Having regular health checks throughout life can help keep the doctor away. By Joanna Egan.

Also available in Health Journey 2013 Issue 1.

Even if you're generally fit and healthy, regular visits to the doctor can be worthwhile. Standard check-ups and screening tests can reveal the warning signs of disease, giving you the best chance of receiving timely, potentially life-saving treatment.

"Women should have regular health check-ups from their teenage years until death," says Dr Jane Howard, from Brisbane-based women's health clinic, the Lilian Cooper Centre. While some tests, such as Pap smears and breast exams, should be a part of every woman's health routine, others may only be necessary for those at high risk. Speak to your GP to find out which tests are recommended for you.

General health checks:

Routine check-ups provide an opportunity to discuss diet, level of physical activity and medical history. "I check the height and weight of all my patients at each visit," says Jane. "I also check their blood pressure and every few years, on increasing frequency with age, I do a blood test to check their thyroid function, to assess the health of their liver and kidneys, to check for anaemia and to find out what their cholesterol, B12, folate and vitamin D levels are."

While all women are advised to have their blood pressure and cholesterol checked every few years, if you are overweight, or have a family history of high blood pressure or cholesterol, you should have health checks more often. These conditions are strong risk factors for diabetes and heart disease.

It's a good idea to book a long appointment for a routine check-up and find out in advance about any preparations you may need to make. For some tests, such as cholesterol and blood glucose tests, you will need to fast before having your blood taken.

Skin checks:

"Women should regularly have their skin checked, especially if they've got a family history of skin cancer," says Jane. Most skin cancers are treatable if detected early, however almost 1,900 Australians die from the disease each year. Melanoma (a serious, fast-moving skin cancer) can occur in teenagers, so all women, irrespective of age and background, are encouraged to have their skin checked. In addition to professional checks you should become familiar with your skin markings and keep an eye out for changes that occur to the shape, colour or size of moles and freckles.

Pap smears:

A Pap smear is a simple procedure that can be performed by your doctor, nurse or gynaecologist. It detects changes in your cervix and checks for abnormal cells, which can be the early warning signs of cervical cancer. An instrument called a speculum is inserted into your vagina, allowing your cervix to be clearly seen. A small spatula, or tiny brush, is then used to collect a cell sample that is sent to a laboratory for analysis.

All women who have ever been sexually active should have regular two-yearly Pap tests. This applies even if you've had the cervical cancer vaccine, you no longer have sex, or you've only had one sexual partner. Pap tests should begin either from the time a woman turns 18, or two years after she first has intercourse (whichever is later). "Usually, women can stop having Pap smears at age 69 if they've had two normal smears in the last five years," says Jane.

Sexual health checks:

"Checking for STIs involves a urine test, a blood test or some vaginal swabs," says Jane. Sexual health checks are recommended if you're starting a new sexual relationship; you've had a condom break or come off during sex; you've had unprotected sex (vaginal, oral or anal); you've shared injecting equipment; you think you might have an STI; or if your partner has sex with someone other than you. At your appointment, you can also confidentially discuss your sexuality, and your sexual and reproductive health with your GP.

Breast checks and mammograms:

More than one in nine Australian women will develop breast cancer before they reach the age of 85. Early detection offers you the best chance of recovery. You are encouraged to check your breasts regularly from your teenage years onwards. This will familiarise you with the normal look and feel of your breasts and allow you to get to know the changes that occur with your menstrual cycle. If you notice any unusual lumps or nipple discharge, you should visit your GP immediately.

Women are also advised to have their breasts regularly examined by a health professional. "We do breast checks at the same time that we do Pap smears, so they're two-yearly, starting from the teens," says Jane. The check involves your doctor physically examining your breast tissue to feel for lumps or thickenings. They will send you for an ultrasound or mammogram if they notice anything worrying. "If a woman has a family history of breast cancer then we definitely do breast checks more often," says Jane. If breast cancer runs in your family, speak to your GP to find out how often you should be examined.

Mammograms can detect breast cancers that are too small to be felt by hand. Women over the age of 50 are advised to have a mammogram every two years. During the test, each of your breasts is compressed between two flat plates on an x-ray machine, and an image of your breast tissue is produced. Screening mammography is free for Australian women aged 50–69. Contact BreastScreen Australia on 13 20 50 to find your nearest provider.

Bowel cancer screening:

One in 28 women develops bowel cancer before the age of 75. Your risk significantly increases after the age of 50, which is why all Australians over this age are encouraged to perform a bowel cancer screening test, known as an FOBT (faecal occult blood test). The test assesses whether there is any blood in your bowel motions.

A free FOBT kit is posted to all Australians at the age of 50, 55, 60 and 65, as part of the National Bowel Cancer Screening Program. "The test is very easy to use," says Jane. All you have to do is use the swipe sticks provided to take small samples of two of your bowel motions, and then send the samples away for analysis.

Completing an FOBT every two years can reduce your risk of dying from bowel cancer by up to one third. If you are at increased risk of developing bowel cancer, or if your FOBT results come back positive, your doctor will advise you to have a colonoscopy. This involves inserting a small flexible tube with a camera into your large intestine (your rectum and colon) to look for abnormalities.

Bone density tests:

After menopause, your likelihood of developing osteoporosis increases. Bone density tests are quick and painless, using a low-radiation x-ray to assess your bone strength. Jane recommends that all women have a bone density test done at age 50. Women at risk should be tested earlier. Risk factors include smoking, premature menopause and anorexia. "If your bones aren't very strong, you can start doing something about it, such as taking vitamin D supplements," she says.

Other tests:

Prior to becoming pregnant, women are encouraged to have an immunisations review to check their resistance to diseases such as rubella and whooping cough, which can be harmful to unborn babies. During pregnancy, regular antenatal checks are important.

Diabetes screening, through a blood-glucose test, is recommended for women over the age of 40. It involves a blood sample being taken to measure your blood glucose (sugar) levels. Women who are overweight, have PCOS or high blood pressure, or who have had a heart attack or stroke – are advised to have this test done frequently, and from an earlier age.

All women are encouraged to have annual dental checks. Eating a low-sugar diet, cleaning your teeth regularly and visiting your dentist at least once a year for a check-up and clean reduces your risk of gum disease, tooth decay and tooth loss.

Regular eye examinations are advised for women aged over 40 years. They can be performed by an optometrist or ophthalmologist. Hearing tests are also recommended for women aged 50 and older. These can be performed by an audiologist. Speak to your GP, or call the Health Information Line to find out more.

Last updated: April 2013

© Women’s Health Queensland Wide Inc. This article was written by Joanna Egan and reviewed by the Women’s Health Queensland Wide editorial committee. It was published in Health Journey 2013 Issue 1.