How often to do tests: 10 questions about women's health
Feminism goes on the planet by leaps and bounds - and one of his achievements is that they began to talk about women's health more often. The questions are understood as the most serious: it is already known that women feel pain differently, female blood for transfusion is not suitable for everyone, and preparing for the holidays harms the female heart, increasing the risk of asymptomatic myocardial infarction. Separation of duties in everyday life is becoming a popular subject of research: for example, recently scientists have found that household chemicals have a much more serious effect on the function of the lungs in women. Other researchers have found that worrying women about whether they do a “sufficient share” of household chores is detrimental to their health.
Today, the discussion will deal with practical things: at the end of 2017, sociologists said that more than half of Russian women (or more precisely 56%) underestimate the importance of regular medical examinations. We decided to collect basic recommendations concerning health, prevention and visits to doctors. Here and below, the word "woman" is used for convenience, but specific information also applies to those who have a reproductive system characteristic of women - regardless of gender.
Gynecologist or gynecologist-endocrinologist is rightly considered one of the main doctors in the life of a woman. The VTsIOM survey showed that 73% of women between the ages of 18 and 45 in Russia visit the gynecologist at least once a year, while 29% of them try to schedule a visit every six months. This is consistent with the recommendations of the Ministry of Health: under the relevant order, completely healthy women and women with minimal risk should be done at least once a year.
However, doctors who hold positions of evidence-based medicine do not share the point of view of the department. The obstetrician-gynecologist Elena Usoltseva says that if the menstrual cycle is regular and there is no pain or other complaints, you can visit the gynecologist less often - once every three years for oncocytological screening.
Referring to a blood test for every cold, or simply for prevention, is a familiar, but meaningless, story. Experts believe that in the absence of complaints or visible disorders, a blood test is needed in three cases: at the age of 18-20 years, to make sure that the body has entered the reproductive period normally and fully; then, at the age of 35-40, the moment of the beginning of the decrease in the level of sex hormones, which will make it possible to see possible violations and in the future to ease menopause and, finally, during preparation for pregnancy, planning for conception and pregnancy itself, without reference to age.
In other cases, the doctor should be guided by whether the treatment tactics will change depending on the results of the analysis. It is important that donating blood for tumor markers “just in case” is not necessary: these parameters can change under the influence of a variety of external factors and are not used to make a diagnosis. Tumor markers are usually studied in order to monitor the effectiveness of cancer treatment and for the early detection of relapses.
At the same time, modern studies demonstrate that a blood test can be effective in detecting autism, determining suicidal tendencies, choosing an appropriate antidepressant, and confirming chronic fatigue syndrome. But all this scientists have yet to repeatedly confirm.
For what they do not use magnetic resonance imaging as part of popular science research: to see what happens to the brain in schizophrenia, or to find out why favorite music provokes sensations like orgasms in some people. But despite the fact that the MRI procedure is generally safe, since we are not talking about x-rays, there is no need to do it for a healthy person until the age of forty. Of course, if there are no medical indications for this.
Recall that an MRI scan is not quite correct as a snapshot. It is rather a map of electromagnetic signals arising in the body as a response to a strong magnetic field. MRI allows the doctor to diagnose the disease and monitor the treatment process in case of diseases of internal organs, bones or joints. New research also shows that MRI scans may turn out to be better and better than traditional ultrasound in determining the sex of a child.
Swiss scientists have created a "mole", which in the future may help diagnose cancer at an early stage. As the creators of this implant explain, it is able to respond to an atypical increase in blood calcium levels, which may indicate the possible presence of such tumors as lung cancer, prostate cancer, breast cancer and colorectal cancer. But if we talk about ordinary, rather than innovative moles, then their number, as scientists believe, correlates with the risk of melanoma.
How to understand that you need to go to the doctor? American experts suggest using the ABCDE formula: pay attention to asymmetry (asymmetry), irregular borders (border irregularity), color (color), diameter (diameter) and changes (evolution). If you know all your birthmarks since childhood and they have not changed at all since then, then there is no cause for concern. At the same time, keep in mind that moles can grow in size and appear with age, and also darken under the influence of the sun and hormonal changes, so you should not panic if everything happens slowly and evenly.
Not sure about your own diagnostic skills? In this case, it may be useful to use one of the applications designed to identify risks based on the photo. True, despite the fact that when testing applications show impressive results, the experts are critical of them, because even when “communicating” with the smartest of applications, everything depends on the quality of the image.
Cervical cancer - a new breast cancer in the sense that the number of materials about its risks, the need for examination and the effectiveness of treatment is growing exponentially. This is understandable: according to WHO, only in 2015, 280 thousand women died of cervical cancer, and 90% of them died in low- and middle-income countries. At the same time, in economically developed countries, screening for cervical cancer appears to be performed too often.
In most manuals, screening is recommended to begin at the age of twenty-one, but there is also evidence of the risk of such an early screening. A meta-analysis of available data has shown that when abnormalities are detected in the Pap test (Pap smear), the patient must be treated. Nevertheless, the presence of abnormalities, firstly, does not indicate the mandatory development of cancer in the future, and secondly, the intervention can lead to negative consequences during pregnancy and childbirth, including premature birth and perinatal mortality. So it makes more sense to focus on countries with screening programs that produce good results: in Finland, for example, it is recommended to start at age thirty, repeating every five years at normal rates.
Surely, at least once you have heard or read that from a certain age an aspirin tablet per day can significantly improve the quality of life and health indicators. There is evidence that aspirin therapy interferes with blood clotting, reducing platelet accumulation in the arteries and potentially preventing a heart attack. True, self-prescribing aspirin can not; Doctors recommend such therapy only after fifty years or earlier, but in some cases, especially in people with already identified heart diseases or their high risk.
By the way, new research shows that there are drugs that can more effectively than thrombosis than aspirin. In particular, Canadian scientists in a series of experiments found that the anticoagulant rivaroxaban more effectively fights blood clots in the legs and lungs, while not yielding to aspirin for safety.
Now scientists are talking about a possible way to return the function of the ovaries after losing it - so that in the future, pregnancy after the age of menopause is not excluded. Nevertheless, while menopause means loss of fertility; It is believed that contraception can be abandoned after twelve months of absence of menstruation, if other signs indicate changes.
Symptoms of perimenopause (that is, the pre-menopausal phase) include an irregular menstrual cycle, hot flashes, vaginal dryness, sleep disorders and mood swings - the result of unevenly changing estrogen levels. As a rule, women reach menopause at about the same age as their mothers and sisters, although smoking contributes to her earlier onset. After menopause, estrogen is becoming less and increases the risk of diseases such as osteoporosis, heart disease, urinary tract infections, and breast and ovarian cancer, especially if the first menstruation occurred before the age of twelve.
That is why at this time it is important to be observed by a gynecologist who will help alleviate the symptoms (there is evidence that conversations with the therapist can help, for example), take into account any possible risks and prescribe the correct dosages of calcium and vitamin D to reduce the risk of osteoporosis.
Human papillomavirus is a large group (more than one hundred types), some of which are safe, while others, known as high-risk viruses, can lead to the development of cervical, vulvar, vaginal, anus, oral and pharyngeal cancers. The virus is transmitted primarily through sexual intercourse (including oral, vaginal and anal sex), and sex with one partner is sufficient for infection.
The main way to protect against HPV is vaccination. And ideally, a vaccine approved and actively used in different countries should be administered before a potential meeting with the virus - that is, before the start of sexual life, but it is effective in other cases. The journal of evidence-based medicine Current Medical Diagnosis & Treatment for 2017 reports that HPV vaccines were effective when administered not only to boys and girls eleven to twelve years old, but not previously vaccinated to men and women up to the age of twenty-six who are already sexually active.
Breast cancer is one of the most common cancers, and the main risk factor for this tumor is age. While in women under the age of forty-five, only 12.5% of breast cancer cases are recorded, after fifty-five years, the numbers rise to 66%.
Next in age is family history (breast cancer in parents or close relatives), genetics (mainly mutations in the BRCA1 and BRCA2 genes), as well as late pregnancy or the absence of pregnancy in one's entire life. If there are no such risk factors, and the pain, discomfort, or lumps in the breast do not bother, screening mammography is recommended after fifty years every two years. On the recommendation of an oncologist, women from forty to fifty years old can be examined.
Hormonal contraception - a way to protect against unwanted pregnancy, the most effective when properly used. The rules, as it is logical to assume, means a doctor - and although you should not be afraid of hormonal contraceptives, you should not engage in their self-assignment either, if only because hormones are a very thin story that affects all body systems.
Published in 2017, the results of a study by Danish scientists, who found that absolutely all hormonal contraceptives provoke cancer, caused a lot of controversy in the scientific community. In particular, the experts recalled that hormonal drugs are the main method of contraception for women aged twenty to thirty years old when the risk of breast cancer in the absence of risk factors, including genetic ones, is small enough. Some time later, scientists from Oxford stated that their study - no less extensive than in Denmark - shows just the opposite, demonstrating a significant reduction in the risk of endometrial cancer, colorectal cancer and ovarian cancer after five years of taking hormonal contraceptives.
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