Erum Ilyas, M.D., a dermatologist in King of Prussia, PA, spends more time taking care of her three children’s teeth in a year than she has her own health … ever. “I schedule my appointments only when I hear a scary story or witness something in my own practice.”
She isn’t alone. In a 2018 survey of 1,000 women ages 30 to 60 by public-relations firm GCI Health, nearly 1 in 3 confessed they didn’t get screened regularly for medical conditions, citing a lack of time. And 89 percent of moms surveyed put their kid’s health needs first.
Before you dismiss reprioritizing, consider this: Checkups and screenings aren’t as frequent as they once were. “Most of the stuff you need is not on a yearly interval,” says Lydia Pace, M.D., associate physician in the Division of General Internal Medicine and Women’s Health at Brigham and Women’s Hospital in Boston and an assistant professor at Harvard Medical School.
Plus, you can base your checkup schedule on your health and family medical history. So read on for the list of checkups you can and can’t put off—and why.
The guideline: Every six months
Only 64 percent of adults have visited a dentist in the past year, according to the American Dental Association (ADA). But going less than twice a year and not addressing cavities quickly could cost you more time and money. Just ask Carrie McKinley, who works in publishing. The Hudson Valley, NY, mom to a 6-year-old hasn’t had a small cavity filled, which costs about $100 and takes 20 minutes. “It’s gotten so bad, it bleeds when I brush it,” she admits. Now she might need a $600-plus root canal, which takes multiple appointments.
And there are many conditions that dentists can spot during a regular exam, including anemia and diabetes, explains Brittany Seymour, D.D.S., an assistant professor at Harvard School of Dental Medicine and spokesperson for the ADA.
Who can put off a visit: Moms with few dental issues, but only your dentist can say for sure.
- Pregnant women and moms who vomited or whose gums bled
- during pregnancy. Bleeding gums should be monitored before developing into gum disease, which has been linked to strokes. And gastric reflux and vomiting can lead to dental erosion;
- Smokers. Tobacco use (even vaping) increases your risk for gum disease as well as oral cancers;
- Junk-food fans. You probably know that sugary treats can decay teeth. What’s less obvious: Saliva counteracts cavity-causing acids, and snacking produces less saliva than eating meals;
- Having a health condition, such as diabetes, which ups your chances of gum disease.
The guideline: Once a year
Many doctors believe a yearly checkup can keep moms on top of vaccinations and screening tests, with schedules dependent on your family history or overall health, especially for cancer. “We’ve all seen patients who were diagnosed late and had worse outcomes,” Dr. Pace says.
Who can put them off for six months: Moms at a healthy weight with no chronic conditions or family history of them.
- Moms with above-normal BMIs. You’re at a higher risk for cancer, cardiovascular disease and diabetes, so you need closer monitoring;
- Moms who had pregnancy complications, such as gestational diabetes and high blood pressure. “They’re markers of increased risk for cardiovascular disease,” Dr. Pace explains. Gestational diabetes also ups your Type 2 diabetes risk;
- Moms who developed a mental-health condition during pregnancy or postpartum. Your physician can suggest ways to feel better;
- Stressed moms. Reactions to stress, such as drinking too much wine, eating sugary, fatty foods, and getting little sleep can lead to cardiovascular disease, says Catherine Witkop, M.D., an Air Force colonel, vice chair for medical education in the Department of Preventive Medicine and Biostatistics, and professor of preventive medicine and obstetrics and gynecology at the Uniformed Services University of the Health Sciences in Bethesda, MD;
- Moms who get fewer than two-and-a-half hours a week of moderate exercise—activity that gets your heart rate to 120 to 130 beats per minute—according to the U.S. Department of Health and Human Services. “But set realistic goals and work from there,” Dr. Pace says. For example, if your daily commute includes some walking, try adding a run a week, she suggests. Work up to a second weekly run.
Cholesterol and Blood-Pressure Screenings
The guidelines: For cholesterol, once in your 20s, then every four to six years from age 45 if you’re not high risk; every two years for blood pressure
High cholesterol could lead to heart disease, while hypertension—blood pressure over 120/80—can damage your cardiovascular system. Your primary-care doctor can check your levels for these.
Who can put off cholesterol screenings for six years: Women with little risk for heart disease.
- Moms with a family history of heart disease or strokes, which can increase your risk for developing the same;
- Moms who had high blood pressure or gestational diabetes during pregnancy;
- Moms with Type 2 diabetes;
- Overweight moms.
The guideline: Every three to five years, along with a Pap test up to age 65
Getting pried apart by a cold speculum used to be a routine feature of yearly gyno visits, but no more. Studies have shown that the exam isn’t effective for screening for ovarian and uterine cancers, says Dr. Witkop. That’s why it’s now up to you and your doctor how often you should have them.
Who can put them off longer than five years: No one (sorry!)
Who might need them more frequently: Moms experiencing pain or symptoms such as itching, discharge or bleeding between periods. These can signal an infection, which pelvic exams can spot.
The guideline: Every three years, usually after age 45
About 30 million Americans have Type 2 diabetes, which most often develops in those over 45, according to the Centers for Disease Control and Prevention.
Who can put them off: Women under age 45 without risk factors.
Who can’t: You’ll be tested sooner than age 45 if you:
- had gestational diabetes;
- are overweight;
- have polycystic ovary syndrome;
- have a parent or sibling with Type 2 diabetes;
- get little to no exercise.
The guideline: Every three to five years, depending on your age and the test you take.
If you’re in a monogamous relationship, you’ve had only female partners or you’ve had the HPV vaccine (which covers some, not all, strains), you should still get screened with a Pap test or with the Pap/HPV screen. “HPV, the virus that causes cervical cancer, can stick with women for years before it shows up as an abnormal Pap,” Dr. Witkop says.
Who can put them off: Women over 30 whose combined Pap/HPV test has come back normal can get screened every five years.
- Women who get a Pap smear instead of the combined test need to go every three years;
- If you’ve had an abnormal HPV/Pap smear, you’ll be screened more frequently too.
The guideline: Usually one to two years, starting between ages 40 and 50
Jennifer J. Bickerton, a mom of three in Rowayton, CT, might let years go by between other appointments but has been diligent about getting a yearly mammogram since she was 35. “My mom had breast cancer. I have a fear of it,” the PR firm owner says.
Who can put them off until 50: Those at low risk for breast cancer, but you also should weigh “early detection’s benefits versus the risks for false positives and unnecessary biopsies.” About half of all women getting regular mammograms will get a false positive over 10 years, says the American Cancer Society.
- Women whose mothers or sisters had breast or ovarian cancer. Like Jennifer, these women might start screening in their mid-30s;
- Overweight women;
- Drinkers and smokers;
- Women who started their period
- before age 12 or had children after 35;
- Moms who didn’t breastfeed.
Colorectal Cancer Screenings
The guidelines: Starting at age 50, get screened every one to 10 years, depending on the test.
The rates of colon cancer have been rising in those under 50—including white women in their 30s and Latinas in their 20s, which is why the American Cancer Society recently recommended everyone start being screened at age 45. But most health organizations aren’t on board with that recommendation yet.
The gold-standard screening test is still the colonoscopy. But the test—which involves drinking a laxative over 24 hours to clean out your bowels before you’re probed with a device that can detect polyps the next day—has challenges. “It’s time-consuming, stressful for some, and someone needs to pick you up afterward,” Dr. Pace says. The alternative: a fecal test, done every one to three years.
Which one is right for you? “A colonoscopy might be the most efficient because if it’s normal, then you’re done for another 10 years,” Dr. Pace says. (But discuss with your provider.) .
Who can start at age 50: Women with average risk for colorectal cancer.
- Women who have pre-cancerous cervical cells; cervical and rectal cancers are linked;
- Women with a history of polyps;
- Women with Crohn’s disease, colitis or IBS, which also increases your risk for colorectal cancer;
- Those with a sibling or parent who has had colon cancer or multiple polyps.
Should Your Gyno Be Your Primary-Care Doc?
It depends, say experts. Ask yourself:
- Do you have any medical conditions? If you had pregnancy complications, physical or mental, or have a chronic condition like asthma or GERD, an internist or family physician might be a better bet, says Lydia Pace, M.D., of Brigham and Women’s Hospital in Boston. Just bring up your pregnancy history with that doctor.
- What’s more convenient for you? If you’re more likely to see your gyno for a yearly well-visit, then as long as she can handle all your screenings, that should be fine, says Dr. Pace.
- What’s the scope of care that your OB-GYN offers? If she doesn’t provide the full range of primary care, such as managing chronic medical conditions or offering all preventive services or immunizations, then she isn’t a good candidate, adds Catherine Witkop, M.D., who helped write ACOG’s well-woman guidelines.
Getting to the Doctor or Dentist on Time
Some tips from moms and other pros:
- Find a family physician who can see you and your kids, preferably back to back.
- Think of medical visits as self-care, say many doctors. The payoff: When you feel better physically, you’ll be more even-keeled emotionally.
- Be honest with your doctor or dentist about your busy schedule so they can work with you. Some offices text or call with reminders or offer online portals to make scheduling easier.
- Use milestones (your child’s birthday, the first day of school) as a date to trigger you to schedule your appointments.
- Get someone to keep you on schedule—your partner or a sibling.
- If all else fails, don’t beat yourself up. Just do better next time.