Healthy Lifestyles: Health Self-evaluation Tools for Women

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The number of tests, exams, and evaluations necessary for a woman to maintain proper health can be overwhelming. In addition to issues specific to women such as breast, vaginal and ovarian health, women also need to be aware of concerns such as heart disease, as women may have nearly double the risk of dying from heart disease compared to men. (5) For this reason and many others, it is important for women to take control of their health and take all the steps necessary to ensure a healthy life.

We want to help you determine how healthy you are now, as well as discover areas for improvement. Of course, none of these Self-evaluation Tools for Women replace the need to consult a physician. But when it’s time for your next appointment, these tools can help put you in the best position to ask critical questions in a discussion with a healthcare provider. Clicking on any of the following topics takes you right to the information you want.

Take a look at yourself

Osteoporosis: signs, symptoms, and steps to take

Heart disease: signs, symptoms, and steps to take

Mood disorders: signs, symptoms, and steps to take

Body shape: the importance of being who you are

Diet: understanding the food pyramid, caloric intake, and body mass index

Breast self-exam: the importance of being proactive

Have a doctor take a look

Osteoporosis: DEXA scan

Heart disease: cholesterol screening

Cervical Cancer: Pap smear

Breast Cancer: mammogram

Colon Cancer: colonoscopy

Annual physical examination

Osteoporosis

It is estimated that 80% of Americans with osteoporosis are women.(4) By the age of 30, the average woman will have reached her peak bone mass.(2) After this point, bone deterioration can outpace formation. As many as 78% of American women do not get the recommended daily dose of calcium needed to maintain strong, healthy bones.(2) Perhaps it’s because they’re not including enough milk, yogurt, cheese, or supplements in their diets. Also, calcium can’t provide benefits by ingestion alone; it needs to be absorbed by the bone. Vitamin D is vital for calcium absorption and for improving muscle strength; it may even reduce an older person’s risk of falling by 22%. (11)

In addition to sex and age, there are some other factors that increase the risk of osteoporosis:(28)
Race: being White or Southeast Asian
Family history: having a parent or sibling with osteoporosis
Frame size: having a small body frame
Tobacco use: researchers believe it contributes to weak bones

Click here for still more risk factors as identified by the Mayo Clinic

Take steps to protect against osteoporosis

Heart disease

In 1 year, coronary heart disease was responsible for over 262,000 female deaths.(5) The American Heart Association recommends a daily dose of about 500 mg of DHA/EPA for people with no known coronary disease, and 1,000 mg for patients with known coronary disease.(9) The average American woman, however, consumes an average of only 90 mg of DHA/EPA per day.(8) Clearly, there is a national gap between what the female body needs and what it’s getting.

In addition to sex, there are some other factors that increase the risk of heart disease:(28)
Race: being African American, Mexican American, American Indian, or native Hawaiian
Family history: having siblings, parents, or grandparents with heart disease
Age: being older than 65; rising rates of obesity may lower this age in the future Tobacco use: exposure to cigarette smoke acts with other factors to greatly increase the risk by damaging blood vessels
Obesity: straining the heart with excess weight

Are you at risk? Click here for additional factors as identified by the Mayo Clinic

Take steps to protect against heart disease

Mood disorders

Depression is the leading cause of disability in women worldwide.(10) Studies have shown that the state of a person’s mind is an essential element to her health and well-being. Negative thoughts can cause you to stumble on the path toward reaching goals, but switching the brain to positive thoughts produces benefits like endorphins (which create a natural “high”), gamma globulin (fortifies the immune system), and interferon (combats infections and viruses).(33) Calcium has also been shown to have a beneficial effect on mood.(16) Omega-3 fatty acids have been found to protect against mood fluctuations.(15) Additionally, low folate levels have been found in depressed patients, and adding folic acid has been shown to improve responses to anti-depressant therapy.(58) If you think that you might suffer from moodiness or depression, your first step toward taking control is to find out more about these disorders. Explore the following resources and contact a physician for further diagnosis.

Take a self-evaluation for depression from the Harvard Medical School

Take steps to protect against mood fluctuations

Body shape

Waist circumference is a strong predictor of increased risk for heart disease. (34) And in this regard, some women are apples, some are pears. All of us notice our weight and need to keep it at a healthy level to protect ourselves from arthritis, cardiovascular disease, diabetes, and other conditions. But losing weight is more important for women shaped like apples than for those shaped like pears. Apples are naturally prone to heart disease, which is especially true if they are carrying extra weight around the middle.(34) However, heart disease is the leading cause of death in the United States, and it is fatal to far more women than breast cancer.(35) All overweight women share this heightened risk for cardiovascular disease (and for diabetes, too) and need to take steps to reduce the possibility of illness.

Diet

According to the President’s Council on Physical Fitness and Sports (LINK TO www.fitness.gov/resources_factsheet.htm), the percentage of adults in the US who were overweight (body mass index >25) in 1999−2002 was 65%. Obesity cuts across all ages, genders, racial and ethnic groups, and can cut years off your life. Here are some steps you can take toward a healthier you:(36)
Build your own food pyramid plan: Embrace the new food pyramid and get help choosing the foods and amounts that are right for you. Visit mypyramid.gov for more information.

Of course, one of the guiding principles of this plan is to make smart choices about what we consume (meals should be consistent in amount and should not include a lot of fried foods, processed foods, or sweetened beverages). (37)

Know your caloric intake: The FDA has determined a 2,000-calorie-a-day diet to be healthy for adults and teenage girls. Many sedentary women, older adults, and children need fewer than 2,000 calories a day and may want to select target levels based on 1,600 calories a day. Some very active women, active men, and teenage boys may want to select target levels based on 2,800 calories per day.(38) So, read labels on canned goods and bottles; peruse the packaging on chips and snacks; examine the wrappers on fast food and candy. By knowing what you’re putting into your body, you’ll have a better expectation of what you can get out of it. By the way, some women find a food journal to be helpful because if it isn’t written down, we might fool ourselves into believing it didn’t count! Use our Personal Health Worksheet to help keep things straight.

Use the interactive daily caloric intake calculator

Check out some dietary guidelines from the American Heart Association

Get a better understanding of food labels

Understand your body mass index (BMI): How does your body weight compare to your height? How do you compare to others in terms of your health? Your BMI can identify if you have excessive body fat—a major risk factor in your health.

Use an interactive BMI calculator

Learn more about how to lose and manage weight

Have a doctor take a look

Breast self-exam (BSE)

According to the Susan G. Komen Breast Cancer Foundation, an estimated 212,920 new cases of breast cancer will be diagnosed in American women in 2006 alone. Regular BSEs are a simple preventative step and should be undertaken on a monthly basis after the age of 20.(39) The Mayo Clinic recommends that if you find a tiny lump or other change in your breast and haven’t yet gone through menopause, you may want to wait one menstrual cycle before seeing your doctor.(28) You can always call your healthcare provider and ask if waiting is necessary. If the change persists, have it evaluated promptly. Early detection makes treatment easier and more effective.

For information on risk factors, diagnosis, treatment options, and more, view Anatomy of Breast Cancer

Mammogram

A mammogram involves a series of X-rays with the purpose of imaging the breast tissue. Currently, it is the best imaging technique for detecting tumors before they can be felt. Women over 40 should get a mammogram every 1 to 2 years. This guideline was just re-issued by the federal government’s US Preventive Services Task Force. And, it is also the position of the Secretary of the US Department of Health and Human Services. (40) Check with your doctor to determine when you should have this test.

DEXA Scan

DEXA or DXA stands for “dual-energy X-ray absorptiometry,” which is the preferred technology to measure bone strength, also known as bone density. Having a DEXA scan is safe and painless. It’s much like having an X-ray taken but uses less radiation. Most frequently the hip and spine are tested as these are the bones that most frequently break in people who have osteoporosis.(23)

In a DEXA scan, an open machine takes pictures of your bones and calculates their density. Bone density is used to determine low bone mass and fracture (broken bone) risk and to indicate osteoporosis. DEXA detects low levels of bone loss better than a basic X-ray.(23)

The National Osteoporosis Foundation (NOF) advises bone density testing for all women under age 65 who have one or more risk factors for osteoporosis in addition to menopause. And the NOF recommends all women over age 65 have their bone density tested. Medicare covers DEXA scans in many cases.(24)

For more information on DEXA scans, visit the National Osteoporosis Foundation’s website.

Check with your doctor to determine when you should have this test.

Pap smear

A Pap smear or Pap test, along with a pelvic exam, should be a part of your routine healthcare if you are 21 or older (or under 21 and sexually active for 3 years or more). This exam checks for changes in the cells of your cervix. It can detect infections, abnormal cervical cells, and cervical cancer. In 2004, 3,500 women died from cervical cancer in the United States. If caught early, the chance of beating cervical cancer is very high.(41)

The American College of Obstetricians and Gynecologists recommends a Pap test:

- every year if younger than 30
- every 2−3 years if over 30 and have had 3 normal tests for 3 years in a row
- not at all if 65−70 and have had at least 3 normal tests and no abnormal tests in past 10 years
- every year no matter how old you are if you are HIV-positive or have a weakened immune system

Check with your doctor to determine when you should have this test.

Colonoscopy

According to the Colorectal Cancer Network, colorectal cancer (which includes cancers of the colon, rectum, anus, and appendix) is the second-leading cause of cancer-related deaths in the United States.(42) Only lung cancer claims more lives. The disease is highly curable—90% survive 5 years or longer—if diagnosed at an early stage. The National Women’s Health Resource Center points out that an important fact for older women to consider is that more women over the age of 75 die of colorectal cancer than of breast cancer.(43)

The American Cancer Society recommends colorectal screenings beginning at age 50 and more frequent or earlier screenings if you have other risk factors, such as a family history of the disease. A colonoscopy allows your doctor to view your entire colon and rectum. If any polyps are found during the exam, your doctor may remove them immediately or take tissue samples (biopsies) for analysis.(44) Check with your doctor to determine when you should have this test.

Learn more about colorectal cancer

Cholesterol screening

Cholesterol is a soft, waxy substance found among fat in the bloodstream and in the body’s cells. Too much cholesterol (due to both genetics and diet) in the blood is a major risk factor for coronary heart disease, which leads to heart attack. Coronary heart disease is diagnosed when fatty deposits on the arteries restrict or block blood flow to the heart, potentially leading to a heart attack. 37 million American adults have high blood cholesterol levels, and 105 million have cholesterol levels that are higher than desirable.(28)

Total cholesterol
Below 200 mg/dL	Desirable
200-239 mg/dL	Borderline high
240 mg/dL and above	High

It is recommended that everyone age 20 and older have a “lipoprotein profile” every 5 years.(45) This test is done after a 9- to 12-hour fast without food, liquids, or pills. It gives information about total cholesterol, LDL cholesterol (aka the “bad” cholesterol), HDL cholesterol (aka the “good” cholesterol), and triglycerides. If your total cholesterol is determined to be 200 mg/dL or more, or your HDL cholesterol is less than 40 mg/dL, you need to have a follow-up lipoprotein profile done to determine your LDL cholesterol and triglyceride levels. Check with your doctor to determine when you should have this test.

Annual physical exam

It’s a good idea to schedule an annual exam with your gynecologist once a year. This visit will include a breast exam and a Pap smear, but it also presents an opportunity to talk to your physician about new medications or supplements you may be taking; your diet, amount of exercise, mental well-being, and general health habits; as well as any serious medical events that have occurred within your immediate and extended family.