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Women's Health Q&A with Dr. LoPiano

Answers to your burning questions about women's health.

Jillian LoPiano, M.D.

Medically reviewed by

Jillian LoPiano, M.D.


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1. How can women do more to take care of their health?

I am a big advocate for symptom tracking, which can include anything important to you. It is commonly used for periods, but PMS symptoms, bleeding patterns, birth control and other drug side effects are great ways to have your own body literacy and help communicate to your doctor how you feel and what you may need. I am also an advocate for coming up with a list of questions and concerns in a notebook before any doctor's visit — I even do this as a patient!

2. What health screenings should women get regularly? At what age and at what frequency should women be getting these screenings?

An annual health check-up with a primary care provider is a great way to stay on top of your health, though screening needs are based on age and risk profile. A primary care provider will use your personal history, family history and other risk factors to guide screening. So with that in mind, this is not a comprehensive list, but it gives you an idea of some standard screening guidelines for even low-risk individuals. 

For most low-risk women in the gynecology (GYN) space, an annual exam that includes a breast exam is good. Mammograms, the process of using X-ray images to screen for any irregularities in your breasts, have varying guidelines from different medical professional societies, but most recommend annual checks starting between 40 and 45 years old. A PAP test, a procedure that collects cells from the cervix to screen for cervical cancer, with or without HPV testing, is advised every three to five years for women over 25 years old, depending on past results and history. Sexually transmitted infection (STI) testing is recommended at least once a year for women under 25 as well as those over 25 if risk factors are present. 

Heart health is also important! Cardiac risk screening is recommended by the United States Preventive Services Task Force (USPSTF) every three to five years for adult women, with screening for hypertension after age 18. For low-risk women, hyperlipidemia screening — checking your cholesterol and triglyceride levels — is recommended after age 45. 

Thyroid screening is not routinely advised as it is recommended for individuals based on a wide range of criteria such as family or personal history or use of medications that cause thyroid dysfunction; that said, many people do meet the criteria or have symptoms warranting a screening test. 

Colonoscopy is another screening to keep in mind, which is recommended at age 45 for most low-risk individuals. Additional screenings are also available for women of childbearing age planning for pregnancy, as they are eligible to screen for several inheritable diseases and certain health conditions, like anemia. 

And finally, remember immunizations! Though not screenings per se, these are critical preventative measures in healthcare. We recommend flu and COVID-19 vaccines for almost everyone annually, and various age-related immunizations are also strongly recommended.  

3. How do you think at-home testing has particularly benefited women's health? 

Even before the pandemic, access to preventative healthcare was difficult; the global pandemic compounded this issue and made it more critical for healthcare innovation to expand and increase access. Body literacy and knowledge using evidence-based tools are vital to health maintenance and preventative care.

4. What would you say are some of the most important hormones for women to monitor?

There is no evidence for routine hormone monitoring in women's health nor established normal ranges (outside of specific clinical scenarios) for regularly monitoring hormones such as estrogen and progesterone. That said, clinical signs and symptoms of missed or infrequent periods, heavy periods and more may warrant lab evaluation of some hormones.  

5. When would you typically recommend that someone get their hormones, like their thyroid, tested?

Routine screening for non-pregnant asymptomatic adults with no risk factors is currently not supported by rigorous data. However, some medical societies advocate for screening in women over 50 or 60. Patients with risk factors for thyroid dysfunction, such as family history, individuals with autoimmune disease or those with symptoms of thyroid dysfunction, should be screened.

6. Men have thyroids, too; why is thyroid testing much more common for women?

Certain types of thyroid dysfunction are more common in women, so providers may have their radar higher on women with symptoms related to thyroid dysfunction and test more. This is speculation, but we do know thyroid disease is more common in women, epidemiologically speaking. This is also speculation, but some thyroid tests are part of the investigation done when women have menstrual irregularities, which may skew to increased testing in the female population.

7. Do women and men have different nutritional requirements, particularly regarding vitamins and minerals? 

General recommendations for both men and women include limiting processed and unhealthy fats, sugars and alcohol while increasing fiber-rich, nutrient-dense foods such as fruits, vegetables, grains and legumes. 

Women have a few unique considerations: pre-pregnancy, pregnancy, and menopause. Folic acid supplementation in all women of childbearing age is recommended for preventing neural tube defects. Physicians often recommend iron supplementation for anemia, particularly during early pregnancy, though it is not routinely recommended for every patient. On the menopause spectrum, calcium supplementation may be recommended for women with osteoporosis. Otherwise, there is a wide range of clinical circumstances where screening for other vitamin deficiencies may be needed.

8. How can different stages of women's life impact their metabolic biomarkers?

Good nutrition and regular exercise are essential in every phase of life. One primary stage related to weight and metabolic function is menopause. Vasomotor symptoms, night sweats and poor sleep can contribute to slowing metabolic processes and lack of energy during day hours can indicate a need for good nutrition and exercise. Additional changes can include shifting fat distribution and decreasing lean muscle mass. This is often a troubling phase for women, and they regularly seek clinical advice when it occurs.  

9. How might they adapt to these changes? What aspects of their health should women keep track of?

I always advocate keeping track of menstrual cycles and associated physical and emotional symptoms. This creates body awareness for women and also assists a healthcare provider in focusing on any concerning signs and symptoms that may point to a medical diagnosis. 

10. What imaware tests are focused on women's health?

imaware offers a selection of at-home tests to help you care for your health. imaware's Women's Health & Wellness Test measures various important biomarkers, from vitamin D and ferritin levels to heart health indicators like cholesterol and triglycerides and measuring your thyroid-stimulating hormone. Specific tests, like the Thyroid Screening Test and Baseline Heart Health Test, are also available if you only want to focus on one area.  

Updated on
April 12, 2023
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