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4 Ways to Keep on Top of the Health Game

From a pregnancy pause to menopause – the changes in a woman’s body during this period are as
dynamic as they are vast. Dr. Ayesha Jacub discusses key preventative steps towards ensuring optimal health
and diverting disease

1. Know your breast:

Mammograms and screening
Breast cancer is the most common cancer affecting women who do not smoke. The risk of developing breast cancer can be decreased by:
• Regular exercise
• Maintaining a healthy weight
• Avoiding alcohol
• Carefully considering the benefits and risks of Hormone Replacement Therapy
The UK NHS Breast Screening Programme (i.e. mammography) has been shown to reduce mortality (likelihood of death) from breast cancer*. These results correlate with studies from other countries. Screening allows cancer to be detected earlier, leading to earlier and possibly less radical treatment.




What is mammography?
It is a type of low energy X-Ray used to detect abnormalities in breast tissue such as masses and microcalcifications.



When should I do a mammogram and how often should it be done?
Each country has its own protocol for breast cancer screening and the age at which mammography should be performed.
• In the UK, the NHS cancer screening programme invites women between ages 50 and 70 for screening every three years. They have started extending their programme to women in their late forties and up to 73 years.
• According to the Centers for Disease Control and Prevention (CDC) in the United States, “Most women should have their first mammogram at age 50 and then have another mammogram every two years until age 74.”




Know your breast
A breast self examination is when you check your own breasts for lumps, changes in size or shape of the breast, or any other changes in the breasts or underarm ** . This can be done regularly to know your breast in terms of the regular tissue composition and feel so that you can be more attuned to any abnormality. Although it has not been found to decrease the risk of mortality from breast cancer, it is important as it can assist with early detection of breast concerns.





2. Circumvent cervical cancer:

Pap smears
After breast cancer, cervical cancer is the most common cancer in women under 35. The majority of cervical cancer cases are thought to be caused by HPV (Human Papilloma Virus). Cervical cancer can be prevented by:
• Practicing safe sex with a single partner as the virus which is thought to cause cervical cancer is sexually transmitted
• Cervical screening
• HPV vaccination – available in some countries
• Quitting smoking



What is the screening test for cervical cancer and how is this performed?
A pap smear is the screening test of choice whereby a doctor or nurse inserts an instrument called a speculum to widen the vagina. Cells and mucus from the cervix are collected and sent for laboratory investigations to detect abnormal cells in the cervix.



At what age should I get a pap smear performed and how often does it need to be done?
The NHS recommendation (UK) invites women aged 25-49 for screening every three years, and women aged 50-64 are invited every five years. The CDC recommends getting “regular Pap tests at age 21, or within three years of the first time you have sex – whichever happens first.”




3. Delight in sunlight and consume calcium

Osteoporosis is a disease of low bone mass and bone deterioration which puts a woman at an increased risk for developing fractures. Bone disease often occurs later in life but beginning prevention at a very young age and continuing with these measures throughout adulthood is very important. Strong dense bones require adequate calcium, Vitamin D and sufficient weight bearing.




Weight Bearing Exercise
These exercises allow muscles and bones to work against gravity allowing for bone strengthening. According to the Dietary Guidelines for Americans, adults need to engage in at least 30 minutes of moderate physical activity on most (but preferably all) days of the week.




Vitamin D
• A deficiency here leads to a deficiency in bone mineralisation, eventually leading to osteoporosis.
• It is important for cell growth, immune function, reducinginflammation and neuromuscular function.
• It helps your body to absorb calcium.



Getting enough:
• Found in milk, eggs and oily fish.
• Get enough sunlight as most vitamin D intake is made in the skin through sunlight exposure.
[If you are at risk of not receiving enough vitamin D, consult with your doctor about taking Vitamin D supplements.]




It is a building block for bones; strong bones mean enough calcium!



Getting enough
It is absorbed from food and can be found in the following foods:
nuts, dairy products, dark leafy vegetables and calcium fortified foods.




4. Folate and ferrous for the foetus

A healthy pregnancy yields happy, healthy babies and mums. In readying your body for pregnancy, Dr. Ameera Adam ((Obstetrics and Gynaecology registrar from Cape Town, South Africa) recommends that mums-to-be take folate and iron supplements (ferrous sulphate). Folic acid supplements at the time of conception and in the first trimester reduce the risk of neural tube defects in the baby. Women who are on chronic medication should consult their doctor about whether these drugs will affect foetal development – they may need to be changed or substituted. According to Dr. Adam, “Physiologically, the best age to fallpregnant is around 25 years of age.” She maintains that women wishing to conceive should abstain from smoking and drinking and optimise their health status by exercise and healthy eating.



* Clinical Medicine – Parveen Kumar and Michael Clark
** Centers for Disease Control and Prevention
Ayesha Jacub (MBBCH). Diploma in Child Health (CMSA).


Disclaimer: For specific conditions, aches or pains, you should always seek the advice of a qualified medical professional.





Staying Well This Winter