Women's health needs are often folded into generic screening, when in reality cancer risk, cardiovascular risk and hormone health can all present differently in women. We asked Dr Carolyn Barshall, a leading GP with over 30 years' experience and a special interest in screening, to explain what a women's health assessment at Lumen Harley Street actually involves, from cancer screening to heart health, menopause and mental wellbeing.
We look closely at family history of breast cancer or gynaecological cancers, combined with lifestyle and the results we pick up on the physical checks and the highly detailed gynaecological scans and blood tests. That lets us give good guidance on cancer screening, and we have strong links with excellent screening services nearby if a referral is needed. All women have different histories, so that is why a detailed consultation with time to speak to an experienced doctor is really important.
Ultrasound scanning of the pelvis is very useful for looking at the ovaries to check for ovarian cysts or other concerning changes. We also look at the uterus, specifically the lining of the womb (the endometrium), and check that the thickness is normal. As part of the screening, if a woman is due for a gynaecological examination, we can also do a physical examination and smear test. So we're looking at imaging results and physical findings together, combined with family history and medical history, to build a holistic bigger picture.
Yes - MRI also images the pelvic organs in exquisite detail again without any X-rays, so it is very safe, like ultrasound. It can give higher resolution images of the female pelvic organs, especially including the ovaries, which can be harder to see clearly, so that gives us additional information alongside the ultrasound findings.
We take a full family history and carry out a physical examination, teach self-examination and breast awareness, and can refer for a mammogram and/or breast ultrasound scan depending on age and individual risk factors.
We take a full gynaecological history, and we can perform a smear test if this is due and the client is not menstruating. If a smear test is due, it is best to book the assessment in between periods. The smear test looks for the presence of high-risk HPV subtypes in the first instance, and cells from the cervix can be subsequently examined under the microscope if need be based on these results.
Of course, women can succumb to many other cancers such as skin, lung, colorectal, brain, lymph node, blood and kidney cancers, so all of our check-ups look for any evidence of issues in other parts of the body too. The Lumen assessments are designed to be “broad-brushed” but focused too. All are designed to look for any evidence of cancer, mainly using scanning technology.
Screening needs change across different life stages, and a good assessment should reflect that rather than applying a one-size-fits-all checklist. Family history, lifestyle and where you are with menopause all shape what's actually worth checking.
All of our Lumen health assessments include a detailed female health consultation, check-up and assessment with scanning of the pelvic organs too.
Yes, we have a strong interest in menopause and perimenopause. A lot of women are a bit confused about the difference between the two, so it's a good space to explore that properly. We check serum oestrogen levels as part of the bloods (Lumen 2 and 3), advise on any other checks that should be done, and can advise about HRT if it's appropriate.
That's a good question, and yes - this is something we look at closely at Lumen. Heart disease in women is often overlooked. It can present differently than it does in men, but we're very aware that women carry as high a risk as men after menopause, so our screening is aimed at detecting early changes in the cardiovascular system in women too. This is the case in all of our health assessments, depending on the level. The Lumen 3, for example, includes a full CT coronary angiogram to assess the inside of the heart arteries in detail.
We look at family history and lifestyle, both of which matter a great deal. Genetics and risk factors both play a role. Key risk factors are a family history before 60, increasing age, smoking, blood pressure, cholesterol levels, and alcohol. Combined with cardiac testing - usually an echocardiogram and an exercise test called a stress echo, or even a CT coronary artery angiogram (Lumen 3) - we can build a very good picture of how healthy and fit the heart is. We also review specialised blood results related to lipids and cholesterol, so we can advise accordingly, whether that's lifestyle changes or ongoing checks.
Yes - I see mental health as a very important part of people's overall health. At Lumen, we focus on checking people's wellbeing and lifestyle, which can be incredibly important and easily overlooked if the right questions aren't asked.
It's quite a full day. Usually people will have had baseline blood tests and a body composition assessment before I see them. I meet with them twice for consultations during the day to complete a history and examination, and then at the end of the day we run through most of the blood test results and any imaging results that need to be highlighted. In the middle of the day, I would join the radiologist for a virtual tour of their images if they have had MRI scans, which is the part many ladies find particularly interesting and enlightening.
Although there's a lot involved, the day is spaced well, with time for a break and lunch. Most people end up saying they enjoyed the day more than they expected, and that they felt well looked after - we get very positive feedback. Being able to talk through most of the results on the same day is a real bonus, and as I also sit in with the radiologists when they go through the imaging results, so I know exactly what's been discussed. Overall, it's a much easier process than people expect, and people really appreciate having the time to talk through different aspects of their lifestyle, and sometimes mental health, so we can put the whole picture together.
From cancer screening and heart health to menopause and mental wellbeing, a Lumen assessment is built to look at the full picture in one visit, with time to talk through results properly rather than rushing through a checklist.
Get in touch with our team at Lumen Harley Street to find out which package is right for you.
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