Dr. Rad in Shondaland: Expert Guidance on Scheduling Check-Ups and Appointments

When Should You Plan Check-Ups and Appointments?

“It’s not a secret that women, no matter what phase of life we’re in, can tend to put things like our own personal well-being last, trying to take care of others,” says Dr. Shilpi Agarwal, a board-certified family-medicine physician at Georgetown University. This, she reminds us, can become even more of a habit as we transition into spouses, parents, and caretakers.

When it comes to health, keeping up with preventative care is important, especially for women. “It can help to tease out things that women might be feeling that they’ve never really sat down to talk about, whether that be low-level anxiety, GI discomfort, allergies, or anything like that,” Agarwal says. It can also help women ward off disease and catch ailments early. “The phrase ‘early detection saves lives’ is not just gimmicky,” she adds. “It’s true.”

Here’s a guide to what women should be prioritizing when it comes to their health, including keeping up with physicals, mammograms, vaccines, family planning, and beyond.

Find a primary-care physician

“If you have an established relationship with a doctor, it’s a lot easier when you’re sick because you have a go-to doctor to make an appointment with,” Agarwal says. “This doctor will have all sorts of checks and balances that can help you keep track of whether or not you got your tetanus shot, are up to date on STI screenings and beyond,” Agarwal adds.

A primary-care physician can also refer you to specialists when needed. Visiting your regular doctor is a good time to just check in with your overall health and get a report card about what’s going on. “You might think, ‘Oh, I’m having a lot of stomach pain. Is it stress? Or I’m having this symptom or that symptom?’” Agarwal says. During your annual physical, your doctor will screen for things like high blood pressure, body mass index (BMI), cholesterol, heart rate, family history of diseases, mental health, and more.

Keep up on preventative tests

Pap smear

This should start at the age of 21 and be done at least every three years. “After 30, we also check for HPV because HPV is what we know is linked to cervical cancer,” Agarwal says.

Going to the gynecologist, says Dr. Andrea Eisenberg, a board-certified ob-gyn and HealthCentral women’s health specialist, is more than receiving a pap smear. “Your OB can assess any changes in health,” she says, including issues like weight, changes with menstruation, a new sexual partner, new symptoms (like new onset acne or headaches), changes in their life that might affect their health (getting married, considering pregnancy), or family history (a mother being diagnosed with breast cancer).

Mammogram

By age 40, women have the option to start receiving annual mammograms. The American Cancer Society recommends that women 45 to 54 get these tests performed on an annual basis. Over the age of 55, women with clearance from their doctors may switch to mammograms every two years. Women with dense breasts may be referred for a 2D or 3D (tomosynthesis) mammogram or ultrasound, depending on the recommendation of their doctor. “These recommendations may change if there is a family history of breast cancer or any abnormality found at a woman’s yearly gynecology exam,” Eisenberg says.

Colonoscopy

This is a screening for colon cancer, under sedation, where a thin scope with a light and camera are used to examine the colon and remove precancerous lesions (polyps). “The average risk can start at age 45, and if normal, you can repeat every 10 years,” says Dr. Supriya Rao, a Boston-based ob-gyn. “If you have a family history of colon cancer, you should speak with a doctor about starting earlier than 45.”

Lung cancer

“Women 55 and older who smoke or have quit within the past 15 years should receive a yearly low-dose CT scan to screen for lung cancer,” says Dr. Brooke Stubbs, a board-certified internal-medicine physician with Rooted Femme.

Osteoporosis

“Women should receive a DEXA scan for bone density starting at age 65 and then every 15 years, unless they are at increased risk,” Stubbs explains.

Cardiovascular disease is deadly amongst women. So, work with your doctor to take care of your heart.

Dental exams

Regular dental checkups, as frequently as every six months, are important for oral health. Oral problems, if not treated, can affect your heart, gut, and mental health.

Vaccinations

“The CDC recommends yearly vaccination for influenza, the pneumococcal vaccine at age 65, a Tdap (tetanus, diphtheria, and pertussis) booster every 10 years, the shingles vaccine at age 50, the HPV vaccine up to age 45, and a Covid vaccine,” says Stubbs. Make sure to keep your doctor up to date on your vaccine records and discuss if there are any new ones you should be taking beyond those.

Family planning

There are many contraceptives to choose from, including birth control, intrauterine devices, and condoms. If you’re ready to conceive, head to your doctor for a fertility check. “Checking a hormone called AMH gives you an idea of your egg supply or egg count and makes sure it is in a normal range for your age,” says Dr. Jennifer Makarov, an ob-gyn and reproductive endocrinology and infertility specialist at New Hope Fertility.

Makarov recommends that women start thinking about having children or freezing their eggs by the age of 35 “because the egg quantity declines significantly after 35 and decreases potential parenthood for the future.” The general guideline, she says, is that ages 35 and under should aim to freeze a minimum of 10 to 15 eggs and those 36 to 39 years old should freeze a minimum of 15 to 25 eggs.

There are many types of birth control, so find one that best suits your lifestyle.

Hormonal health

Menopause is defined as the end of menstruation, or not having a period for 12 consecutive months. “On average, this happens to women at age 51, though the timing varies significantly,” says Dr. Kathleen Jordan, chief clinical officer of Midi Health. But the menopause transition starts long before your period ends. “As our ovaries begin to secrete less estrogen, we enter a roller coastering of hormone levels that trigger a variety of symptoms, a stage known as perimenopause, and for most women it occurs throughout our 40s, if not earlier,” Jordan explains.

Your doctor can help you treat many of the accompanying symptoms. This, according to Jordan, can include everything from hormone replacement therapy to non-hormonal prescription medications, herbal therapies, lifestyle adjustments, and some complementary therapies. “There are multiple forms of hormones, including patches, gels, and pills,” she says. “Trained practitioners can work with you to figure out what works best for your body.”

Be sure to keep tabs on your hormones in general. Dr. Steve Rad, a Los Angeles, California-based maternal fetal specialist and perinatologist, notes that hormonal-imbalance symptoms include fatigue, hair loss, mood swings, irregular periods, irritability, infertility, difficulty concentrating, sudden weight loss or weight gain, night sweats, reduced sex drive, hot flashes, panic and anxiety, acute depression, difficulty sleeping, sleeping too much, sudden new acne, abnormal hair growth, brain fog, dry skin, chronic diarrhea or constipation, appetite changes, recurring headaches, vaginal dryness, unstable blood sugar, skin aging and thinning, and thinning bones.

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