Health Screenings for 5 Common Disorders Get Tested and Take Action to Avoid Women’s Health Conditions

If you’ve been ignoring chest discomfort or a wicked case of the blues, National Women’s Health Week is a good time to see your doctor. Let Lifescript’s Medical Detective and top experts tell you how to get important health screenings and reduce your risk... Juggling job and family? Barely have time to eat properly each day, let alone squeeze in doctors’ appointments, health screenings, exercise and a mental-health check with your best friend? It’s time to hit the pause button. National Women’s Health Week – coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health and running May 13 to 19 – is your springboard to putting good health ahead of the daily rat race. That means lining up health screenings you may have neglected – mammogram and Pap smears, to name two – and making sure you’re handling stress in a healthful way. “Women have to be very careful,” says Marisa Weiss, M.D., director of breast radiation oncology at Lankenau Medical Center in Wynnewood, Penn., founder and president of Breastcancer.org and author of Living Beyond Breast Cancer (Three Rivers Press). “As the most important caretaker in your family, you can’t be the last person you take care of,” she says. “Remember, your daughters are watching, patterning their behavior from you!” Weiss adds. “If you neglect yourself, they’ll follow the same pattern.” Not to mention that you may miss early detection of serious health conditions, making treatment more challenging. Lifescript’s Medical Detective checked in with the nation’s leading women’s health experts to get their advice about 5 health conditions you must pay attention to. 1. Heart disease Based on all of the pink ribbons and fundraising walks, you’d think that breast cancer is the No. 1 killer of women. Think again. Heart disease tops that list, accounting for 25% of women’s deaths, according to the Centers for Disease Control and Prevention (CDC). And if you’re a woman under age 50, you’re twice as likely as a man to die from a heart attack. “Women often ignore the fact that they’re at risk for heart disease,” says Vera Rigolin, M.D., associate medical director of the Program for Women’s Cardiovascular Heath at Northwestern Memorial Hospital’s Bluhm Cardiovascular Institute in Evanston, Ill. Many women condiser heart disease a man’s problem, so common health conditions such as heart attacks and strokes are off their radar, Rigolin says. Moreover, because women with heart disease may exhibit different symptoms than men, the signs of heart disease are more likely to be overlooked. For example, two-thirds of deaths from heart attacks happen among women who’ve never had chest pain – the most commonly associated symptom, according to the nonprofit Women’s Heart Foundation. Here are important ways to reduce your risk: First, identify your risk factors, Rigolin says. You can’t change your family history or your gender and age, but you can correct modifiable risks – such as obesity, cholesterol levels, blood pressure, physical activity and smoking. Next, reduce your risk: Quit smoking, lose weight, manage high cholesterol and blood pressure, exercise and limit alcohol and stress. Know your body. “If you start to feel symptoms that aren’t typical, don’t ignore them,” she says. They include: tightness in your chest; nausea; discomfort in your back, arm or jaw; discomfort between your shoulder blades; and shortness of breath. Calcium supplements may increase your risk for heart disease, according to some studies. If you take them, “do it for a good reason, like lowering your risk of osteoporosis,” Rigolin says. Health screenings Get an electrocardiogram (EKG) – a test that checks your heart’s electrical activity – as part of your annual physical exam. 2. Skin cancer Women who sunbathe for hours take pride in their tans. But they may face something less glamorous later in life: skin cancer. It’s the most common form of cancer in the U.S., according to the nonprofit Skin Cancer Foundation (SCF). More new cases are diagnosed every year than breast, prostate, lung and colon cancers combined. Basal cell carcinoma, the most common form of skin cancer, rarely is fatal, according to the foundation. Squamous cell carcinoma is the second-most common form, with 700,000 cases diagnosed each year, resulting in 2,500 deaths. Melanoma is the deadliest, usually caused by exposure to ultraviolet rays from the sun or tanning beds. The survival rate is 99% if melanoma is caught before the tumor penetrates the skin, but falls to 15% if the disease is advanced. Until age 39, women are almost twice as likely as men to develop melanoma. Between 1980 and 2004, the yearly number of melanoma cases in young women rose 50% to 13.9 cases per 100,000, the foundation reports. One cause may be the growing popularity of tanning beds, experts say. The good news: Women tend to “fear health problems more than men and seek medical help sooner,” says Alex Khadavi, M.D., a dermatologist in Encino, Calif., and associate professor at University of Southern California’s Keck School of Medicine in Los Angeles. Early detection and treatment are key to surviving and recovering from skin cancer, he adds. Skin cancer primarily is a lifestyle disease, so it’s highly preventable. Try these prevention tips from the National Cancer Institute and Skin Cancer Foundation: Use a broad-spectrum (UVA/UVB) sunscreen with a sun-protection factor (SPF) of at least 15. Apply it 20-30 minutes before going outdoors. Reapply every two hours or right after swimming. Avoid staying in the sun for long periods, especially when it’s at its strongest at midday. Prevent sunburns. Steer clear of tanning booths. Wear long-sleeve shirts, long pants, sun hats and sunglasses outdoors. Health screenings “Everyone should have a yearly skin check, but if you have a history of pre-cancer or skin cancer, you should be examined by a dermatologist every 3-6 months,” Khadavi says. Do a monthly self-exam of your skin, from head to toe, to check for new or changing moles. Skin cancers found and removed early are almost always curable. Have any new or unusual moles checked promptly by your doctor. 3. Breast cancer After skin cancer, breast cancer is the most common cancer among American women, according to the American Cancer Society. In 2007, about 203,000 American women were diagnosed with breast cancer, and about 41,000 women died from it. It’s among the health conditions women most fear. “The good news is that we have advances in diagnosing and treating breast cancer,” Weiss says. And progress in genetic testing has provided “better tools to look for [genetic] needles in the haystack.” Health screenings Here are the exams you should get and when, according to Weiss: Mammogram: Get one annually, starting at age 40. Weiss recommends digital mammography, which is 15%-28% more effective than standard film mammograms in detecting tumors in women under 50, women with dense breast tissue and those beginning menopause, according to a UCLA study. Health insurance providers (private and government) are developing policies for covering this procedure, according to the Food and Drug Administration. Check with your insurer to see if you’re covered. Ultrasound: This painless procedure, in which high-frequency sound waves produce pictures of your breasts, is recommended for women with dense breast tissue. A dense breast has less fat in proportion to the glandular and connective tissue, and it is a risk factor for breast cancer. A mammogram can determine your breast density. Ultrasound can detect small breast cancers that mammograms don’t pick up. Have the screening once or twice yearly. Magnetic resonance imaging (MRI): Have an MRI once or twice annually, in addition to a mammogram, if you’re at high risk for breast cancer. Those risks include gene mutations (defects) inherited from a parent, such as BRCA 1 and BRCA 2; a strong family history of breast cancer; your having had breast cancer; or you had radiation treatments as a teenager. Molecular biological testing: Not readily available yet, these tests will help determine how quickly tumors are growing and whether the cells’ genetic material makes them resistant to chemotherapy. “It’s like an FBI report on the genes that turn on breast cancer growth and its ability to spread,” Weiss says. 4. Depression Everyone goes through blue periods, but some cases are more serious and need professional treatment. Depression – a mental health condition marked by difficulty sleeping and eating, lack of enthusiasm for work and simply not enjoying life – is on the rise, says Susan Nolen-Hoeksema, Ph.D., a psychology professor at Yale University and author of Women Who Think Too Much (Holt Paperbacks). Depression strikes women more frequently than men too. In 2008, 8.1% of U.S. women were depressed, compared with 4.6% of men, according to the National Institute of Mental Health. The gender gap is greatest between puberty and menopause. The health condition is caused by genetic, biological or psychological factors, and it runs in families. Female hormonal changes may be a culprit in the higher incidence of women’s depression, experts say. Other reasons: “Women feel like they have less control over their lives than ever before, and they soak up the emotions and stress of others,” Nolen-Hoeksema says. “This contagion of stress contributes to greater rates of depression.” Health screenings Initial screening for depression can be done by primary care physicians, who should ask these two questions, according to the U.S. Preventive Services Task Force: “Over the past two weeks, have you ever felt down, depressed or hopeless?” “Have you felt little interest or pleasure in doing things?” Patients who answer “yes” may undergo longer diagnostic procedures – by a primary care doctor or psychiatrist – such as those found in the Diagnostic and Statistical Manual of Mental Disorders. Depression can’t be prevented, but it can be treated. Here’s how: Meditation helps depressed people who focus on “racing negative thoughts,” Nolen-Hoeksema says. Instead of playing the same negative mental tape repeatedly in your head, meditation helps you focus on the present and “move into active problem-solving.” Medications: Newer antidepressants, such as selective serotonin reuptake inhibitors, or SSRIs (including brand names Prozac, Zoloft and Lexapro), often help. So do serotonin and norepinephrine reuptake inhibitors, or SNRIs (including brand names Effexor and Cymbalta). Older antidepressant medications, such as tricyclics and monoamine oxidase inhibitors (MAOIs), are prescribed occasionally. Nolen-Hoeksema also recommends short-term, intensive talk therapy in conjunction with medication. “Combined, they work very well,” she says. 5. Thyroid diseases The butterfly-shaped thyroid gland, which sits below the Adam’s apple in your neck, does some heavy lifting. It regulates your body temperature and metabolism, which determines how fast you burn calories. About 20 million Americans have some form of thyroid disease, and women are 5-8 times more likely than men to get them, according to the Cleveland Clinic in Ohio. It's unknown why, but it doesn’t appear to be a hormonal effect of estrogen, researchers say. Two common health conditions are associated with your thyroid: Hypothyroidism, which occurs when the gland produces too little hormone (you feel cold and tired). It’s often caused by an autoimmune disorder called Hashimoto’s disease. Hyperthyroidism, in which the thyroid produces too much hormone (heart rate increases, and you sweat and gain weight). It’s usually caused by an autoimmune disorder called Graves’ disease. Diagnosed cases of thyroid cancer are up about 6.5% in recent years, according to the National Cancer Institute, partly because advances in ultrasound technology have allowed doctors to detect smaller tumors. Although not life-threatening, hypothyroidism or hypothyroidism can affect your blood pressure and cholesterol levels, says endocrinologist Helen Baron, M.D., assistant professor of clinical medicine at University of Southern California’s Keck School of Medicine. Health screenings You can’t prevent thyroid disease, but the best way to slow its progress is to detect it through screening: The “gold standard” is a test for thyroid stimulating hormone (TSH), which you should have every couple of years, Baron says. The simple blood test measures the amount of thyroid hormones in your system. If you have a family history of thyroid problems, get a screening annually, or right away if you experience thyroid disease symptoms. A thyroid scan picks up iodine distribution in your body and is used to diagnose the cause of hyperthyroid disease. “Take inventory of your body,” Baron says. “It’s normal to have peaks and valleys in energy and well-being. If you’re stuck in a valley or peak, get checked by your doctor.” Thyroid diseases are lifelong, but treatable: Hypothyroidism is treated with a drug called levothyroxine, a synthetic hormone tablet. Hyperthyroidism usually is treated with drugs that block hormone production; radioactive iodine, which disables the gland; or surgery, which removes part or all of the gland, according to the Cleveland Clinic. For more information and expert advice, visit Lifescript's Women's Health Center. Women's Health: How Much Do You Know? As a woman, your health concerns are as unique as your body. How you take care of yourself has a huge impact on your future, affecting everything from your ability to have children to your risk of heart disease. There's no substitute for good health, and when it's gone, it's often gone for good. Don't let it pass you by.