Health experts agree. Regular checkups are your best protection against serious medical problems. But women as a group seem to have particular difficulty in taking care of their physical well-being.
Why is this so? Partly because women are culturally conditioned to feel guilty if they're not taking care of others and to feel guilty if they are taking care of themselves."Women are a self-sacrificing group," says Valerie Logsdon, a gynecologist practicing in at the Millcreek Women's Center in Salt Lake City. "The same reluctance a woman has about spending time or money on herself in other areas of her life typically crops up when it comes to taking care of her body."
Logsdon continues: "If I told a woman her husband had a one in 10 chance of getting breast cancer (and that's an incredible risk!) and that she needed to make sure he was doing monthly self examations, she'd do it. But if I told this same woman she had a one in 10 chance of getting breast cancer and that the best way to find this cancer early is with regular self-exams, she typically won't do it. In this society women tend to regulate their own health care to a back seat, and when it comes to health care, sometimes that means at the expense of their own lives.
"I see women every day who have put themselves in jeopardy - a woman who hasn't had a Pap test for 10 years, or one who spots post-menopausally and postpones doing anything about it for two years while she takes care of other people," says Logsdon.
"I remember a sad case of a nurse I treated while in medical school that affected me deeply - a woman, about 40, with a husband and five kids - who one day opened the refrigerator and hit her breast. She noticed that night that she had a sore where she hit herself. It didn't get better, it got bigger, and it started draining - but she put off going to a doctor because she was busy and had her kids to take care of. When I saw her she had a breast cancer as big as a tangerine. This was a condition that was clearly abnormal - experienced by a woman who clearly knew better -but she put off taking care of it because she had other things to do. I did a mastectomy, but the cancer had already metastasized, and she died."
If a woman is to take care of her physical well-being and to systematically track her health, what steps does she need to take? "It all boils down to a yearly health exam," responds Logsdon. "An exam is a health-screen for major problems that affect a woman's physical and emotional health, including all of the cancers that she's particularly vulerable to - breast, cervical, endometrial, rectal or ovarian. It also provides a woman with a relatively tight link with a physician with whom she feels comfortable. Women need that link because many of their health problems will be in relationship to their periods, pregnancies and sexual intercourse, and those are difficult things to talk about to just anyone.
"Add to a yearly exam doing a monthly breast exam forever," Logsdon says. "Since the incidence of breast cancer increases dramatically after age 30, I always recommend a screening mammogram sometime between ages 35 and 40 and then, between 40 and 50, every other year; from 50 on, every single year."
And how do you do a breast exam? Logsdon explains this three-stage procedure: "The best time is right after your monthly period because prior to that your breasts are more lumpy and tender.
"First, stand in front of a mirror, put your hands over your head and push down, which spreads out your breasts and tightens the muscles. Check to make sure your breasts look normal to you - that there are no lumps, bumps, dimples or wrinkling of the skin.
"Then take a shower and use the slipperiness of the soap to do a breast exam. Essentially, just feel your breasts in an orderly fashion - circles, squares, crosses, lines, back and forth - however you want to. The goal is to memorize what your breasts feel like - just to know where all your normal lumps and bumps are.
"Then dry off and lie on the bed before you get dressed. Put one arm over your head, which again spreads out the breasts, and use your other hand to feel for lumps. If you've been doing this monthly, you'll recognize any changes that take place either abruptly or slowly. Anytime you discover an irregularity that doesn't go away with a month's cycle, bring it to the attention of a physician."
In summing up, Logsdon advises women: "You function best - for the family or others - when you're at your best physically or emotionally. If you can't take care of your physical well-being for yourself, do it for other people, because it really does make you a much happier, healthier, and more energetic person."