SMG News

For more information, contact: 908-977-9500 Media Relations

A Lifetime of Women's Health

Last updated: May 15, 2018

A Lifetime of Women's Health:
An overview of the key components of your annual 'checkups'

By: Karen Piwowar MD, Summit Medical Group Family Medicine Team

Most of us remember the regular 'checkup' appointments we got when we were children. However, once we get older, there is a tendency to neglect this type of preventive or health maintenance doctor's visit and only make an effort to see our doctor when we are not feeling well.  


So, what is an adult ‘annual checkup’? And why is it an important part of staying healthy as we age? 

As a primary care physician (PCP) I cannot place enough emphasis on the importance of establishing a good relationship with a PCP that you trust and see regularly.  You and your PCP will use this annual checkup appointment as an extensive review and exploration into your unique risk factors for illness in the context of your personal medical, social, and family history.  The visit also helps your doctor get to know you and witness how your body changes with age, stress, and illness.

Here is a brief overview of important topics that should be addressed by your physician during an annual checkup:

Which health tests are right for you?
Contrary to popular belief, there is no generally prescribed set of "routine" blood tests or other health tests that should be performed every year at your checkup. Certain tests, if ordered inappropriately, can give you a false sense of security or unnecessary alarm.  The appropriate tests for you depend on your age, habits, risk factors, current health condition. That is why it is important to have a PCP who knows you well enough to help make these types of decisions.

Which cancer screenings are right for you?
Our focus as health care providers has been to create ways to detect these cancers early in hopes that the sooner we find them, the better we can treat and potentially even cure patients of these diseases.  Yet, there is no "one-size fits all" recommendation for any health screening tests and not all tests are created equal in terms of accuracy.  This is where a careful examination of your personal and family history will help your doctor determine which screenings should be initiated and when.  Your annual checkup gives you and your PCP the opportunity to discuss the latest guidelines on how and when to start cancer screenings.

Are your vaccines up-to-date?
Vaccination prevents infectious disease like the flu, pneumococcal pneumonia, meningitis, and tetanus. Your PCP will review your history and follow current guidelines to make sure you get any missing vaccines or booster shots as needed.

Here are some common vaccines recommended for women of all ages:

  • An annual flu shot plus tetanus booster every ten years is recommended for all adult women.
  • If you are pregnant or if you’re a caretaker for a newborn, a Tdap shot (a combination vaccine that covers tetanus + diphtheria + pertussis AKA “whooping cough”) is recommended to protect you and your unborn or new baby.
  • Women over the age of 60 may need the Zoster vaccine to reduce risk of shingles
  • And at the age of 65 vaccination to reduce the risk of pneumonia is usually recommended

Monitor your height, weight, & body mass index (BMI):
Your doctor may be able to detect issues with your health based on sudden increases or decreases in your weight, height, and BMI. For example, a significant loss in your height after menopause can be a warning sign for bone conditions such as osteopenia and osteoporosis which can put you at risk for significant fractures if left untreated.  Another important measurement includes your weight and BMI. Sudden, unexpected weight loss can be a red flag for an underlying disease process.  Excessively high BMIs (which are categorized in terms of “overweight”, “obese”, and “morbidly obese”) will put you at risk for a variety of health conditions including diabetes, heart disease, and osteoarthritis of the knees. 

Can vitamins and supplements boost your health?
The best way to get your vital nutrients is from a well-balanced diet rich in all the major food groups (especially fresh vegetables, fruits, legumes, and protein sources from animals or plants). If you follow a restrictive diet for personal, religious or health reasons it may be beneficial to discuss whether there are vitamins and minerals that are missing from your diet. There are also many chronic medical conditions that make it difficult for your body to absorb or properly use certain key nutrients.  If you are taking any supplements or herbal therapies, make sure you discuss the benefits and risks with your PCP.

What type of exercise is right for me?
Maybe you can sense a theme at this point. I strongly believe there is no “one-size fits all” approach to health and medicine. This is very much the case in creating a plan for staying active.  While it is universally accepted that physical activity is important for people at every stage of their life, it is not always feasible to expect everyone to spend hours at the gym or running laps every day to stay healthy. The benefits of regular physical activity include improved mood, increased mental clarity, reduction in the risk of heart attack, blood pressure, cholesterol, the risk of type 2 diabetes and some cancers. It is also proven to build stronger bones, muscles and joints, helping to prevent osteoporosis.


How is your sleep quality and quantity?
Good sleep is one of the most important components of a healthy life for all humans. It comes so naturally to us that we rarely stop to think about just how troublesome things can be if our natural sleep cycle is disrupted.  Insomnia can significantly impact your health and wellbeing. It is often a by-product of other issues such as chronic stress, depression or anxiety.  Another increasingly common sleep related disorders is obstructive sleep apnea (OSA). OSA can go unnoticed and untreated for years before you start to show signs such as high blood pressure, trouble losing weight, and chronic fatigue.  For a quick reference, here is a link from the CDC that gives you an overview of just how many hours you should be sleeping based on your age (

Discuss age-specific concerns:
Aging is the main reason why an annual checkup is not a onetime discussion but an ongoing conversation. Some key areas that change with age are issues of heart, bone, skin, reproductive and sexual health.  The complexities of these issues evolve over the course of a lifespan. Here are just a few examples of unique, age-specific concerns:


The problems that arise in adolescence can have lasting effects on the rest of your life. The key is to identify issues early and start creating healthy habits to promote well-being that will last a lifetime.

  • Nutrition strategies to prevent obesity, type 2 diabetes, and heart disease
  • Screening for risk factors that may affect high school/college athletes
  • Mental health problems, eating disorders and learning disabilities
  • Substance abuse issues
  • Abnormal or painful menstruation
  • In sexually active teens, screening for sexually transmitted infections + family planning/contraception

Early Adulthood (20s-30s):

This age is a common time for developing symptoms of autoimmune diseases, diabetes and other chronic conditions.  Looking closely at your family history and risk factors can identify areas of concern that may require additional testing to detect these diseases early.

  • Preconception counseling - If having children is part of your plan at this stage in life it is important to discuss the unique nutritional needs and health screenings that will prepare you for pregnancy and childbirth.
  • Family planning/contraception
  • Regular pap smears will monitor for signs of HPV infection and abnormal cervical cells which can help detect the early stages of cervical cancer. Starting at age 21, make it a priority to get a pap smear and discuss how often you need to come in to have the pap smear done

Adulthood to middle-age (40s-50s):

Your metabolism slows down with age, presenting a suitable time to re-evaluate your nutrition and exercise routines.

  • For most average-risk women, breast cancer screenings with regular mammograms start at age 40 and colon cancer screenings begin at age 50.

Maturity (50+):

  • Managing menopause - The average age of menopause is 45-55. This change marks the end of your reproductive years. Talk with your physician about ways to manage bothersome symptoms of menopause.
  • Menopause also creates other changes in the body such as decreased bone density and increased risk for heart disease
  • Immunizations for infuenza, zoster, and pneumonia become more important as you reach maturity.

Please remember that annual checkups should be tailored to your unique needs as an individual. Establishing a relationship with a provider that your trust and see regularly will help you both create a comprehensive plan to keep you healthy and happy!

Karen Piwowar, MD is a member of Summit Medical Group's Family Medicine Team. Dr. Piwowar provides primary care for patients of all ages—from pediatrics to adolescents and all the way through every stage of adulthood. She is a strong advocate for adolescent and women's health. She provides patients with family planning strategies, contraception management (including IUD and Nexplanon placement/removal), STI screenings, cervical cancer & breast cancer screenings, as well as issues that affect women at menopause and beyond.

Schedule an appointment with Dr. Piwowar or another experienced provider at our new Women’s Multispecialty Health Center in West Orange.