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• Women’s Preventive Health Care:
  Preventive care is an important part of a woman's health routine. Every woman has a unique personal and family medical history that affects her risk for developing certain health problems. Use this checklist as a guide to assess your risks. Complete the checklist and bring it to your next doctor visit. We encourage you to talk with your doctor about your individual concerns, your family history and your current health status. Under each category check all that apply to assess your risk:

  Osteoporosis:
  Osteoporosis is a disease that is characterized by low bone mass. All adults gradually lose bone mass over time. In women, the rate of bone loss accelerates when ovaries stop producing the hormone estrogen. That's why it's important to assess your risk of osteoporosis now and take steps to prevent the disease. Having one or more of these risk factors increases your chance of developing osteoporosis.

  	I have stopped having menstrual periods.
  	I am Caucasian (white) or Asian.
  	I have a slight/slender frame.
  	I have a family history of osteoporosis.
  	I have broken a bone in my adult life.
  	I take steroid medications.
  	I have a diagnosis of hyperparathyroidism
  	I smoke cigarettes.
  	I do not eat foods rich in calcium such as, (milk, cheese, yogurt, etc.) and/or do not take calcium supplements.

  Diabetes:
  Diabetes is a disease that occurs when the body:
  

  1. does not produce any insulin. . . . or
  2. does not produce enough insulin. . . . or
  3. does not properly use insulin.

  Insulin is a hormone that is needed to convert sugar into energy. According to the American Diabetes Association, 5 million Americans have diabetes and don't know it. It often goes undiagnosed because many of its symptoms seem harmless. Early detection and treatment can help prevent the chance of developing complications. Assess your risk for diabetes. This condition is more common in African Americans, Hispanics/Latinos, Native Americans and Asians. So, if you are a member of one of these ethnic groups, you need to pay special attention to the risks. Talk to your doctor if you:

  	Are overweight
  	Have a family history of diabetes
  	Have excessive thirst
  	Have increased urination
  	Have blurred vision
  	Were diagnosed with diabetes during pregnancy, or delivered a baby weighing more than 9 lbs.

  Please note: If you have diabetes, during menopause hormonal changes can cause blood glucose to fluctuate.

  Heart Disease
  Heart disease is the leading cause of death in women. The hormone estrogen helps protect the heart and arteries against cholesterol, the substance that can block blood vessels. After menopause, estrogen levels decrease and the benefit estrogen once provided also decreases. The decrease in estrogen increases a woman's risk for heart disease. Early detection of the risks listed below may help you prevent serious health problems.

  	I smoke cigarettes
  	I have high blood pressure
  	I have high blood sugar or Diabetes
  	I have high cholesterol
  	I have a family history of heart disease
  	I am overweight
  	I do not exercise

  Depression:
  In the United States, one in ten adults experience depression each year and women experience depression at about twice the rate of men. Because depression often goes unrecognized, nearly two-thirds of people with depression do not get the help they need. A variety of biological and social factors unique to women's lives are suspected to play a role in developing depression. Menopause in general is not associated with an increased risk of depression. And yet, the specific causes of depression in women remain unclear; many women exposed to these factors do not develop depression. What is clear is that regardless of the contributing factors, depression is a highly treatable illness. You may be depressed if you consistently:

  	Feel down, depressed or hopeless
  	Loose interest and pleasure in usual activities
  	Feel tired and fatigued
  	Feel guilty or worthless
  	Have changes in appetite (loss of appetite or overeating)
  	Have changes in sleep habits (insomnia or over-sleeping)

  Breast Cancer:
  Breast cancer is the second most common cancer among women, after skin cancer. It is the second leading cause of cancer death in women, after lung cancer. Some women are at an increased risk for breast cancer. Some of the risk factors include:

  	Age 40 years or older
  	First-degree relative (mother, sister or daughter) with breast cancer
  	Relatives with breast or ovarian cancer
  	A family history of breast or ovarian cancer and Ashkenazi Jewish heritage
  	Started menstrual periods before age 12 or went through menopause after age 55
  	Given the hormonal drug diethylstilbestrol (DES) during pregnancy
  	Use of oral contraceptives (birth control pills)
  	Long-term (several years or more) use of hormone replacement therapy after menopause
  	Consume 2-5 alcoholic drinks a day
  	Overweight and on a high fat diet

  Cervical Cancer:
  Cervical cancer was once one of the most common causes of cancer death for American women. Between 1955 and 1992, the number of cervical cancer deaths in the United States dropped by 74%. The main reason for this change is the increased use of the Pap test-a screening procedure that can find changes in the cervix before cancer develops. It can also find early cancer in its most curable stage. Some of the cervical cancer risk factors include:

  	A history of human papillomavirus infections (HPV) (Viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells).
  	Tobacco Smoking
  	Blood test results that show past or current Chlamydia infection
  	Overweight with diet low in fruits and vegetables
  	Long-term use of oral contraceptive
  	Mother used the hormonal drug Diethylstilbestrol (DES) during pregnancy
  	Family history of cervical cancer

  Colorectal Cancer:
  Colorectal cancer is the third most common type of cancer and the second leading cause of cancer deaths for both men and women in the United States today. Although colorectal cancer can affect anyone, some of us may be at increased risk. Talk to your doctor if you have one or more of the following risk factors:

  	Age 50 years or older
  	A history, or strong family history of colorectal cancer or polyps
  	History of chronic inflammatory bowel disease including ulcerative colitis and Crohn’s Disease
  	History of tobacco use, and/or excessive alcohol use
  	African American
  	Overweight and do not exercise

  Screening Guidelines:
  ConnectiCare encourages you to receive preventive screenings according to accepted guidelines.

  Breast Cancer Screening
  Mammography:
  

  	Age 40-49 performed every 1-2 years
  	Age 50+ performed annually

  Physician Breast Exam:
  

  	Between the ages of 20-39, women should have a clinical breast exam every 3 years
  	After age 40, women should have a clinical breast exam annually

  Self Breast Exam:
  

  Monthly over the age of 20

  Talk to your physician about breast self-examination. Know how to check your breasts for lumps or changes. Be aware of how your breast normally feel and report any changes to your physician immediately.

  Cervical Cancer Screening
  Pap Smear:
  

  	Annual pap smear screening should begin approximately 3 years after initiation of sexual intercourse or by age 21, whichever comes first
  	After first screening, annual pap smear screening for women up to age 30
  	Women of any age who are immunocompromised, are infected with HIV, or were exposed in utero to diethylstilbestrol(DES) should be screened annually
  	After age 30, women should discuss the screening options with their physician.

  Colorectal Cancer Screening
  

  	Starting at age 50, yearly take-home-stool-testing cards for blood given to you by your physician (it is very important to return these cards to your physician after testing), or
  	Flexible sigmoidoscopy every 5 years, or
  	Stool Blood test (FOBT or FIT), plus flexible sigmoidoscopy every 5 years, or
  	Double-Contrast Barium Enema (DCBE) every 5 years, or
  	Colonoscopy every 10 years
  	Discuss testing with your doctor

  Routine Physical Exam Age 21-49 every 1-3 years as appropriate
  

  Age 50 and older annually

  Cholesterol Screening
  

  Age 20 or older should have a fasting total, LDL, and HDL cholesterol and triglyceride every 5 years

  Talk with your doctor:
  At your next visit, remember to talk with your doctor about any health issues that are of concern to you:

  	Osteoporosis		Diabetes		Heart Disease		Depression
  	Breast Cancer		Cervical Cancer		Colorectal Cancer		Screening Guidelines

  Screening Test Checklist
  Please take this checklist with you to your doctor's office and fill in the date you had any of the tests listed below, the test results, and when you should have your next test. To assist you and your doctors in managing your health, please ask your Specialist at the time of your office visit to forward your test results and medical report to your Primary Care Physician.

  Name of Test/Screening	The last time I had the following test/screening was: (month/year)	Test/Screening Results were:	I should schedule my next test/screening for: (month/year)
  Bone Mineral Density
  Blood Sugar
  Cholesterol
  Blood pressure
  Depression Screening
  Mammogram
  Pap Smear/Chlamydia
  Colorectal Cancer Screening

  Sources: National Institute of Mental Health, American College of Obstetricians and Gynecologists, & the American Cancer Society

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