Checks: what do you need?

The checks they are a fundamental tool of the preventive medicine: detect risk factors and symptoms precocious of some diseases. They also serve so that the specialists give us welfare guidelines. It is not a matter of reviewing every inch of our organs, but rather that the attending physician tells us what tests are convenient for us, taking into account the family history, clinical history, habits and circumstances of each one.

At 20 our body is strong, but we are impulsive and that has its risks. At 40, the body begins to register the passage of time, at 50 menopause arrives … The problems that affect the female health They are different at each age. Therefore, with the help of experts, we review the most recommended checkups in each age range.

At 20

The body functions like a clock, safe from the deterioration caused by the passage of time, and the main risks come from lifestyle and impulsiveness. Therefore, "under normal health conditions, at this stage no large medical tests are required"Says Dr. Mª del Carmen Vericat Queralt, Internal Medicine Sanitas CIMA Hospital, which explains that it is convenient a visit in which to review the toxic habits, family history and a physical examination that includes weight and height control , blood pressure measurement, cardiorespiratory auscultation, electrocardiogram, abdominal and thyroid examination. And a complete blood test with blood count, renal and hepatic function, sugar and lipid profile. The doctor. Manuel Landecho, specialist of the Unit of Checks of the Clinic University of Navarra, adds that it is important to value the emotional health: "It is a period in which important changes are experienced, such as beginning to face adult problems, which have an impact on the state of mind".

Gynecological review. From the first sexual intercourse, or at 21, an annual gynecological examination and the first cytology will be performed. It should be repeated every one or two years, depending on factors such as pregnancy or contraceptive use. A mammography scan and a gynecological ultrasound will be done, to assess especially the ovaries, since cysts may appear. "At this age it is more frequent to present dysmenorrhea (intense pain in the ruler) or disorders, due to the immaturity of the hypothalamic-pituitary axis that governs menstruation. This can cause short cycles and abundant rules, which could trigger anemia; or anovulatory cycles or very sporadic rules. If they are accompanied by acne and hirsutism, we must rule out polycystic ovarian syndrome, "says Dr. Celia Marcos, a gynecologist at Dexeus Mujer, specialized in lower genital tract pathology.

Sexually transmitted diseases. The important thing is prevention: the topic of contraception must be addressed in the consultation. If there is no stable partner, the condom is advised. If there is one, and it is valued to move on to another method, it is advisable to carry out both a blood test where hepatitis B and C, HIV and syphilis are requested. "If you have had risky relationships, it is advisable to perform endocervical cultures to detect sexually transmitted infections such as chlamydia, gonorrhea, ureaplasma and mycoplasma, in addition to a blood test," says Dr. Marcos.

From 30 to 49

In youth, the risks to health come from the lifestyle.

The sedentary, the stress and other habits associated with these (inadequate diet, smoking) may already be rooted in our lives and that favors problems such as cholesterol, hypertension, obesity and diabetes, which in turn predispose to poor cardiovascular health. "Therefore, especially after the age of 40, in the Clinical Inspection Unit of the University of Navarra, we recommend an annual global assessment of health, including life habits, complete analyzes, a chest image test. and abdomen, a gynecological examination and an electrocardiogram, "says Dr. Landecho. After 45, except for specific cases, it is good to do periodic mammograms" It is also advisable to evaluate the thyroid function every four or five years, with the corresponding analysis. If it is altered, an ultrasound of the gland will be performed.

Cardiovascular health. Yes, you have to worry about the cholesterol, the tension and the good progress of our vascular system. "An annual control of the risk factors must be carried out: figures of tension below 140/90, cholesterol lower than 200 mg / dl, blood glucose below 100 mg / dl, do not smoke and exercise they are the basis of cardiovascular health, "says Dr. Carme Oliveras, coordinator of the Check-up Unit at the Universidade Dexeus Hospital.

Diabetes. The 45 years are a frequent age of onset of type 2 diabetes mellitus, which can occur earlier if there is overweight, sedentary lifestyle, family history or gestational diabetes, or problems such as polycystic ovarian syndrome. However, 43% of those who suffer (almost two and a half million people in Spain) do not even know, something that puts them in serious danger. That is why it is convenient to include an analytical test with glycemia and glycosylated hemoglobin.

In the 50s

The hormonal changes of menopause affect the heart and bones.

Checks are especially meaningful, because they detect the cardiovascular and tumor risks. The incidence of breast cancer it increases, above all, between 50 and 65 years old. "It is very important to perform breast examination and mammography, at least biannually. Mammography is used to support mammography in certain circumstances that the doctor will evaluate. It is also necessary to continue carrying out the clinical examination, cytology and gynecological ultrasound"Advises dr. Luciana Bergamaschi, gynecologist of Dexeus Woman specialized in menopause. It is also convenient to start fecal occult blood tests every two years, or to have a colonoscopy every five years, in order to prevent colon cancer. If there is a family history, it must be done at an earlier age. Abdominal ultrasound is also recommended to evaluate liver, pancreas and kidneys.

Densitometry. The hormonal changes of menopause result in greater bone loss in women. Therefore, it is advisable to perform this test that measures the calcium content in the bones and helps to know the risk of fracture. It will be repeated as necessary, although never before two years. "In some circumstances, such as precocious menopause and very low weight or special medications, densitometry controls can be requested before," clarifies dr. Bergamaschi. It is also important to inform women that it is essential for the prevention of osteoporosis "Increase the consumption of calcium in the diet, a good vitamin intake with regulated exposure to sunlight, aerobic exercise at least three days a week and no smoking," advises Dr. Vericat Queralt.

Oral health. At age 50, the immune system is weakened and the mouth is one of the most susceptible points. That is why dental control is recommended once or twice a year, for dental examination and cleaning. "It is important to have a well-linked relationship of dental involvement, such as gingivitis, with cardiovascular disease. Poor gum health is a risk factor, because the germs that cause it can enter the bloodstream and affect cardiac arterial vessels, "says Carme Oliveras.

As of this age, the risk of decay by the recoil of the gums, which reveals part of the roots of the teeth, which are very vulnerable. In addition, the secretion of saliva is reduced and, therefore, its protective function. Another common problem is periodontitis or inflammation of the gums. "It can lead to loss of the tooth and be a source of cardiovascular risk and bad breath. The loss of parts leads to bad mastication, avoiding hard foods (meat) and unbalanced diet in older people, "concludes Dr. Oliveras.

After 60

In addition to the recommendations of the previous stage, specialists underline the importance of physical exercise and the benefits of vaccination, with two major milestones: the anti-flu (annual), and the pneumococcal (one dose, in the conjugate vaccine, or every five years, with the polysaccharide).

Starting at age 60, glaucoma and macular degeneration must be ruled out.

Tumor detection. Early detection of oncological disorders it's crucial. "Women who smoke, or who have quit smoking less than 10 years ago, have an increased risk of lung cancer," says Dr. Vericat Queralt, specialist in Internal Medicine at the Sanitas CIMA- Hospital. There is controversy regarding the benefits of continuing to perform mammograms for women over 75, because some experts do not recommend them. "

Sight and hearing. "From this age, we attend more specifically to the deterioration of these organs, which can increase the isolation and deteriorate the mood," warns Dr. Landecho. As age advances or if there is a family history, an annual eye check should be done to rule out the glaucoma, which can be asymptomatic and cause loss of irreversible vision. It can also be caused by diabetic retinopathy. If you have this disease, you have to do an eye fund every year. And age-related macular degeneration (AMD) and cataracts must be evaluated.

As for the ear, we recommend a annual control of the otolaryngologist, who will perform an otologic examination and an audiometry to detect presbycusis (hearing loss due to age). According to the results, different therapeutic options will be evaluated to avoid problems of social integration, with the consequent isolation and possible depression.

The 4 ages of the heart

one. At 20. There is a small percentage of young people with hereditary cardiovascular problems. Most unexplained sudden deaths at an early age are due to heart diseases of genetic origin. Those under 35 are recommended to have a medical history that includes an examination of the circulatory system and an electrocardiogram. If sports are practiced, it is recommended to perform a stress test and echocardiogram to rule out problems.

two. At 45. The woman begins to undergo hormonal changes and the cholesterol and hypertension controls should be more exhaustives. It is advisable to perform an exercise or ergometry test every two years and a carotid Doppler ultrasound, every four years in premenopause and every two years in postmenopause. A chest x-ray, every two years for nonsmokers and annual for smokers (and at this age it is crucial to quit this habit, which triggers the risks).

3. After 50. After menopause, the protection of estrogen is lost and progressively equals the male in cardiovascular risk. Strict control of risk factors is necessary through laboratory tests (cholesterol, glycemia, triglycerides), complete cardiological examination with stress test and echocardiogram. A TSA EcoDoppler is also recommended to see the state of the vertebral and carotid arteries.

Four. After 60. Result advisable to perform complete analytical, cardiac tests and Doppler echo TSA. From an advanced age, it is also recommended to perform a cranial CT, which will serve as a basic study of neurological type to rule out cerebral vascular pathologies, atrophy or degenerative problems of different kinds. Through a basic mental test, the existence of memory problems will also be assessed.