A Woman's Annual Physical

Taking care of yourself... Working with your doctor

When it comes to their own medical care, women – especially women under forty – are shortchanging themselves. A doctor should not just be someone you call to get a prescription or to deliver a baby. A doctor should be an integral part of your life. Your doctor should be someone who knows you as a person, not just a sick person.

Every women over eighteen who values here health should have an annual physical exam performed by a competent internist or primary-care physician. It will enable you to develop a relationship with your doctor. If your doctor is familiar with your family medical history, your lifestyle, and your overall health, she will be in a better position to detect small problems before they blossom into big ones. And, if you have a good rapport with your doctor, you will be more likely to pick up the phone and let her know if you’re experiencing any unusual symptoms. If more women felt comfortable with their doctors, there may be fewer women ignoring important symptoms such as chest pain, and there may be fewer cases of unreported heart attacks among women. Getting to know your doctor is well worth the investment. One day, it might save your life.

What to expect from your doctor

Before you arrive for your appointment, your doctor should review your file so that she is familiar with your case. It’s reasonable to expect your doctor to know who you are, what problems she has treated you for in the past, and what medication you are taking. If your doctor makes no attempt to get to know you, perhaps you should make it your business to get to know another doctor.

It is within your right to expect your doctor to return your phone calls as quickly as she can. It is also reasonable to expect your doctor to be there for you during a crisis. It is inexcusable to send a patient to the hospital and not be there for her, unless you are tied up in another emergency.

What every woman needs to know and when she needs to know it

AGES TWO TO SEVENTEEN

Every girl should have an annual physical examination by her pediatrician that includes the following:

• Her growth patterns should be monitored.
• Her blood pressure should be measured.
• A CBC (complete blood count) should be performed.
• If a sibling, parent, or grandparent has a cholesterol level in the ninety-fifth percentile, the child should have a lipid profile. If her total cholesterol is less than 150 and her HDL is higher than 40, the test need not be repeated for five years.
• If she is sexually active, she should have a Pap test.

AGES EIGHTEEN TO TWENTY-NINE

• By age eighteen, every woman should have an annual physical with an internist.
• A Pap test and a complete pelvic exam should be done during her annual physical.
• By age twenty, every woman should have at the least a screening test to determine total blood cholesterol. If the level is more than 240 mg/dl, she should have a complete blood lipid profile to determine HDL-LDL breakdown and triglycerides.
• If a woman takes oral contraceptives, she should have a lipid profile done annually.

AGES THIRTY TO THIRTY-NINE

• As part of her annual physical, by age thirty every woman should have a complete blood lipid profile. If it is within normal range, it need not be repeated for five years. However, if she has any risk factors for CAD (family history, obesity, smoking, etc.) it should be redone every two years. If a woman takes oral contraceptives, the lipid profile should be done annually.
• A Pap test and pelvic exam should be done annually.
• Between ages thirty-five and thirty-nine she should have a baseline mammogram. If the mammogram is normal, it can be redone every two years. If she has a family history of breast cancer, her physician may recommend it more often.

AGES FORTY TO FORTY-NINE

• As part of her complete physical, by age forty a woman should have an electrocardiogram (EKG) every year.
• Every two years, she should have a mammogram.
• A Pap test and a pelvic examination should be done each year.
• Every year she should have a blood lipid profile.

BY AGE FIFTY, THE FOLLOWING TESTS SHOULD BE PERFORMED ANNUALLY

• Mammogram
• Lipid profile
• EKG
• Annual Physical

This page was contributed by Marianne J. Legato, M.D. and Carol Colman, authors of The Female Heart, The Truth about Women and Coronary Artery Disease, Simon & Shuster, 1991. Reprinted with permission.

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©1999-2000; updates: 2002, 2004, 2005, 2007 Women's Heart Foundation, Inc. All rights reserved. Unauthorized use prohibited. The information contained in this Women's Heart Foundation (WHF) Web site is not a substitute for medical advice or treatment, and WHF recommends consultation with your doctor or health care professional.