Mercer's Medical Centre | General Practice & Family Medicine

Mercer's Medical Centre

General Practice & Family Medicine

Q&A Female 40 - 60

You may be interested in our Well Person Check. Please follow this link for more information.

1. Are you a healthy weight?

(70% of adults are overweight but only 38% of them think they are) Here's how to check if you are unsure.

Answer Yes:

If you have checked your Body Mass Index (BMI) and it is between 19-25, well done. (Body Mass Index is a measure of the relationship between your weight and your height.)

We have a tendency to gain weight over time. It is important to be mindful to maintain a healthy weight. A good method is to weigh oneself once a week as part of a health routine. 

It is also important to stay active and exercise regularly. 

Answer No:

It is important to maintain a healthy weight. You can check if your weight is healthy by going to Weigh 2 Live

Obesity is killing 6,000 people in Ireland per year through its direct link to diabetes, heart disease and cancer. If you are overweight or obese you should tackle this now. As we age, we have a tendency to put on weight. It is likely that if you are overweight or obese, then obesity will worsen with time without proper attention. Returning to a healthy weight increases self esteem, physical energy and mental health. 

Here are some useful links relating to diet and exercise: 

Weigh to Live Website: this is an excellent website which allows you to calculate your Body Mass Index, tells you if you are overweight and gives you information on exercise and diet. It helps you set goals and record your progress. It also contains a structured 10week plan for balanced weight loss which prepares you for life long weight maintenance. You can track your food intake and exercise on line or print out a food diary to use at home. 

Some people are drawn to the latest celebrity diet. Here is some information which explains why this can be very unhealthy. 
review of 10 most searched for commercial diets

What can we do at Mercer's?

If you have been following the advice contained in the links above and are having trouble losing weight,  please make an appointment to see us. It is useful if you bring a food diary and exercise diary - you can find one here

We can make suggestions, discuss underlying causes for motivation difficulties and perhaps refer you to a dietician or a psychologist if there is underlying psychological distress. Occasionally, it is worthwhile doing a  blood test to check hormones, particularly thyroid function. Also, if you are obese or overweight, you may be predisposed to other illnesses such as diabetes, high blood pressure and high cholesterol, so it may be worth checking for these. 

Those who are very obese (BMI > 40)  and who have failed other treatments may be candidates for surgery. If your BMI is in this range, we can refer you to the specialist weight management clinics run by consultant endocrinologists, psychologists, dieticians and physiotherapists. 

2. Do you smoke?

Answer: No

Well done. Not smoking is one of the most important things you can do for your health. 

Answer: Yes 

Stopping smoking is the most important thing you will do for your health and long term quality of life. Many people continue to smoke despite knowing that 1 in every 2 smokers will die of a tobacco related disease. Smoking is a challenging habit to stop. However, many people do stop smoking either on their own or with the help of medication and psychological support. 

The national smokers quit line can be contacted on 1850 201 203. They can put you in touch with a one to one counselling service for smoking or a local smoking cessation group. 

The HSE has a very helpful website for those contemplating quitting. It is worth looking at even if you don't feel ready to stop. It has motivational tools to help you find the motivation to stop.
It has information on the benefits of stopping and the risks of continuing.
It has a calculator to help you assess how much you are spending on cigarettes.
It has information on withdrawal symptoms and medications which can help with these.

At Mercer's we can help you with any aspect of smoking cessation. Please make an appointment if you would like to discuss giving up smoking. 

3. Do you know what a standard drink is? 

Answer: Yes 

That’s great. Move on to question 4. 

Answer: No

Most of us don’t know how many standard drinks we consume per week. This is often because different alcohol has different strengths. Below is a helpful explanation. You can also go to the following website and use their calculator. 

A Standard Drink is any drink which contains 10gs of Alcohol. This is equivalent to a half pint of 4.5% strength lager, or 25ml of 40% strength spirits (pub measures in Ireland are 35ml), or 100ml of 10% strength wine. 

  • A bottle of wine is 7-9 Standard Drinks 
  • A can of lager is 2 Standard Drinks 
  • A ‘naggin’ 200mls of spirits is 8 Standard Drinks. 

4. Do you drink more than 11 standard drinks per week?

Answer No: 

That's great. 

Do you consume it in one go? Binge Drinking is defined as drinking more than 3 standard drinks daily. Here is some information on Binge Drinking Patterns.

Note: if you are pregnant you should not drink any alcohol.



Answer: Yes

Alcohol can be positive part of Irish social rituals but also can be a very destructive force in people's lives. It is important to maintain a healthy relationship with alcohol. If your alcohol consumption is at a level that is affecting or threatening to affect your health, your relationships, your work and your family, then your alcohol intake is too high. By drinking more than 17 units of alcohol per week you are putting your health at risk. 

Here and here are some alcohol intake self assessment questionnaires which you may find useful. 

Women over the age of 40 are particularly susceptible to the 'wine epidemic'. This starts with an occasional glass of wine in the evening, escalating over time to a dependency requiring wine every evening. One becomes dependent on wine to sleep and the individual often develops irritability and depression. 

If you are drinking too much, it is important to assess how much damage this is doing and what steps you need to take to change this. Some people will be able to make simple changes to restore balance to their relationship with alcohol and some people will need to abstain from alcohol altogether in order to stop harming themselves. 

The stages of Alcohol Use are described well at this website. Knowing what category of alcohol misuse you fall into can help guide your alcohol reduction plan.

If you are in any doubt as to which group you are in, you should make an appointment to see a doctor or an alcohol specialist. If you are concerned about your alcohol intake, we are happy to help. 

For more general information on Alcohol please go to Drink Aware or Livewell

This website has a directory of services which may Help  those with alcohol difficulties.

Alcoholics Anonymous can be contacted here.

Lifering is often seen as a non religious alternative to AA where a person attends regular meeting to help remain alcohol free.
Note: if you are pregnant you should not drink any alcohol.

5. Do you have problems sleeping or problems with irritability, low mood, worry, appetite, stress or relationships?

Answer: No 

That's great. It is unlikely you are suffering from any mental health problems. 

Answer: Yes

There are many reasons why you could develop the above problems. They can reflect depression and/or anxiety. They could be a reaction to life events or could occur in conjuction with an underlying physical illness. 

If you are suffering from the above you should make an appointment to see a doctor so we can try to pinpoint the cause of what is happening to you. It is sensible to seek extra input and advice during challenging times. 

Here are links to some self assessment questionnaires which can help you assess whether you are suffering from depression or poor wellbeing. Here and here 

If you are suffering from stress and mental health difficulties, the links on this page may be useful 

6. Are you in a monogamous relationship with a person who you are sure does not carry a sexually transmitted infection? If not, and you are sexually active, do you practice safe sex?

'Safe sex' is using a condom or dental dam during all sexual contacts.

Answer: Yes

That's good, please continue to do so.

This will help prevent you contracting sexually transmitting infections. However not all infections are fully preventable by this eg. lice or herpes so if you have any symptoms please attend the practice or the Sexually Transmitted Infections (STI) Clinic at St James.   

Many people decide to stop using barrier protection when they enter a long term stable monogamous relationship following both parties having a negative STI screen. This screen can be done in Mercer’s Medical Centre or in the hospital clinic. 

Answer: No 

Sexually transmitted infections are on the rise in Ireland. People can carry STI without having any symptoms. They may result in long-term health problems such as infertility, ectopic pregnancies and genital cancers. 

It is important to diagnose STIs to treat as soon as possible for the individual and also to prevent spread. 

This diagram below might give you a sense of how many people you have been exposed to sexually. 

This website explains what sexual activities can transmit various illnesses: In the bottom right hand corner of this website there is an STI self assessment check which can help you decide if you may have been exposed to STIs.  

The STI Clinic (GUIDE) at St. James's Hospital Website provides links to many reputable STI sites.  

Where to get checked?  

If you have not noticed anything wrong, and have not been in contact with someone who has an infection, you may be interested in our STI screening programme as detailed below. However, if you have a lump or bump, pain or discharge, then this would not be appropriate and you should make an appointment to see your doctor for assessment. 

At Mercer’s Medical Centre we offer STI screening. It involves 3 consultations: an initial assessment by the doctor or nurse, followed by testing by the nurse and then a follow up appointment with the doctor for results. There is a separate charge for this, payable by all patients. Please see our info sheet and questionnaire here

However we are not a specialist service and we may need to refer you for specialist advice or testing to the St. James's STI Guide Clinic or to a private specialist. You may also choose to avail of screening free of charge at the St. James's Clinic, which is an anonymous service.

 

7. Have you had a cervical smear test in the past 3 years (aged 25-44)?

Answer Yes:  

That’s great. Please attend for a cervical smear when next called by Cervical Check. Shorter smear test intervals may be required if you have had an abnormal smear in the past. 

If unsure, you can check when you are next due by going to Cervical Check.

Answer No:

A cervical smear test aims to catch changes in the cervix (the neck of the womb) before they become cancerous so that they are easily treated. The aim of the test is to prevent cervical cancer. Women aged 25 to 44 are offered and should avail of a free smear test every three years. Women aged 45 to 60 are offered and should avail of a free smear test every five years. 

Please go to Cervical Check to learn more about cervical screening.
What is a smear test 
You can also check whether you are eligible for a free smear test.

 

8. Are you registered with Breast Check and do you attend your mammograms (aged 50-64)?

Answer Yes:

That's great, you should continue to do so.  

It is also very important to regularly self examine your breasts. You should always attend the doctor if there is a change in your breasts, even if you have a recent clear mammogram. 

For advice on how to check your breasts please go to this website.  

Answer No:

Breast Check invites women aged 50-64 every two years for a free mammogram (breast X ray). This aims to pick up the very early stages of breast cancer, which are easily treated. You should avail of this. 

For more information on breast screening click here.

In order to register for Breast Check please go to this website

It is also very important to regularly self examine your breasts. You should always attend the doctor if there is a change in your breasts,  even if you have recently had a clear mammogram. 

For advice on how to check your breasts please go to this link.

9. Have you had a bone health assessment or a bone density scan (post menopausal women)?

Answer Yes:

That’s great. Continue to follow the advice given by the doctor at that time.  

You may find the following links helpful: 
Irish Osteoporosis 
Diet and osteoporosis
Exercise and Osteoporosis  
General osteoporosis overview including information on diet and exercise and possible vitamin d and calcium supplements which are sometimes taken for osteoporosis

Answer No:

All post menopausal women should consider their bone health. Osteoporosis can be a serious condition and in many cases is easily improved with medication and lifestyle changes. 

If you have any of the following risk factors you should definitely get a bone health assessment with your doctor:

  • Previous fracture as an adult 
  • Long term steroid medication
  • Family history of osteoporosis eg. if a family member had a hip fracture
  • If you have a low body weight - less than 58kg
  • If you smoke
  • If you drink more than 14 units of alcohol per week
  • Coeliac Disease 

Some women without these risk factors also choose to get a bone health assessment done.  

More detailed information on people who are at risk of osteoporosis is available here, 

A doctor will perform a frax assessment. Frax is a tool which tells us whether you are at risk of osteoporosis. The doctor can then decide whether you need treatment and/or a bone density scan or your doctor may decide to do a dexa bone density scan directly, depending on your medical and family history.

It is recommended that women over 40 should take on board the following lifestyle measures to prevent osteoporosis in the future:
Diet and osteoporosis
Exercise and Osteoporosis 
General Osteoporosis overview including information on diet and exercise and possible vitamin d and calcium supplements which are sometimes taken for osteoporosis.

 

10. Have you had a blood pressure check?

Answer: Yes 

That’s great. If it was abnormal continue to follow the advice given by the doctor. If it was normal you should continue to monitor your blood pressure. 

Some people suggest checking your blood pressure every 2 years. We recommend you should have a blood pressure check at least every 5 years and more frequently over the age of 40. 

Answer: No 

You should have a blood pressure check at least once between the ages of 18-40. 

Thereafter you should continue to get your blood pressure checked at least every 5 years. 

11. Have you had a cholesterol check?

Answer: Yes

That’s great, continue to follow the advice given to you by the doctor at that time. 

Answer: No

You should get a once off check of your cholesterol between the ages 18-40. 

If you have any of the following risk factors for heart problems, you should get your cholesterol checked at least every 5 years between the ages 18-40: 


- Family history of Heart Disease: that is, if you have a family member who has had a heart attack or stroke when they were 60 years old or younger. 

- If you are overweight or obese

- If you are a smoker

- If you have high blood pressure or diabetes

12. Have you had a diabetes check?

Answer: Yes

That’s good, continue to follow the advice given to you by your doctor at that time. 

Answer: No

Don’t worry, if you do not have any symptoms and if you do not have any risk factors, the guidelines suggest that you do not need diabetes testing until you are over 45 years of age. 

If you are over weight (BMI > 25 - see question 1), have any of the following risk factors, or are unwell, you should have diabetes blood testing: 

  • If you have a family History of Type 2 Diabetes 
  • If you are from an ethnic group which has a high risk of diabetes. This includes most people of Asian or African-Caribbean origin. 
  • If you have an enlarged waist circumference. This is a waist circumference ≥94cm (37 inches).  

 

If unsure you can use this website to help you decide. You can of course also make an appointment to talk to your doctor.

13. Do you look after your teeth?

Answer: Yes

That’s good; please continue to attend your dentist as often as was recommended at your last visit. 

Answer: No

You should attend your dentist at least every 2 years. Some people will need to attend as frequently as every 3 months. The dentist should decide the frequency for which you need to attend when they assess your teeth and your risk of dental problems. 

WHY? 

Regular visits allow your dentist to detect early signs of problems with your teeth and gums while they are still at an easily manageable stage. For example, regular dental visits can lead to early detection of periodontal (gum) disease. This can reduce the risk of permanent damage to your teeth and gums and help prevent costly and painful treatments in the future. Here is a link to NHS information on dental health. 

You may be interested in our Well Person Check. Please follow this link for more information.