Women’s health checklist
Posted on 31 July 2017
Our expert runs through the 5 health checks that women of all ages should keep top of mind.
- Breast cancer checks
In South Africa, breast cancer is the most common cancer in women of all races, according to the 2012 National Cancer Registry (NCR) but it has a high rate of survivorship owing to early detection and treatment. While most breast lumps are harmless, they should always be checked by a medical professional. If caught early enough, localised cancers can be removed without having to remove the entire breast.
A mammogram is a special X-ray for detecting breast lumps. If symptom-free, women should have a mammogram done every second year after the age of 40. ‘Women with a strong family history of breast cancer should ideally see a geneticist to discuss BRCA1 and BRCA2 testing for breast cancer,’ says gynaecologist and endoscopic surgeon Dr Natalia Novikova of Mediclinic Cape Town.
- Ovarian cancer testing
There are various kinds of ovarian cancer, and all are fairly uncommon. ‘Risk factors for ovarian cancer include older age, having one or more relatives with ovarian cancer, having abnormalities in the BRCA1 or BRCA2 genes, being overweight, and never having been pregnant,’ says Dr Novikova.
Unfortunately, most cancers that affect the ovaries are diagnosed in an advanced stage because there are no reliable early signs. Vague and subtle symptoms can include fatigue, abdominal swelling and pain, changes in bladder and bowel habits, and shortness of breath.
‘There are two tests available to screen for ovarian cancer: pelvic ultrasound and a blood test to check for a tumour marker called Ca125. Neither is 100% reliable,’ says Dr Novikova. She adds that the advantage of having the screening test is early detection, but the disadvantage is the chance of unnecessary surgery for something that is not actually cancer. She advises that women with a strong family history of ovarian or breast cancer should see a geneticist to discuss BRCA1/2 testing. The presence of these genetic abnormalities can cause breast or ovarian cancer.
- Cervical cancer signs and prevention
In South Africa, cervical cancer is the most common cancer among women aged 14-44, and it is the leading cause of cancer deaths among women in general. In its early stages, this cancer often has no symptoms, but later it can cause heavy vaginal bleeding and/or discharge and pain. The South African HPV Advisory Board recommends that women have a pap smear from when they become sexually active or turn 21, every three years.
The human papilloma virus (HPV) is a common viral infection that can be passed on during sex, and some types of this virus have been linked to cervical cancer. For this reason, the World Health Organisation recommends HPV vaccines which, combined with regular cervical screening, can help protect girls and women against the most common cancer-causing virus types or catch the disease early.
- Colon cancer tests
Colorectal cancer – cancer of the colon, rectum and/or bowel – is one of the most common cancers affecting adults worldwide, with 90% of cases in people aged 50 and older. There are often no symptoms in the early stages of the disease; later, the most common symptoms are a change in bowel habits, including diarrhoea or constipation, blood in the stool, fatigue and weight loss.
Because it takes 10 to 15 years for colorectal cancer to develop, regular screening can reveal polyps, which can be removed before they become cancerous. A colonoscopy involves the doctor passing a scope (a tube with a small camera on the end) into your bowel to look at the colon. Women with an average risk of colon cancer should have their first colonoscopy at age 50, and be screened every 10 years thereafter. ‘There’s also a new DNA stool test to screen for colon cancer, which may be an option for some patients,’ adds Dr Novikova. Ask your GP about the available options.
- Correct birth control
Choosing the most age-appropriate form of contraception can be challenging, because as women’s bodies change with age, so do their contraceptive needs and preferences. But unintended pregnancy is an issue for all pre-menopausal women, so it’s important to stay informed – especially if you’ve trusted the same form of contraception for years.
For women under 40, there is a wide variety of contraceptive options. ‘Long-acting contraceptives are very popular and have a great safety profile,’ says Dr Novikova. She lists the following options:
- An intrauterine device [IUD], coil or loop is inserted by a gynaecologist, usually in their rooms under local anaesthesia. It lasts for five years, but the doctor can remove it very easily when desired.
- Implanon is a small, thin rod that is inserted into the arm. It It releases the synthetic hormone progestin to prevent pregnancies, lasts for three years and is very effective.
- The vaginal ring has a similar hormone content to the contraceptive pill. Inserted into the vagina by the patient, it remains in place for three weeks. She then removes it for one week and has a period before repeating the cycle.
- The contraceptive patch also has similar hormonal content to the contraceptive pill. Women have to apply a new patch every week, then go without the patch for one week during their period.
The ideal for women over 40 is generally long-lasting reversible contraception such as an IUD, while sterilisation by tubal ligation (‘having your tubes tied’) is a safe and permanent option.