5 medical tests every woman should have

Rick LewRick Lew1. Audiogram

Why You Need It: To find out if you are one of the more than 28 million Americans with measurable hearing loss -- and, if so, to take steps to keep it from worsening.

When and How Often: Schedule an audiogram if you have trouble making out what people are saying, hear ringing in your ears, feel a plugged sensation, or have a family history of hearing loss. Otosclerosis, a genetic disorder that prompts abnormal growth of the bone of the middle ear, is more prevalent in women and often surfaces when a woman is pregnant or between 15 and 30.

What to Expect: You wear headphones while a licensed audiologist or ear, nose, and throat doctor has you listen to sounds. "We check for your ability to discriminate between tones of different frequencies," says David Fabry, Ph.D., a former president of the American Academy of Audiology.

What the Results Mean: If your audiogram is normal, you'll come back every two to five years for a follow-up test. If your audiogram shows you have high-pitch hearing loss, you may have more difficulty hearing certain voices and might need a hearing aid.

2. Bone-Mineral Density Test

Why You Need It: To find out whether you're at risk for osteoporosis. This crippling weakness of the bones afflicts nearly 10 million older Americans, 80 percent of whom are women, according to the National Osteoporosis Foundation.

When and How Often: Have your first DXA (dual-energy X-ray) test at age 65 and another every five years thereafter. Women can lose up to 30 percent of their bone mass in the five to seven years following menopause. Get tested at menopause if you weigh less than 127 pounds, have ever smoked, have a history of nontraumatic fractures as an adult, or have a family history of osteoporosis.

What to Expect: The DXA test, the most accurate bone-density test, is safe and noninvasive: You lie fully clothed on a table while the X-ray machine scans your spine, hips, and wrists. If your bone density is low, your doctor may recommend the NTX test, a urine test that measures the rate at which you're losing bone mass; she may also want you to be X-rayed annually.

What the Results Mean: If your DXA shows you have osteopenia, a preosteoporotic state of low bone density, your doctor will recommend you consume at least 1,000 milligrams of calcium and 400 to 800 IUs of vitamin D daily without fail. (All women should get this amount, in fact.) She'll also suggest regular exercise. If you have osteoporosis, your doctor may give you a drug like Actonel or Fosamax. (See A Decade-by-Decade Guide to Protecting Your Bones)

3. Clinical Breast Exam and Mammogram

Why You Need It: Both types of screening can detect breast cancer when it is confined to the breast. Ninety-seven percent of women diagnosed at this stage survive without a recurrence for at least five years, according to the American Cancer Society.

When and How Often: Starting when you're age 20, your doctor should manually examine your breasts at your regular checkup. By age 40, you should have a mammogram (an X-ray of the breasts) once a year. "Schedule your mammogram right after your period," says Holly Thacker, M.D. "That's when the breasts are least tender."

What to Expect: Mammograms are done by standard X-ray. "If you've had previous mammograms and you're now using a new facility, be sure the radiologist compares your old films with the current ones," says Suzanne Trupin, M.D., a clinical professor of obstetrics and gynecology at the University of Illinois College of Medicine at Urbana-Champaign.

What the Results Mean: If the mammogram picks up an abnormality, such as a small deposit of calcium or a mass, your doctor may ask you to undergo a breast ultrasound or in some cases a breast MRI. These tests can determine whether a lump is a solid mass and if a biopsy is necessary. (Get The Facts on Breast Cancer)

4. Colonoscopy

Why You Need It: To detect colorectal cancer before symptoms occur. In Its early stage, this disease is more than 90 percent curable, says Bernard Levin, M.D., vice president for cancer prevention and professor of medicine at the University of Texas M.D. Anderson Cancer Center, in Houston.

When and How Often: Doctors suggest you have your first colonoscopy at age 50. If a parent or sibling was diagnosed with colorectal cancer or polyps before 50, you are at higher risk and should get your first test 10 years before they were diagnosed and repeat it at least every five years. If no problems are found and you have no family history, testing can be limited to once every 10 years.

What to Expect: For a colonoscopy, the gold-standard diagnostic test, your doctor uses a colonoscope, an instrument with a tiny video camera, to examine your large intestine for polyps and other growths.

What the Results Mean: If polyps are found, they will be removed and biopsied, says David E. Beck, M.D., chairman of the department of colon and rectal surgery at the Ochsner Clinic Foundation, in New Orleans. Depending on the results, you may need surgical treatment or additional testing within three to five years.

5. Comprehensive Eye Exam

Why You Need It:
To catch any eye health problems, from vision changes and sties to cataracts and glaucoma. Glaucoma is highly treatable, and in most cases glaucoma-induced vision loss can be slowed with medication if treated early, according to Richard Bensinger, M.D., a spokesman for the American Academy of Ophthalmology.

When and How Often: Even if your vision is good, you need a basic eye exam by age 40 and then every two years until 65. After 65 it should be done annually. Get exams before age 40 if glaucoma runs in your family; if you have a risk factor, such as diabetes; if you are African American; or if you use steroids. Contact-lens wearers should see a doctor annually.

What to Expect: Your ophthalmologist will check the pressure in your eyes. Elevated pressure is a symptom of glaucoma. He will examine your eyelids, eye linings, and pupils for abnormalities; your optic nerve for signs of brain tumors; your corneas and irises for problems; your lenses for cataracts; and your retinas for signs of macular degeneration, a deterioration of retinal cells.

What the Results Mean: If your vision is poor, of course, your doctor will probably suggest glasses or contact lenses. If you have signs of glaucoma, treatment usually starts with eyedrops, followed by laser therapy and surgery if the drops are ineffective. Vitamins and laser treatments can slow the progression of macular degeneration.

See 5 More Medical Tests Every Woman Should Have

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