Dr. Jacqueline Gerhart: Just In Time For Mother's Day
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that usually appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Readers: With Mother's Day coming this week, I wanted to answer some of the most common questions I'm asked from women in my practice.
When do I need a Pap smear?
Pap smears are a screening test for cervical cancer. A pap smear will show if there are any abnormal cells on a woman's cervix. The current guidelines released in 2012 say Pap smears should start at age 21, even for those who have never had sex, or before 21 for those who began having sex sooner.
After age 21, Paps should be done every two years until age 30, and then every three to five years after age 30. The "three-year plan" applies to patients where only a Pap smear is done. The "five-year plan" applies if the Pap smear cells also are tested for human papilloma virus (HPV). This is called "co-testing."
If there are abnormalities on your Pap smear, this frequency interval may change or further testing may be needed.
How do I know if I’m going through menopause?
Menopause is defined as the end of your menstruation and your fertility. Usually, after you have no longer had your period for one year, you are considered to have gone through menopause. For some women - such as those with irregular periods, who take hormone pills or who have had a procedure that causes them to stop bleeding - the exact timing of menopause can be less clear.
The average age for menopause in the U.S. is 51. Before going through menopause, you may have changes in your periods. They can be more or less frequent, heavier or lighter, or even skip multiple months and then come back.
Other signs you are starting menopause include vaginal dryness, hot flashes, night sweats, sleep changes, mood changes, weight gain and thinning hair. These symptoms are usually normal for menopause. Keep a journal of your symptoms, and if you feel they are abnormal or severe, see your physician.
I'm always tired; do I need my hormones checked?
There are many reasons women are fatigued. The most common are from lifestyle issues such as stress, poor sleep hygiene, lack of exercise, use of alcohol or caffeine, and side effects of medications.
However, other medical and psychological conditions also can cause fatigue. Examples include restless leg syndrome, low vitamin levels (such as iron or vitamin D), low thyroid hormone, low blood counts (anemia), obesity, depression and anxiety.
Your primary care physician can do a complete history and exam to help determine which of the above reasons may be contributing to your fatigue.
I'm older than 60. Should I be taking an aspirin daily?
National guidelines note that women between the ages of 55 and 79 should take aspirin daily. This is recommended to help prevent stroke. In clinical trials, taking low-dose aspirin (75 or 81 milligrams daily) seems to have the same benefit as taking higher-dose aspirin (like 325 mg daily).
The higher the dose of aspirin you take, the more likely that you could have a complication from taking it. So I usually recommend a baby aspirin (81 mg daily) for my patients. This recommendation does depend on what other medications you are on, and if you have an increased risk of complications from aspirin.
Complications include bleeding, bruising and stomach irritation or ulcers. So if you are already on a medication that alters your blood's clotting abilities (such as Coumadin or warfarin), or if you have known stomach irritation or an ulcer, you may be advised against taking aspirin.
I hope that laughter and love fill your Mother's Day! Here’s to a healthy year for mothers everywhere.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 05/08/2013