En español l Smart questions pave the route to better health care — and to a better partnership with your doctor. "Health care comes with so much information, doctors are so concerned about time, and patients have concerns not addressed," says Leana Wen, an emergency physician at Brigham & Women's and Massachusetts General in Boston, and coauthor of When Doctors Don't Listen. "Patients have to know what questions to ask. Don't wait until something bad comes up to communicate. Create a relationship while you're well."
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To get the ball rolling, doctors weigh in on 10 essential questions to ask your physician now.
1. When do I need my mammogram, pap smear and colon cancer test?
"Ask your doctor to tailor screenings based on your personal, medical and family history, and your values," says Wen. "For instance, if you're 80, you may not want cervical cancer screening since it progresses so slowly." For each screening, ask what the risk, benefits and alternatives are. Women over 50 should ask about mammograms, pap smears and colorectal cancer, says F. Michael Gloth III, M.D., associate professor of medicine and director of outpatient services for the Division of Geriatric Medicine and Gerontology at Johns Hopkins Bayview Medical Center in Baltimore. Screenings for high blood pressure, diabetes, high cholesterol and osteoporosis should be on your radar, too, says Wen.
2. I think I've started menopause. Should I be doing anything differently?
Menopause, which officially begins 12 months after your last period, increases your risk for heart disease, the leading cause of death in women. Ask about related risks such as high blood pressure, diabetes, obesity and smoking. And address menopausal symptoms such as hot flashes, sleep difficulties and vaginal dryness. Postmenopausal women are at much higher risk for osteoporosis than men, says Wen. The National Osteoporosis Foundation recommends 1,200 mg of calcium and 800 to 1,000 IU of vitamin D daily for women over 50. Hormone replacement therapy may help reduce menopausal symptoms such as vaginal dryness and night sweats. But many women have become leery of HRT. A large 2002 Women's Health Initiative Study found that women who took HRT were at increased risk for breast cancer, stroke and heart disease. But then a 2012 16-year study at Hvidovre Hospital in Denmark found that hormone therapy begun right after a woman's final period protects women from heart attack and heart failure. And cancer risk for women who did or did not take HRT was the same. Ask your doctor about the timing, risk and benefits.
3. I find that I'm less interested in sex these days. Is there anything I can do about it?
A menopausal drop in estrogen levels may cause sex drive to droop — as can a thyroid problem. "Your doctor may not bring that up, so you have to," says Wen. Ask your doctor to review your medications — studies show that prescription medications are often responsible for sexual problems. If sex is painful, you may simply need artificial lubrication or there could be an underlying medical problem. Sometimes a health scare can prompt a dry spell, but that doesn't mean you can't resurrect your sex life. An honest conversation with your doctor is a good place to start.
4. I'm newly single and have started dating. Should I be tested for sexually transmitted diseases?
Don't laugh. According to the U.S. Centers for Disease Control and Prevention, syphilis, chlamydia and gonorrhea have increased among ages 45-64 in the last decade. For instance, in 2000, there were 900 cases of syphilis in that age group. By 2010, the number almost tripled. "Older women are starting relationships," says Clancy. "But they may not think about protection. Ask your partner to wear a condom."
5. Should I start taking a daily aspirin?
A daily baby aspirin (81 mgs) can help prevent strokes and heart attacks, but your doctor may advise against it if you have blood clotting issues, stomach ulcers or take blood thinners, says Wen. Aspirin affects clotting and can cause stomach bleeding.
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