Dear Jacqui:
I am 55 years and going through menopause. I?m on ERT (estrogen replacement therapy) and notice some changes in my body. What tests should I have on a routine basis to protect my health?
Katy

Dear Katy:
The recommended test for women over fifty are the following:

1) Yearly mammograms or sonograms are a must.
Dr. Robert Bard, a leading expert in sonography prefers sonograms because they are non invasive (no radiation), the patient gets the answer immediately, the results are more accurate than mammography especially in fibrocystic areas of the breast.

In many cases sonogram can avoid the need for Women on hormone treatment can avoid painful exploratory biopsies) because they more clearly demonstrate benign changes as well as tumor sites. Ask your physician to request a sonogram if you have "lumpy" breasts or are on hormone therapy.

(For a recommendation call Dr. Bard directly at 212 355-7017.) Whichever procedure you chose, be sure to save your test results and films from year to year. If you move, have them transferred to your new physician so he has a basis of comparison. It?s always a good idea to do a monthly breast examination yourself. Early detection is the best protection.

2) Yearly PAP smears for cervical cancer done by your gynecologist or GP.
At the same time you should have an internal pelvic examination. Generally you will receive test results within one week?s time.

3) Post menopausal women who are not on hormone replacement therapy should include a bone densitometry test to screen for osteoporosis.

4) Women on ERT should note the date they start with hormone replacement therapy.
After five years of estrogen/progesterone therapy the risk of breast cancer increases by 8% every year according to the latest and largest government sponsored study.

5) In postmenopausal women hyperthyroidism may occur at this time in their lives.
A blood test to assess thyroid function is advisable, especially if you experience symptoms of sensitivity to cold temperatures (frequently cold hands or feet), weight gain or fatigue.

6) If your libido is low ( loss of sexual drive) or your physician recommends hormone replacement therapy it is important to test your various hormone functions first before starting the treatment. Hormones are powerful drugs. They present benefits as well as risks and should not be taken indiscriminately.

Jacqui

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