Health Screening Guidelines For Women

with Patricia Dolhun, M.D., Gynecologist, Columbia St. Mary’s

Posted: Oct. 1, 2005

Regular health screenings can help women and their physicians identify many problems early, when treatment may be most successful. That’s just good common sense, said Patricia Dolhun, M.D., a gynecologist with Columbia St. Mary’s Hospital and Madison Medical Affiliates.

When is a good time to begin these physical exams? “Young women who have no identifiable gynecologic problems, such as abnormal bleeding or pelvic pain, should start their screenings at age 21,” she said. “But there’s an exception to this rule: Young women who become sexually active before age 21 should be screened once they become sexually active.”

Patricia Dolhun, M.D., Gynecologist, Columbia St. Mary’s "Health screenings also include tests for sexually transmitted diseases if appropriate, cholesterol, thyroid, immunizations and health habits."

During the screenings, gynecologists will do a physical examination and obtain a Pap smear.

During a pelvic exam, the gynecologist examines the pelvic area, internally and externally, for anything abnormal. The Pap smear test is a simple, quick procedure that involves a small swab gently scraping the cervix to obtain cells for the Pap evaluation. The cells are prepared and sent to a laboratory where they will be inspected for signs of pre-cancerous changes or viral infection.

Important tests
“Health screenings also include tests for sexually transmitted diseases if appropriate, cholesterol, thyroid, immunizations and health habits,” she said.

Testing for blood cholesterol determines high blood cholesterol levels, which can lead to heart disease. A fasting lipoprotein profile is the most accurate type of cholesterol screening; it measures both good and bad cholesterol and triglyceride levels.

Testing blood sugar levels evaluates the possibility of diabetes and should be checked starting at age 40, or sooner in the woman with risk factors.
Colorectal screening and bone density testing are offered for women at mid-life and beyond.

“We’ll also evaluate height, weight and calculate a woman’s body mass index,” Dr. Dolhun said. “At the screening, we take the opportunity to discuss the importance of preventing sexually transmitted diseases (STDs) and provide pregnancy counseling and/or pregnancy prevention information — ranging from abstinence through contraception.”

Most women by age 18 will have had a full host of immunizations if they’ve been under a pediatrician’s care, she said. “But we also want to make sure they have been immunized with the rubella and hepatitis B vaccines. These have implications for their child-bearing years.

“For women between ages 20 to 40, we again caution against high risk behavior and screen for STDs. We also encourage women to include folic acid, calcium and vitamin D in their diets. Folic acid is recommended for anyone contemplating a pregnancy. It helps the neurologic and cardiac functions of the developing infant. Later on in a woman’s life, we also encourage them to take folic acid in conjunction with vitamin B because these are heart healthy for the women themselves.”

Breast cancer
Dr. Dolhun encourages women to do monthly breast self-examinations. “Examining the breasts monthly allows her to be aware of what feels normal and what doesn't,” she said. Any unusual breast symptoms or change in breast tissue such as swelling, dimpling, nipple discharge, persistent pain, redness, unusual masses or any other variation in how the breasts look and feel should be reported immediately to a health care professional.

A mammogram and breast exam by a trained health care professional are the most reliable methods for finding breast cancer in its earliest, most treatable stages, according to Dr. Dolhun. Beginning at age 40, women should have a mammogram every one to two years, and yearly after age 50.

A mammogram produces images of the inner breast tissue (of each breast) on film, using a very low dose of radiation produced by a machine specifically designed for mammograms. Mammograms can help identify cysts, calcifications and tumors within the breast. It is currently the most effective way to detect early breast cancer.

Mental health
Mental health screening is also important for women, she said. “Women can be experiencing stress, anxiety, depression or drug abuse issues, so when we talk to our patients we want to know about these areas of their lives. We want to make sure they’re safe in their homes, so we ask about domestic violence.”

Regular health screenings for women will guide them towards better health and make fulfilling, happier lives.

Patricia Dolhun, M.D.
788 N. Jefferson St. #300
Milwaukee, WI 53202
414-272-8950

We Have Answers Do you have medical questions or need help finding a doctor? The experts at Columbia St. Mary's and Advanced Healthcare can help. Click here.