Women are usually busy fulfilling their many roles in life.
They are wives, mothers, professionals, daughters, and friends.
And with their long list of things to do, health gets pushed aside.
What they do not realize, however, is they need to be healthy to be at the top of their game.
PEP.ph (Philippine Entertainment Portal) talks to obstetrician-gynecologist Dr. Maynila Domingo about the routine check-ups women need to do.
PUBERTY, 9-14 YEARS OLD
According to Dr. Maynila, women must start visiting an OB-GYN as early as nine years old.
The primary purpose of this is to protect her from cervical cancer with the HPV (human papillomavirus) vaccine.
Cervical cancer may take 20 years or longer to develop after an HPV infection, so early prevention is key.
She says, "As early as nine to 11 years old, we advise vaccination [against] HPV.
"That age kasi na 9 to 11, wala na yung regular check-up kasi sa pediatrician, di ba.
"You would bring them to the OB or pedia to be vaccinated."
Mayoclinic.com cites the recommendation of the Center for Disease Control and Prevention (CDC) that it's ideal for girls to "receive the vaccine before they have sexual contact and are exposed to HPV," as HPV is a virus acquired through sexual activity. The early protection from the HPV virus can help prevent cervical cancer.
In addition, the HPV vaccine works to prevent vulvar cancer that occurs on the outer surface of a woman's reproductive organ.
"Certain types of HPV have also been linked to cancers in the mouth and throat, so the vaccine likely offers some protection against these cancers, too."
For people under 14 years old, HPV vaccine is given in two shots with an interval of 6 to 12 months from the first injection.
Aside from taking the vaccine, Dr. Maynila also notes that puberty is the stage when girls should expect and observe the physical changes in their bodies.
This includes breast development, growth of body hair, vaginal discharge, increase in height, widening of the hips, and getting your first period.
REPRODUCTIVE AGE, 15-49 YEARS OLD
The reproductive age of women starts on their first menstrual cycle and ends on their menopause. On average, it ranges from 15 to 49 years old.
During this stage, Dr. Maynila advises women to visit their OB-GYN for an annual gynecologic exam.
"Dapat may yearly na gynecologic exam. So ine-examine noong doctor, kinakapa yung tiyan [if] may bukol ba sa tiyan.
"We can do rectal exam for virgins. Kung may sexual contact na, internal exam or pelvic exam.
"Ang reason niyan kasi, yung mga myoma, yung mga bukol sa obaryo."
Mayoclinic.com describes myomas or uterine fibroids as "non-cancerous growths of the uterus (benign tumors) that often appear during childbearing years.
"It is not associated with an increased risk of uterine cancer and almost never develop into cancer.
"[Myomas] range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones.
"In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage and can add weight."
Although myomas are not cancerous, doctors recommend having yourself checked to prevent other complications like infertility, miscarriage, and "pregnancy complications such as placental abruption, fetal growth restriction and preterm delivery."
They can also cause discomfort that can lead to anemia and fatigue.
"Minsan wala iyang symptom until malaki na," says Dr. Maynila.
"Kung yearly ka magche-check-up, maa-address na."
Pap smear or pap test, according to Mayoclinic.com, is a procedure involving "collecting cells from your cervix."
The procedure allows doctors to detect cervical cancer on the onset and provide you with speedy cure.
Dr. Maynila tells PEP.ph that women must take it yearly, contrary to international standards of having it done every three years.
"Twenty-one years old dapat ideally nakakapagpa-pap smear na.
"So the recommendation internationally is to have it done every three years for the conventional type. Pero every five years kung sinasabay mo yung testing for the virus.
"But in the Philippines, our practice is still to check it every year."
This is because the equipment or technology of local laboratories is still yet to be improved compared to those abroad.
She reiterates that only women 21 years old and above should start having themselves tested.
"Kunwari may sexual contact na siya ng 18, hindi pa naman siya ipa-pap smear. Twenty-one and above.
"And then we stop it until depende, kung 65 t'apos normal naman all throughout, puwede naman mag-stop.
"'Tapos kung magpa-plan siya mag-pregnant, may mga supplementation naman."
"Once a woman reaches 40, dapat nagpapa-mammography na except kung may family baseline ng breast cancer," Dr. Maynila recommends.
Mammography, according to Mayoclinic.com, is "X-ray imaging of your breasts designed to detect tumors and other abnormalities.
"Mammography can be used either for screening or for diagnostic purposes in evaluating a breast lump."
Dr. Maynila also states that although it is recommended to start having a mammography at the age of 40, you should undergo the procedure as early as possible if your family has a history of breast cancer.
"Kailangan ma-identify niya yung youngest age na nagka-cancer, then earlier than that age siya dapat magpa-mammogram.
"Kailangan niyang malaman [yung] youngest age not just [of] first-degree relatives.
"Kasi yung breast cancer [and] ovarian, medyo strong yung familial component niya.
"Meaning namamana siya talaga. So if you have more than one family member [na] may cancer or very young nagka-cancer, yung chances na dahil sa genes yun, mataas.
"So it will be prudent for the other family members to screen early."
If you can't have yourself screened, perhaps due to budget or time constraints, you can do a manual self breast check at home instead.
"Ngayon naman, kunwari hindi ka naman nagma-mammogram, monthly sa sarili mo, magse-self breast exam ka. One week after your mens.
"Do not examine it before [your mens] kasi you can really palpate some cyst, and your breast is more tender kapag malapit ka na magkaroon. So monthly yun."
Nationalbreastcancer.org gives a step-by-step guide on how to check your breasts for any lump:
In the shower: Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area.
In front of a mirror: Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead. Look for any changes in the contour, any swelling or dimpling of the skin or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles.
Lying down: Place a pillow under your right shoulder and your right arm behind your head. Move the fingers of your left hand around your right breast gently in small circular motions covering the entire breast area and armpit. Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.
MENOPAUSAL STAGE, 50 YEARS OLD AND ABOVE
Having yourself checked regularly should not stop when you reach your senior years.
In fact, you should do twice the work in taking care of your health as it is when your body begins to be more susceptible to diseases and illnesses.
Dr. Maya advises women to continue doing manual breast checks at home and taking a trip to your OB-GYN's clinic regularly.
"Kung menopause naman na, every start of the month, magka-kapa siya 'tapos yearly pupunta siya sa doctor para yung doctor ang kakapa.
"Meron pa rin silang pap smear, may baseline electrocardiogram (ECG), lipid profile or checking of the cholesterol level, sugar level kasi iyan yung makikita natin kapag menopause na."