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    Need for checkup????
    Anon_77197 posted:
    I am a very fortunate postmenopausal woman who has never needed treatment for any menopausal issues. I have not been sexually active since entering menopause many years ago.

    Do I need to continue having "well woman checkups" since I don't have any current issues or history of problems since menopause?
    rhondamay responded:
    Here is what the National Institutes of Health's Web site for patients and their families says about "well woman checkups":
    to2learn replied to rhondamay's response:
    Thank you Rhondamay for your response and weblink

    I consider myself very lucky that I've always listened to my body and mind when it comes my health,. Thus I can avoid alot of screenings since I never sexually abused my body and don't fall into alot of the categories mentioned in the link. The article is only for woman up to 64 which I have passed. I would just assume physicians wouldn't ask if your older than 65 anyway. Especially in the health war we live in today
    StellaLane replied to to2learn's response:
    I had my annual physical this week and make certain I receive all the tests. I have had cancer and do want to make certain if I have any problems, I catch it early. Also, we are checked for ovarian cancer that my doctor found on a lady that he found out that morning was stage 3. I want to receive all advanced notices possible and will not let a little discomfort bother me. I am over 70 years of age and the speculum (sp) was the smallest they have! My sexual activity also ended years ago but I will not rest on that laurel! We are not told to get check ups to make the doctors rich but to give ourselves the best health possible. My last test is my colonoscopy which I will have on October 29 which is my three year check as they found three polyps three years ago and were of the type that can turn cancerous. We must take charge of our own health. We are a part of our health team.
    Mary Jane Minkin, MD responded:
    Dear Anon_77197,
    This is the central question of many debates right now on health care. I personally do think a regular check up is helpful, but there are several points of view out there. I think a checkup on overall health is helpful (like making sure one is up to date on cholesterol and diabetes screens, for example) and is a good thing, and including women's health issues (like mammography) is important too.
    But as I tell everyone, stay tuned to the controversies,
    Mary Jane
    to2learn replied to StellaLane's response:
    StellaLane.. I appreciate your incite, to this healthcare issue for senior women.

    First I want to congratulate on your vigor to concur cancer in your own life. I am blessed so far to have not been faced with that health issue. My father died of undiagnosed colon cancer even after years of trying to talk to doctors who accepted Medicare. Talk about being thrown off the cliff!
    I wish you the best possible outcome when you have your colonoscopy on the October 29th. I guess I need a heavenly sign to think that the "system" does not discrimiate.
    Anon_77197 replied to Mary Jane Minkin, MD's response:
    Dr. Minkin I appreciate your professional advise in reference to "well women checkups".

    I have been told that it would be to my advantage to get a
    "senior checkup"????? Does that just include, weight, BP, CBC, urinalysis, DEXA scan( diagnosed osteoporosis) EKG and chest x-ray (asthma history)? This is what my checkups have consisted of in the past. No suggestion of any "well woman checkup". Appreciate your input so I can have a candid conversation if needed.
    Mary Jane Minkin, MD replied to Anon_77197's response:
    Dear Anon_77197,
    Looks like you are getting most everything covered. The only others I would suggest you look into are your lipid profile issues and blood sugar levels; frequency of testing there is based on individual risk factors, previous values, etc.-but it looks like you're on top of most things.
    We are all going to be seeing changes in frequency of many tests, based on good large surveys of what they turn up in particular populations (for example, EKG's believe it or not are not always necessary-that's one to keep an eye on).
    Good luck,
    Mary Jane
    to2learn replied to Mary Jane Minkin, MD's response:
    Dr Minkin:

    The physician (PCP) I consult does not recommend mammograms or women wellness checks under his "senior checkups" starting at age of 65 which I am now.

    I have read about the controversy about EKG's usefulness in diagnosing/ detecting heart disease. It will be interesting what I will be told is recommended at my age when I go next month. Having family history of stroke, heart disease, melanoma and colon cancer. It is a continual learning experience trying get the physician and staff to talk with me, not at me.
    Thank you
    Mary Jane Minkin, MD replied to to2learn's response:
    Dear to2learn,
    Maybe I'm confused here-does your PCP not recommend a mammogram at least every other year? I think that most physicians in the country would recommend that a 65 year old woman would do a mammogram every other year, if not every year (there there is some controversy)-most of us would recommend a mammogram at least every other year,
    Mary Jane
    to2learn replied to Mary Jane Minkin, MD's response:
    Dear Dr. Minkin:

    My last mammogram was 2010. I decided to have one after obstaining for 21 years due to developing severe breast pain that lasted more than 4 weeks. I'd had similar pain with a history of intruductal papaloma in years past after nursing for seven years. The only suggestion made to me by the PCP at the time was to take aspirin not get a mammogram.

    I'm wondering if the recommendations is not made because he knows I'm not very receptive or personally comfortable to those suggestions. So it is just a mute subject.
    Mary Jane Minkin, MD replied to to2learn's response:
    Dear 2learn,
    In general, I recommend a mammogram at least every couple of years. However, a few tricks to making them more comfortable: avoiding caffeine for several weeks in advance usually helps; and I usually suggest my favorite breast "cocktail": vitamin B6, 100-200 mg; vitamin E, 200-400 units, and evening primrose oil, 2 capsules; you can take them all together, and again, I would try these several weeks before the mammogram. If the mammogram is just too uncomfortable, despite these measures, I will suggest that my folks do an ultrasound; it doesn't replace the mammogram (there is info on a mammogram that you really cannot get from an ultrasound) but it does give you some information.
    Good luck,
    Mary Jane
    to2learn replied to Mary Jane Minkin, MD's response:
    Dear Dr. Minkin:

    I totally agree with your recommendations for women 65 mammograms and with the majority of physicians in our country. It will be interesting if the PCP suggests I obtain a mammogram in that the subject has never come up in past years.

    I so appreciate sharing your favorite breast"cocktail".
    I take multivitamins and many other OTC supplements but not specifically to ease breast tenderness. The suggestion you made in lieu of a mammogram brings up another question in reference to identifiying how dense are my breasts. I have read that knowing the density of ones breasts is a good idea. How do I obtain that information?

    I read that recommendations still exist for some women 65 to receive pap tests. Other reports stated if a woman has had at least 3 negative results than they can stop getting the test.
    Does that also include pelvic exams since the screening is done together?
    Thank you again
    Mary Jane Minkin, MD replied to to2learn's response:
    Dear Liz,
    You are raising many interesting points. As far as breast density, a mammogram will give you that information. However, it is not a straight forward issue. Breast density is subjective; even in my institution, I have had two faculty members in the radiology department read the same mammogram: one said dense, the other said not dense; this does happen-it is a subjective measurement. The recommendation regarding a "dense breast" mammogram by many radiologists is to do an ultrasound; however, ultrasound is also a very subjective test; and dependent on the skills of the ultrasonographer. There is really very little data showing that dense breast ultrasound followup saves lives; it does pick up a relatively few more cancers; however, it also leads to a significant number of breast biopsies, to answer questions raised by the ultrasound. So it is a topic still under discussion by radiologists themselves.
    Also still under discussion is the Pap smear/exam question. I still believe an annual visit is a good idea, even if a pap smear isn't done; women can discuss lots of things going on that they might not bring up with a health care provider. I still think an annual exam is a good thing, too-but there is considerable discussion in the literature about how many abnormalities one finds doing routine exams.
    Also certain folks do need Pap smear followup, even beyond the age of 65. For women who have had uterine or cervical cancer, they still need Pap smears. So if you are considering stopping doing Paps, do check in with your health care provider if you are in a category where you still require them.
    Good luck, and thanks for raising good questions,
    Mary Jane
    Jerseygirl832 replied to Mary Jane Minkin, MD's response:
    Dear Dr. Minkin,

    I started menopause at 39 years old and was told by my GYN that the longer you are in menopause the less dense your breast become. My breast are getting denser every year and I don't understand why. My Mom and Sister are both breast cancer survivors and I worry every year when I go for my Mammogram because I am just not sure they are seeing everything. I end up getting an ultrasound every year as they quite frankly just can't see through the density. I have been told by the Radiologist that it wouldn't be a bad idea for me to have breast MRI's. I have had 3 biopsies on my breast and all showed cysts. What are your thoughts on my situation. Thank you for being available for us women.

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