Who Gets This Test?

An estrogen test measures any of three forms of the hormone:

• Estrone (E1)
• Estradiol (E2)
• Estriol (E3)

A test for one type may be called an “estrone test” or an “E1 test,” for example. The screening may also be referred to as an “estrogenic hormones” test.

Doctors may recommend testing of estradiol or estrone for symptoms such as:

• Vaginal bleeding after menopause
• Problems with menstrual cycles
• Infertility
• Menopausal symptoms such as hot flashes, night sweats and irregular menstrual periods

If you take hormone therapy to treat symptoms of menopause, your doctor may give you an E1 or E2 test to see how well treatment is going.

Girls whose sex organs develop earlier or later than normal may also get tested for E1 and E2 levels.

Doctors usually test E3 during pregnancy, when it temporarily becomes the main estrogen. Abnormal levels of estriol may be a sign of problems with the baby’s health -- but you’d get a lot more tests to find out for sure.

You might need several tests to track changes in your estrogen levels over time.

Testing in Men

Men also have estrogen, although their levels are usually lower than they are in women. Estrogen levels that are too low or too high in men can lead to health problems.

A man might have an estrogen test to:

• Check on whether puberty is delayed
• Diagnose enlarged male breasts, a condition with doctors call gynecomastia
• Find if high estrogen levels are due to low levels of testosterone or androgen --two key hormones in men
• Find tumors that make estrogen

Preparing for the Test

You don’t need to do anything special to prepare for an estrogen test. You don’t need to stop eating or drinking anything before it as you do with some types of blood tests. But before the test, you should tell your doctor about all the medications and supplements you take. It’s especially important to tell your doctor if you take birth control pills or hormone therapy, which may affect the test results.

During the test, your doctor or another health care professional will take a little blood from a vein in your arm. A lab will then test that blood sample.

What the Results Mean

Estrogen levels that are considered normal or healthy depend on your age and your gender. For women, pregnancy will also have a big effect on your estrogen levels. Where you are in your menstrual cycle could also affect the results.

High or low levels of a specific form of estrogen aren’t enough to diagnosis of your condition. The test results can help, though, to find the cause of your symptoms.

High levels of E1 or E2 could mean early puberty in girls or tumors in the ovaries in girls and women. For boys and men, increased E1 and E2 levels could signal delayed puberty, tumors in the testicles, and may be the cause of gynecomastia.

For both men and women, high E1 and E2 levels could mean:

• Hyperthyroidism
• Cirrhosis (liver damage)
• Tumors in the adrenal glands

For pregnant women, high E3 levels could mean labor will occur soon.

Low estrogen levels in women are signs of several conditions, including:

• Low levels of pituitary hormones
• Poorly functioning ovaries
• Failing pregnancy (when estriol levels drop)
• Eating disorder
• Turner syndrome (inherited condition caused by an abnormal or missing X chromosome)

Low estradiol levels also happen, naturally, after menopause.

Other Tests

Depending on your estrogen test results and your symptoms, your doctor may recommend other tests to help pinpoint a diagnosis.

One common test checks for levels of follicle-stimulating hormone (FSH). FSH manages the menstrual cycle in women and stimulates egg production in the ovaries. In men, FSH prompts the production of sperm. If infertility is a concern, a test of FSH and luteinizing hormone (LH) are appropriate for men and women. The same is true if early puberty is suspected in boys or girls.

Talk With Your Doctor

If you have questions about your hormone levels or any health issue, ask your doctor. It helps when you’re as detailed as possible in describing your symptoms. The more information your health care provider has, the better.