Toledo Gynecologist Dr. Croak Interviewed in Ohio Magazine

Health Checklist
Physicians share what screenings women need to get and when.

Your annual physical is an important appointment. It establishes a personal baseline so you and your doctor know where your health stands, and it provides time to discuss concerns or ask questions.

“Unfortunately, if you aren’t going to see your doctor every year, some issues may fall through the cracks,” says Dr. Andrew Croak of the Northwest Ohio Center for Urogynecology and Women’s Health in Perrysburg. The center offers the latest technology in treating women, from minimally invasive laparoscopic and robotic surgery to MonaLisa Touch laser therapy for menopausal concerns.

Dr. Cynthia Kravec, an internal medicine physician at Mercy Health in Youngstown adds that preventive care is ultimately what impacts people’s overall health and well-being. “We can catch diseases earlier,” she says, “and hopefully prolong life and make sure that life is productive and healthy.”

20s: Women up to age 26 can get the human papillomavirus vaccine, a big step in preventing cervical cancers, says Kravec. Blood pressure should be checked every three to five years beginning at 18, and cholesterol checks should begin at 17 to 21. Body mass index is also important. “We are checking people at a very young age for risk factors of diabetes and talking about meeting guidelines for physical activity,” Kravec says.

30s: Cervical cancer screenings and Pap smears are recommended every three years if normal, Kravec says. Bone health is also a focus during this decade. “I counsel all women and men, to some extent, about making sure they get 1,500 milligrams of calcium and 800 to 1,000 [International Units] of vitamin D every day,” Kravec says. Age 35 to 40 is when a woman’s risk of breast cancer increases, adds Croak, so it’s important to talk about family history and to determine when is the best time to get the first mammogram. For most, that is age 40.

40s: The American Cancer Society advocates mammograms beginning at age 40 and every year following. Women should also get their blood pressure checked annually. If cholesterol was normal in a woman’s 20s, it is checked again at age 45 and every five years after, according to Kravec. “We are starting to focus in on diabetes and checking blood sugar,” she adds. “That means a hemoglobin A1C test in anyone over the age of 40, particularly if body mass index exceeds 25.”

50s: Age 50 is when a colonoscopy should be ordered. If the test is normal, women can wait 10 years before the next one. Mammograms continue, as does monitoring bone health, blood pressure, cholesterol, blood sugar and weight. “A big part of preventive care is maximizing your health through lifestyle,” says Dr. Anita Somani, a Comprehensive Women’s Care physician at OhioHealth Riverside Methodist Hospital in Columbus. “Building muscle mass helps with changes in metabolism.”

60+: By age 65 all women should have at least one bone mineral density scan. Also important are the pneumonia and shingles vaccines. Cardiac risk is a primary concern, too. Health screenings continue through a woman’s 60s and into her 70s. “We are doing a better job now of addressing pelvic health,” says Croak, adding that includes sexual, bowel and bladder function. “Urinary leakage affects more than 60 percent of women over age 50.” Lack of pelvic strength can lead to prolapse, a problem for at least 20 percent of women in this age group, says Croak. “If we can screen those women and get them into conservative pelvic floor therapy programs … they may not require significant interventions.”

By Kristen Hampshire