Menopause: Special Tests and Follow Up Visits
by Michael Russell
Ideally, all women should begin to have biannual mammograms, or breast x-rays, at the age of forty years. The reason for this is that mammograms can detect breast cancer before a palpable lump has developed and increase the rate of early detection. Early detection of breast cancer can increase survival rates. At the very least, you should have a mammogram at the time of menopause, if you are over forty and especially before beginning hormone replacement therapy. This is because if you have a tiny, undiagnosed cancer in your breast, hormone replacement therapy could stimulate its growth. Thus, it is important to rule out the presence of breast cancer before initiating hormone therapy and a mammogram is the most accurate means of doing this. Your physician will examine your breasts very carefully for signs of cancer, but even the best doctor in the world can miss a tiny cancer because it is just too small to feel. A good-quality low-radiation-dose mammogram can reveal tiny cancers, as small as one to two millimeters in size, long before you or your doctor would be able to feel it. In Sweden, studies have proved that routine breast cancer screening of women aged 45 years and over with regular mammograms can reduce deaths from breast cancer by up to 60 percent.
In addition to mammograms, a menopausal woman should have a bone mineral density test to measure the strength of her bones. This will allow your doctor to assess whether you are showing signs of osteoporosis and, if you are, to recommend treatment to try to rebuild bone, or at least to slow bone loss. Ideally, you should have this test done when you reach menopause at regular intervals thereafter. Other tests that should be performed include a complete blood count to check for anemia, as well as blood tests to test your liver function and measure your levels of follicle stimulating hormone, estrogen, blood sugar and cholesterol. If you have a past history of thrombosis (the formation of clots in the blood vessels), then blood should be taken for a clotting factor profile.
All post menopausal women should see their doctors annually. If you are using only natural therapies, such as herbs and nutritional supplements, then the frequency of follow-up visits will vary, depending on your symptoms. However, an annual check-up should still be done. Using natural therapist is more of a self-help enterprise than hormone replacement therapy is. Unless you are working with a nutritionally oriented physician, you may prefer to visit your local health food store or a naturopathic physician for advice regarding adjusting your dosage of vitamins, for example.
If you decide to try hormone replacement therapy, you will probably make this decision during your second visit to the doctor, at which time you and your doctor can discuss the results of all your tests. You may start treatment immediately, or you may feel you need time to think about it, to seek a second opinion, or to sort out your feelings about hormone replacement therapy. The most pressing reason to begin estrogen replacement without delay would be your bone mineral density test, which would mean that you are at high risk of developing osteoporosis.
Michael Russell
Your Independent guide to Menopause
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