Throughout history, no figure has been described, drawn, painted or chiseled more than the woman’s body. Poets fill pages with descriptions of voluptuous curves, painters spend lifetimes drawing female nudes. Even her saunter and the arch of her brow inspires. With such magnificence in design must inevitably come complication and mystery; particularly when it comes to women’s health. The tangled web of guidelines, recommendations, screenings and warnings is nearly too much to unravel, leaving women with the proverbial “one more thing to do”. The same delicate masterpieces must decode the myriad health recommendations between unknotting children’s triple tied tennis shoes, attending to work demands and organizing a pile of mail that never seems to make it past the corner of the kitchen counter.
Tempting as it may be, ignoring health recommendations cannot be an option. Women’s bodies are intricate and diseases creep in while life is happening. The statistics are everywhere: one in eight women will battle breast cancer in her lifetime. Heart disease is her number one killer. Autoimmune diseases such as MS (multiple sclerosis), Sjoren’s syndrome and lupus are 75 percent higher in women than men. Osteoporosis is on the rise. Rheumatoid arthritis, gallstones, irritable bowel, urinary tract infections, kidney disease and high blood pressure also rank high among women’s enemies. With such formidable foes, women must arm themselves with education and prevention, beginning with the annual healthcare visit.
The Annual Visit
Caitlyn Rerucha, a second-year family practice medical resident at Womack Army Medical Center knows the uncertainty in women’s health recommendations well. “We are in a time of great change in women’s healthcare,” she said. With a wealth of new data to give deeper insight into the pathology of diseases and the passing of the Affordable Care Act, prevention has become the key driver in a woman’s medical care. Research results are also causing professional organizations — such as ACOG (American Congress of Obstetrics and Gynecology) and AAFP (American Academy of Family Practice) — to streamline their guidelines.
Historically, a woman’s “annual” was synonymous with “annual Pap smear.” New research, however, shows the necessity of a pap test to be every two to five years, based on age and risk factors. “HPV is extremely common. Eighty percent of sexually active adults are exposed by age 50, and men are mostly asymptomatic,” explained Dr. Rerucha. “HPV causes cervical cancer but grows at an incredibly slow rate. Even if a woman has been exposed to HPV, if she tests negative on her first pap test, the virus is not likely to manifest for up to 10 years later.”
The freedom from an annual pap does not extend to freedom from the annual visit, though. In fact, because women’s healthcare is in such flux, keeping an annual appointment with your primary care physician is more important than ever. Your physician will run a number of screenings to establish your risk for developing an array of preventable diseases, primarily those stemming from high blood pressure and obesity. In addition, an annual check-up with the same physician (as much as possible) allows a relationship of trust and security to grow, which equates to more time spent discussing your concerns and less on family history.
One common hurdle in a woman’s annual healthcare visit is where to go. For years, the trend has been to schedule the annual with an OB-GYN. Dr. Rerucha explained that this trend is shifting. “An OB-GYN isn’t going to do a complete health exam,” explains Dr. Rerucha, “they are only concerned with obstetric and gynecologic issues. Women need to see a primary care physician every year —either a family practice doctor, who will cover all her preventative care needs to include the pap, or an internal medicine doctor who will cover all preventative medical care but the pap. Then she can see an OB-GYN on those years she is scheduled for a pap test.”
Preparing for Your Annual Visit:
To make the most of your annual check-up, spend a few minutes preparing. The following are some guidelines offered by ACOG: When making your appointment, be clear as to the reason for your visit. If you need any special considerations, state them at this time. Also, if you have any new health concerns you wish to discuss, mention them while you are making the appointment.
Before your visit, write a list of questions and concerns you may have. Write down any symptoms, along with any physical signs you can show your doctor. List all medicines, prescription and over-the-counter, that you currently take and why you take them. Include all vitamins and herbal supplements.
For your first visit, be prepared to provide your health history, both personal and family. Include all illnesses, hospitalizations, surgical procedures, lifestyle habits, allergies and any family history of illness and disease.
If you are visiting this doctor for the first time, bring all medical records you have with you. Bring past physicians’ phone numbers and addresses. If you have insurance, bring your card.
During your visit, ask questions if you don’t understand the terminology your doctor is using. Never be afraid to speak up.
If your visit includes a pelvic exam, be honest with any concerns or worries you may have. Your healthcare provider is responsible for making your visit as comfortable as possible. If you are given a diagnosis that requires further care, understand your treatment options and the consequences of each. Ask questions until you understand every aspect of your condition and various treatment plans. Arm yourself with information. Ask your physician for a list of resources.
At the end of your visit, repeat the details of your visit back to your physician. This offers him or her the opportunity to correct any misunderstandings.
An Ounce of Prevention
As mentioned earlier, prevention is a driving force behind the current women’s healthcare screenings and recommendations, but prevention begins at a personal level. “We know what we need to do,” says Michelle Benedict, an exercise physiologist, Level II Crossfit coach and nutritionist, mom and military wife. “But we are pulled in so many different directions and it becomes easy to make excuses for not caring for ourselves.” Benedict also blames the previous generations’ obsession with unhealthy images of the female body, driving women to focus more on “looking” a certain way rather than disease prevention and building a strong body for living well, with all its demands.
Fortunately, Benedict recognizes the trend shifting. “Strong is the new skinny,” she says. Every day she sees women empowering themselves by setting healthy goals — running their first 5K or lifting more than the barbell over their heads — rather than focusing only on the scale. Twenty-first century women are recognizing the rewards of a healthy, strong body.
Healthy living for every woman should include: A diet rich in whole foods: fresh fruits, colorful vegetables, lean cuts of meat, omega-3 fatty acids and whole grains. Shop the perimeter of the grocery store, avoid processed foods and pay careful attention to the amount of starch in your diet. Starch is in all fruits, vegetables and grains in varying amounts. The typical American diet is overwhelmed with starch calories, which, unless you are an endurance athlete, are often stored as body fat.
An active lifestyle: Find something you love and nurture it. From gardening to Zumba to CrossFit to endurance sports, the options for women today are endless and in most every circle of activity, women can find strong support in meeting and exceeding their fitness goals. Regular exercise is also strongly linked to having a positive self-image, increased emotional health and a decrease in the symptoms of depression. Every time you exercise, your body releases endorphins (the feel-good hormone), making exercise its own natural high.
Do weight-bearing exercise at least two days a week. Weight training and other weight bearing exercises are proven bone density builders. Weight training can also raise metabolism (aka: calorie burning function) through an increase in muscle mass (the larger the muscle the more metabolic power needed to maintain it) and improve balance and coordination. Weight training does not have to mean weight lifting, though. You can get many of the same benefits by using your own body weight for resistance during exercises like push-ups and air squats.
Women’s bodies are indeed remarkable — inside and out. As women regard themselves with the thoughtful care and awe poets and painters have practiced for centuries, they will empower themselves in every aspect of their health care journey.