Women's Health & Wellness

Often, women do not have symptoms. When they do occur, symptoms may include:

• Angina (dull and heavy or sharp chest pain or discomfort)
• Pain in the neck, jaw, or throat
• Pain in the upper abdomen or back
• Nausea
• Vomiting
• Fatigue

Sometimes heart disease may not be diagnosed until you have other symptoms or emergencies, including:

• Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath

• Arrhythmia: Fluttering feelings in the chest (palpitations)

• Heart failure: Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck 

HOW DO DOCTORS TEST FOR HEART DISEASE?

Your doctor will perform a physical exam, including blood pressure and heart rate, ask about symptoms, and gather family medical history. Blood tests could be taken to check cholesterol and triglyceride levels.

Noninvasive tests may be performed—including chest X-rays, electrocardiograms (EKG), echocardiograms (ECHO), stress tests, and wearing a Holter monitor. Invasive testing may include cardiac catheterization to allow an inside view of possible blockage of heart vessels to help determine the best course of treatment.        

HOW IS HEART DISEASE TREATED?

Treatment depends on the severity of the condition. 

Call 911 if you experience any of the symptoms listed above.

RISK FACTORS

Risk factors for breast cancer include:

• Age
• Reproductive history
• Having dense breasts
• Personal or family history of breast cancer
• Lack of physical activity
• Overweight
• Hormone replacement
• Drinking alcohol

SYMPTOMS

There are different symptoms of breast cancer, and some people have no symptoms at all.

Schedule a doctor’s appointment for any of the following symptoms: 

• Any change in the size or the shape of the breast.
• Pain in any area of the breast.
• Nipple discharge other than breast milk (including blood).
• A new lump in the breast or underarm.

HOW DOES MY DOCTOR TEST FOR BREAST CANCER?

A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. Regular mammograms are the best tests doctors can do to find breast cancer early, sometimes up to three years before it can be felt.

Screening for breast cancer using digital breast tomosynthesis (DBT), also known as three-dimensional mammography, may be covered annually instead of conventional two-dimensional screening mammography for all women beginning at age 40. Under certain circumstances—if you have dense breast tissue, a prior diagnosis of breast cancer, or breast cancer in a first-degree relative (mother, sister or daughter)—it may be covered beginning at age 30.

Please contact Member Services for details.

HOW IS BREAST CANCER TREATED?

Breast cancer has a high chance of being cured if diagnosed early. Treatment depends on the type of breast cancer and how far it has spread.

Treatment can include surgery, chemotherapy, hormonal therapy, biological therapy and/or radiation therapy.

RISK FACTORS

Lower the risk for cervical cancer by getting regular and consistent screenings, starting at age 21. Pre-cancerous cells can be detected and treated to prevent cancer from developing.

SYMPTOMS

Like many cancers, you may not experience any symptoms at all in earlier stages. Some symptoms that can be experienced are:

• Abnormal vaginal bleeding after sex, after menopause, between periods 

• Unusual vaginal discharge that occurs between periods or after menopause

• Pain during sex

• Pain in pelvic region

HOW DO DOCTORS TEST FOR CERVICAL CANCER?

Two screening tests help prevent cervical cancer or detect it early:

• The Pap (Papanicolaou) test or smear looks for precancers, which are cell changes in the cervix that might become cervical cancer if they are not treated appropriately.

• The human papillomavirus (HPV) test looks for the HPV virus cells that are most likely to cause cervical cancer.  

Both tests can be done at the same time in a doctor’s office or clinic.  The provider collects cells from the cervix to be looked at closely in the lab to find cancer and precancer.  

Regular pap smear testing is recommended for early detection

Individuals with a cervix should get their first Pap test/smear at age 21. If test results are normal, the next test should be completed every three years.

Individuals 30 years old or older with a cervix, have three options:

• Continue getting a Pap test only. If test result is normal, wait three years for the next test.

• Get an HPV test only. If test result is normal, wait five years for the next test.

• Get both an HPV and Pap test together. If test results are normal, wait five years for the next tests.

HOW DO DOCTORS TREAT CERVICAL CANCER?

Two screening tests help prevent cervical cancer or detect it early:

• The Pap (Papanicolaou) test or smear looks for precancers, which are cell changes in the cervix that might become cervical cancer if they are not treated appropriately.
• The human papillomavirus (HPV) test looks for the HPV virus cells that are most likely to cause cervical cancer.

Both tests can be done at the same time in a doctor’s office or clinic.  The provider collects cells from the cervix to be looked at closely in the lab to find cancer and precancer.  

RISK FACTORS

Risk factors for colorectal cancer include:

• Inflammatory bowel disease
• Family history
• Lack of physical activity
• Low fiber and high fat diet
• Being overweight
• Alcohol consumption
• Tobacco use

SYMPTOMS

Like many cancers, colorectal cancer doesn’t always cause symptoms, especially in earlier more treatable stages this is why screening is so important. When people do have symptoms of colorectal cancer, these are some they experience:

• Change in bowel habits
• Blood in your stool
• Diarrhea, constipation
• Abdominal pain that will not go away
• Unexplained weight loss

HOW DOES MY DOCTOR TEST FOR COLORECTAL CANCER?

There are several colorectal cancer screenings that can help find precancerous changes and detect cancer in its early stages when it is most treatable.

The table below shows the different types of screening tests that can be done. Talk with your doctor about which screening is right for you.

In adults younger than 45 and from 76-85 years old, the decision to screen for colorectal cancer should be an individual one, made by the patient and their primary care provider. This decision should take into account the person’s overall health and prior screening history to determine which test is the best.

IF I HAVE COLORECTAL CANCER, HOW IS IT TREATED?

Treatment depends on the type of colorectal cancer and how far it has spread.  Once diagnosed, additional testing will help determine the extent or stage of cancer to indicate the most appropriate treatment.

RISK FACTORS

The following factors increase the risk of contracting chlamydia:

• Having a new or multiple sexual partner(s). While the risk is higher with a new/multiple sexual partner(s), due to the ability for the bacteria to lie dormant for many years, you could still be carrying the bacteria without having new/multiple partner(s)

• Having a sexual partner who has more than one sexual partner

• Having sex with someone who has a sexually transmitted infection

• Having an STI now or in the past

• Not using condoms consistently when not in a mutually monogamous relationship

SYMPTOMS

Chlamydia usually does not cause symptoms.

When symptoms do occur, they may appear from a few days to several weeks after infection. They may be very mild and can be mistaken for a urinary tract or vaginal infection.

The most common symptoms in women include:

• Yellow discharge from the vagina or urethra
• Painful or frequent urination
• Vaginal bleeding between periods
• Rectal bleeding, discharge, or pain

HOW DOES MY DOCTOR TEST FOR CHLAMYDIA?

A chlamydia test can be done on a urine sample (noninvasive) or on samples taken with a swab from the vagina, mouth, throat, rectum, or the area around the cervix. A yearly screening test is recommended for sexually active women 16 to 25 years old and for women 25 years or older who have one or more risk factors listed above.

This routine preventive screening is painless and is a covered benefit.

IF I HAVE CHLAMYDIA, HOW IS IT TREATED?

Treatment for chlamydia can include being prescribed an antibiotic like azithromycin single dose or doxycycline twice a day for 7-14 days. Take all medicine as directed. As soon as you find out that you have chlamydia, be sure to let your sex partner(s) know so they can also be tested and treated. Experts recommend that you tell everyone you've had sex with in the past two months. If you haven't had sex in the past two months, contact the last person you had sex with.

Chlamydia can be passed to sexual partners even during treatment. You should avoid sexual contact until you have finished treatment, and all sexual partners should as well. A three-month follow up test should be completed to ensure the infection has cleared up.

CHECK-UPS AND TESTS DURING PREGNANCY

As soon as you know you're pregnant, make an appointment with your doctor or certified midwife. Your first prenatal visit will provide information that can be used to check for any problems as your pregnancy progresses. It's also a good time to think about how you want to partner with your doctor or midwife.

• Your first prenatal visit includes a health history, physical exam, and blood and urine tests.

• First-trimester exams and tests may include fetal ultrasound, which uses reflected sound waves to provide an image of your fetus and placenta.

• Second-trimester exams and tests may include fetal ultrasound and electronic fetal heart monitoring. Later in the second trimester, you will have an oral glucose screening test for possible gestational diabetes. If you have Rh-negative blood, you may have an antibody screening test and will receive an injection of Rh immunoglobulin. Screening tests help your doctor look for a certain disease or condition before any symptoms appear.

• Third-trimester exams and tests may include fetal ultrasound, hepatitis B screening, and group B strep screening.

It is also important to receive the recommended immunizations when you are pregnant. The Center for disease control and prevention (CDC) recommend having an influenza vaccine (flu shot) before or during pregnancy, depending on whether or not it is flu season during your pregnancy. Women are more likely to have a severe illness from the flu while pregnant, having a flu shot can provide protection from flu complications for you and your baby for several months.

The CDC also recommend a Tdap vaccine to protect against whooping cough during pregnancy. Mothers who receive Tdap create protective antibodies and pass them to their baby before bird to create some short-term protection against whooping cough. This is important because 7/10 deaths from whooping cough occur in babies younger than 2 months old.

Both the flu shot and the Tdap are considered safe and effective during pregnancy.

ADDITIONAL RESOURCES

Additional prenatal care information along with an interactive online tool to reference any time during your pregnancy can be found here:

https://www.healthwise.net/martinspoint/Content/StdDocument.aspx?DOCHWID=center1030

Keep up with your pregnancy journey in all trimester stages by using the guide below. It includes helpful checklists, health and nutrition information, and more:

Your Pregnancy Journey (PDF)

WHAT IS POSTPARTUM?

During the first weeks after giving birth, your body begins to heal and adjust to not being pregnant. This is called postpartum (or the postpartum period). Your body goes through many changes as you recover. These changes are different for every woman.

The first weeks after childbirth also are a time to bond with and set up a routine for caring for your baby. Your doctor will want to see you for a checkup 2-6 weeks after delivery. This is a good time to discuss any concerns, including birth control.

HOW CAN YOU CARE FOR YOURSELF?

It is easy to get too tired and overwhelmed during the first weeks after childbirth. Take it easy on yourself. Your doctor will tell you how to care for your body as you recover.

• Try to sleep when your baby does.

• Ask another adult to be with you for a few days after delivery.

• Let family and friends bring you meals or do chores.

• Plan for childcare if you have other children.

• Plan small trips to get out of the house. Change can make you feel less tired.

• Drink extra fluids if you are breastfeeding.

HOW DOES POSTPARTUM AFFECT YOUR EMOTIONS?

The first few weeks after your baby is born can be a time of excitement—and of being very tired. You may look at your wondrous little baby and feel happy. But at the same time, you may feel exhausted from a lack of sleep and your new responsibilities.

Many women get the "baby blues" during the first few days after childbirth. The "baby blues" usually peak around the fourth day and then ease up in less than 2 weeks. If you have the blues for more than a few days, or if you have thoughts of hurting yourself or your baby, call your doctor right away. You may have postpartum depression. This needs to be treated. Support groups and counseling can help. Sometimes medicine also can help.

Additional postpartum and newborn care information can be found here:

https://www.healthwise.net/martinspoint/find/search.aspx?searchTerm=Postpartum+Care

RISK FACTORS

Non-controllable risk factors include:

• Being over age 50
• Being female
• Menopause
• Family history of osteoporosis
• Low body weight/being small and thin
• Broken bones or height loss
• Certain medical conditions and medications

Controllable risk factors include:

• Not getting enough calcium and Vitamin D in your diet
• Not eating enough fruits and vegetables
• Having an inactive lifestyle
• Smoking
• Drinking too much alcohol
• Losing too much weight

SYMPTOMS

Osteoporosis often does not have noticeable symptoms in the early stages.

As the condition advances, you may have back pain, a loss of height, reduced grip strength, receding gums, or a bone that breaks more easily than expected.

HOW DOES MY DOCTOR TEST FOR OSTEOPOROSIS?

A bone mineral density (BMD) test is a way to determine if you have osteoporosis. The most common is the DEXA or DXA test which measures how solid the bones are in certain areas of the body.

This test is safe and painless and provides information about your bone health. This test can be performed on different bones throughout your body such as your hips, spine, forearms or heels. Bone density tests are recommended for women 65 and older, if you have broken a bone after the age of 50 or you are between 50-64 years of age and have risk factors.

OSTEOPOROSIS TREATMENT

Although osteoporosis is a chronic condition, it is treatable. The goal of treatment is to keep your bones as strong as possible.

Treatment may consist of changing controllable risk factors and/or taking prescribed medications. The medications your provider may prescribe can either prevent further breakdown of bones or can help stimulate new bone formation. These medications can help reduce the risk of breaking a bone.

Bisphosphonates, for example, alendronate and risendronate, are a kind of osteoporosis medication that is often tried first. These medications should be taken as directed by your provider (once weekly or once monthly, etc.) and have a few important details about how to take them:

• Take the tablet first thing in the morning, before you have any other food, drinks, or medications.

• Take with 8 ounces of water and do not eat or drink anything else for at least 30 minutes or 1 hour after taking.

• Avoid lying down for 30 minutes after taking. It is important to remain upright—so sit or stand after taking the medication.

If you are diagnosed with osteoporosis or get a bone fracture from falling from a standing height, speak with your doctor about what treatment option is best for you.

Some women have no or few menopausal symptoms, while other women have more severe symptoms.

Menopausal symptoms can begin several years in advance of menopause and include:

• Hot flashes (getting warm in the face, neck, or chest)
• Night sweats
• Mood changes
• Irregular periods
• Poor sleep
• Increased belly fat
• Vaginal dryness

Some non-medication approaches that may help ease symptom discomfort include:

HOT FLASHES

• Dress in layers that can be removed when a hot flash begins.

• Avoid spicy foods, caffeine, and alcohol as all of these can worsen symptoms.

• Carry a portable fan with you and keep a small personal fan on your desk. 

• Try meditation and relaxation techniques.

• Try to maintain a healthy weight.

MOOD CHANGES

• Try to sleep at least seven to eight hours a night.

• Stay active.

• Consider joining a community or online support group.

POOR SLEEP

• Avoid drinking alcohol, smoking and eating before bedtime. Drink caffeine only in the morning.

• Limit screen-time before bedtime.

• Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that may cause you stress.

• Get plenty of physical activity but avoid heavy exercise right before bed.

VAGINAL DRYNESS

• There are over-the-counter vaginal moisturizers that can help keep your vagina lubricated.

• Over-the-counter vaginal lubricants that are water-based can help sex be more comfortable.

There are some medications that can be prescribed to address some of the symptoms of menopause, including hormone replacement therapies and nonhormonal medications.

HORMONE THERAPY

Hormone therapy can be either estrogen alone, or estrogen in combination with progestin.  Estrogen medication comes in many forms, such as pills, skin patches, implants, and topically applied gels, creams, or sprays.  Topical hormone therapy applied directly to the vagina can help with vaginal dryness while other formulations can help treat hot flashes, night sweats and vaginal symptoms.

Talk with your provider about your health history and risks of taking hormone therapy.

NON-HORMONE THERAPY

Only one nonhormonal prescription medication is approved to treat hot flashes. It is an antidepressant but used at lower doses than used for depression.

OVER-THE-COUNTER MEDICATIONS

Many over-the-counter (OTC) herbs and supplements that claim to treat menopausal symptoms are available. It is unknown whether herbal or natural products are helpful in treating symptoms, as these products do not go through the same safety and effectiveness studies required of prescription drugs.

Always ask your provider before starting a new supplement as they may interact with your current medications.

Avoid and support bladder control problems by utilizing these strategies:

• Keep a healthy weight—obesity and diabetes can increase the chances of developing UI. 
• Quit smoking.
• Limit alcoholic drinks and caffeine.
• Avoid constipation. 
• Perform pelvic floor muscle exercises. 

One of the least invasive forms of treatment are pelvic floor muscle exercises. Specially trained doctors and/or a physical therapist can help you get the most out of your pelvic floor muscle exercises by helping you strengthen your core muscles.

There are other practices that can be used as part of your treatment such as biofeedback. Biofeedback is a way for a therapist to measure your muscle strength and create an exercise program specific to your needs. Research has shown that women who had pelvic floor muscle training have fewer episodes of urinary leakage per day than those who have not.

Other treatment options can include medications, devices, and surgeries. Speak to your doctor to determine what treatment option is right for you.