State of IllinoisRod R. Blagojevich, Governor

Department of Public HealthEric E. Whitaker, M.D., M.P.H., Director

Healthy LifestyleQuiz for Women

A Health QuizThe Illinois Department of Public Health, Office ofWomen's Health, has designed this health quiz foryou. While completing the quiz, write down anyquestions that cause you some concern or that you donot understand and discuss them with yourphysician or health care provider. The last section ofthis booklet includes suggestions for talking to yourhealth care provider that may be helpful to reviewbefore you go to your next appointment. You also cancall the toll-free Women's Health-Line at 1-888-522-1282 for information about any women's health issue.

Heart DiseaseQ) What is the leading cause of

death in women?

A. breast cancerB. cardiovascular diseaseC. accidents

A) B. Cardiovascular disease is the leading causeof death in American women. About 500,000women die each year from cardiovasculardisease and, most times, it can be prevented.

Q)What can you do to help loweryour chances of getting heartdisease?

A. Stop smoking.B. Check your blood pressure regularly. C. Lose weight if you are overweight or obese.D. Keep active.

A) All of the above. By changing yourhabits, you can reduce your chances of gettingheart disease. Your health care provider also

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can help by working with you to control certainhealth problems such as diabetes or highcholesterol levels.

Q)What are some heart attackwarning signs?

A. chest discomfortB. pain in the upper bodyC. shortness of breath

A) All of the above. Discomfort canhappen in your arms, back, neck, jaw orstomach. Other signs may include a cold sweat,nausea or light headedness.

Q)How do you know for sure ifyou have high blood pressure?

A. You have night sweats.B. You have your blood pressure checked.C. You have frequent headaches.

A) B. Most people with high blood pressure haveno specific warning signs. The only way toknow is to have your blood pressure checked.People who are overweight are more likely tohave high blood pressure.

Q)True or False? Having your heart"skip a beat" is a sign of heartdisease.

A) False. Many people with normal heartssometimes feel their hearts skipping a beat orbeating faster or slower than normal. However,these events should be discussed with yourhealth care provider.

Breast CancerQ)What is the best way to find out

if you have breast cancer?

A. annual breast exam by a health care providerB. doing a breast self-exam every monthC. getting a mammogram

A) C. Mammograms are the single best way todetect breast cancer in its earliest form--oftenbefore a lump can be felt. However,mammograms are not perfect and some breastcancers can be missed, especially if the breast isnaturally lumpy. Besides having amammogram every one to two years starting atage 40 (or, as often as your health care providerrecommends), women also should have ahealth care provider do an annual breast examand do monthly breast self-exams beginning atage 20. All unusual lumps or changes, even if amammogram shows no problems, should bestudied further.

Q)What breast changes should bebrought to the attention of ahealth care provider?

A. a lump or thickening in or near the breast orunderarm area

B. a change in the size or shape of the breastC. puckering, dimpling or redness of the breast

A) All of the above. A change you see orfeel in your breast does not automatically meanyou have cancer. There are many breastchanges that are normal or non-cancerousconditions. However, all changes should bereported to your health care provider.

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Q)True or False? Having a familyhistory of breast cancer meansyou will get breast cancer?

A) False. Women who have a family history ofbreast cancer are in a higher risk group; mostwomen who have breast cancer have no familyhistory.

Q)You are more likely to get breastcancer if—

A. you have never had a child.B. you have a major injury or bruise to the

breast.C. you are overweight.D. you have a close (first-degree) relative with

breast cancer (mother, sister, daughter).

A) A, C and D. Never having a child orhaving your first child after age 30, obesity anda strong family history all increase one's risk forbreast cancer. An injury to the breast orfondling the breast does not increase risk.Almost 75 percent of breast cancer cases occurin women without any risk factors, so everyoneshould be checked every year.

Q)True or False? Breast canceralways results in death.

A) False. More than two million women livewith breast cancer today. If detected early,women diagnosed with breast cancer have asurvival rate of 96 percent. Early detection alsogives women more treatment options, includingthe possibility of saving the breast.

OsteoporosisQ)You are more likely to get

osteoporosis if—

A. you smoke.B. you are slender.C. your diet is low in calcium.D. you do not exercise.

A) All of the above. In addition, you alsoare more likely to get osteoporosis if you drinklarge amounts of alcohol, start menopauseearly, have relatives who have osteoporosis, ortake medications to treat asthma, seizures,lupus or hypothyroidism.

Q)What is the most commonsymptom associated withosteoporosis?

A. loss of weightB. loss of heightC. loss of physical strength

A) B. Loss of height may be a sign ofosteoporosis. The bones in the back (vertebrae)crack or break as a result of the bone thinningassociated with aging and, as the spineshortens, a person's overall height can bedramatically reduced.

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Q)True or False? Once you haveosteoporosis, there is nothingyou can do except try to preventyourself from falling.

A) False. There are several new drugs on themarket that either help limit further bone lossor help increase bone strength. If you haveosteoporosis, talk to your health care providerabout these new therapies.

Q)What are the best sources ofcalcium in the diet?

A. milk and milk productsB. dark yellow vegetablesC. sardines and salmon with bonesD. whole grains and oats

A) A and C. Milk and milk products, likeyogurt and cheese, and canned salmon andsardines with bones provide higher levels ofcalcium than other foods. Dark green vegetables,like beet and turnip greens, also provide somecalcium as do certain kinds of tofu.

Q)True or False? Physical exercisecan help lower your chances ofgetting osteoporosis.

A) True. Exercises, such as walking, jogging orworking out with weights, have been shown toincrease muscle strength and to maintain bonestrength.

MenopauseQ)What is menopause?

A. the time when your periods stop permanently

B. a normal part of agingC. a slowing of ovarian activity, including

estrogen production

A) All of the above. Although somewomen can start much earlier or many yearslater, the average age of menopause is 51 years.Women who smoke reach menopause aroundtwo years earlier than women who do notsmoke.

Q)True or False? Perimenopause isthe period up to six years ormore before natural menopauseplus one year after menopause.

A) True. During this time, many women willexperience irregular menstruation, includingskipped periods, light periods and very heavyperiods.

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Q)What are the symptoms ofmenopause?

A. hot flashesB. mood swings, short-term memory lossC. urinary problems, such as leaking when

you cough or sneezeD. vaginal dryness, painful sex

A) All of the above. Not all womenexperience all of these symptoms but thesesymptoms generally cause women to seek outmedical advice.

Q)What are the most serious healthconcerns associated withmenopause?

A. osteoporosis (thinning, brittle bones)B. increased risk for heart diseaseC. hot flashes

A) A and B. While hot flashes are one of themore common and visible symptoms ofmenopause, they are not life-threatening.Osteoporosis and heart disease are serioushealth problems and women should discusswith their health care provider what they cando to decrease the risk of these conditions.

Q)What can women do to minimizethe symptoms and healthproblems associated withmenopause?

A. Maintain a well-balanced diet.B. Participate in a good exercise program.C. Take hormone replacement therapy.

A) All of the above. Modifying your diet toinclude more calcium-rich foods and less fatcan help to reduce the more serious healthconcerns associated with menopause. Weight-bearing and aerobic exercise, such as walking,jogging, weight lifting and dancing, each dayfor 30 minutes at a time can help to reduce boththe short- and long-term effects of menopause.Using menopausal hormone therapy for just ashort time is still approved by the U.S. Foodand Drug Administration to control thesymptoms of menopause and to protect womenfrom bone loss that could lead to osteoporosis.However, each woman should discuss thebenefits and risks of hormone therapy with herhealth care provider and also assess herpersonal risk for these conditions.

Mental HealthQ)What is clinical depression?

A. a personality weaknessB. a normal part of agingC. a treatable medical illnessD. an irreversible disease

A) C. Clinical depression is a medical illness. Thelarge majority of cases, including the mostserious, are highly responsive to treatment, yetonly one-third of people with clinical depressionseek treatment. More that 80 percent of peoplewith depression can be successfully treated.

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Q)What are the symptoms ofclinical depression?

A. persistent sadness, anxiety or nervousnessB. sleeping too little or too muchC. reduced appetite and/or weight loss or

gaining weightD. loss of interest in activities once enjoyed,

including sexE. feeling guilty, hopeless, worthless

A) All of the above. In addition to thesesymptoms, other signs of possible clinicaldepression are irritability, persistent physicalsymptoms that do not respond to treatment,difficulty in concentrating, loss of energy andthoughts of suicide. If you experience at leastfive of these symptoms for two weeks or more,you should seek the advice of a health careprovider.

Q)True or false? Men are twice aslikely as women to experiencedepression.

A) False. Studies have shown that women aretwice as likely as men to experience depression.One in seven women will be affected duringher lifetime, but nearly two-thirds will not getthe help they need.

Q)True or False? Psychiatrists arethe only health professionalswho can properly diagnose andtreat mental illnesses.

A) False. Many professionals can treat mentalillnesses, including social workers,psychologists, marriage and family therapists,and pastoral counselors. Treatment may includemedication, psychotherapy or both. However,

only medical doctors, including psychiatrists,can prescribe medication.

Q)True or False? People sufferingsome mental illnesses may sufferfrom substance abuse (abuse ofdrugs or alcohol).

A) True. Persons with mental illnesses, specificallypeople who are not seeing a professional abouttheir condition, may abuse drugs or alcohol inorder to relieve the uncomfortable symptomsassociated with their illnesses. Individualsshould undergo a complete examination by atrained professional to properly diagnose thecauses for the substance abuse so that treatmentscan be developed to help both problems.

Domestic ViolenceQ)What is the most frequent cause

of injury to women?

A. automobile crashesB. partner abuseC. muggingsD. rape

A) B. More women are injured from physicalabuse by a husband or boyfriend than from carcrashes, muggings and rapes combined. Morethan 4,000 women a year are killed by a currentor former partner as a result of domesticviolence.

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Q)True or False? Domestic violenceonly happens in low-income andminority households.

A) False. Domestic violence can happen toanyone, regardless of where they live or theamount of money they have. However, low-income women are more likely to seek helpfrom public agencies and, therefore, are morelikely to be counted in domestic violencestatistics. Women who seek private help oftenare not included in these reports.

Q)True or False? Because everyoneloses their temper at some time,most domestic violence happensonly once.

A) False. Domestic violence usually increasesover time. Statistics show that once a woman isvictimized, her chances of being hurt again arehigh.

Q)Why would a woman stay withan abusive partner?

A. She is afraid; she is at greatest risk of violence when she attempts to leave.

B. She has nowhere to go and little or no resources to help.

C. Due to cultural or religious beliefs, she mayfeel that it is her duty to keep the marriage together at all costs.

D. She wants to keep the family together for the children's sake.

A) All of the above. Many women wantthe violence to end but not the relationship.They may go through many steps or stages asthey try to create a violence-free life forthemselves and their children.

Q)True or False? Children whowitness physical abuse in thehome are more likely to havehealth and behavioral problems.

A) True. Children often directly see the physicalor mental abuse going on in the home or theyindirectly see it by overhearing fights or seeingthe resulting injuries or property damage. Inaddition to various adjustment problems,children also may feel responsible for stoppingthe violence and protecting their mothers, sistersand brothers. They may feel they are to blame forthe violence, or they may come to believe thatviolence is an acceptable way to solve problems.Several studies have shown that boys who seetheir mothers being abused are more likely tobecome abusers in their teen and adult years.

NutritionQ)Eating at least five to nine

servings of fruits and vegetablesevery day as part of a low-fat,high-fiber diet may help lowerthe chances of getting cancer andcardiovascular disease. Whatconstitutes one serving?

A. 1 cup of raw leafy vegetablesB. 3/4 cup of 100 percent fruit juiceC. 1/2 cup raw or cooked vegetables or

cut-up fruit

A) All of the above. Many people arealready eating two to three servings of fruitsand vegetables a day. Getting five to nineservings a day may be easier than you think.

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For example, to add two servings a day, select alow-fat salad for lunch and have an apple for asnack.

Q)Which of the following is a goodsource of fiber?

A. kiwi fruitB. spinachC. strawberriesD. sweet potato

A) All of the above. The American DieteticAssociation recommends that you have 20-35grams of fiber a day; most Americans averageonly 14-15 grams a day. Fiber is found in wholefruits, vegetables, whole grain breads andcereals, dried beans and peas. Foods high infiber contain five or more grams of fiber perserving. Check food labels to help indetermining the amount of dietary fiber in thefoods you select to eat.

Q)Which of the following containsthe least amount of fat?

A. turkey or chicken hot dogsB. a poached salmonC. broiled chicken breasts

A) C. Many government reports recommend thatAmericans obtain no more than 30 percent oftheir calories from dietary fat each day. Broiledchicken breasts, which get about 20 percent oftheir calories from fat. In contrast, turkey orchicken hot dogs get half their calories from fat,and poached salmon gets 35 percent of itscalories from fat. For a lower fat option, trypasta with tomato sauce and steamedvegetables or bake, broil or boil foods to reducethe total amount of fat consumed in your diet.

Q)If you snack, what are your bestchoices?

A. buttered popcornB. air-popped popcornC. dry-roasted peanutsD. turkey and mustard sandwichE. potato chips

A) B and D. High-fat diets are a risk factor forboth heart disease and cancer. Limiting the fatin your diet to no more than 60-65 grams totalper day (30 percent of total dietary intake) isimportant for your good health. One cup ofbuttered popcorn contains about 10 grams offat while air-popped popcorn has less than onegram of fat. A turkey sandwich on whole wheatbread with mustard has about six grams of fat.Potato chips have about 10 grams and dry-roasted peanuts have 12 grams of fat per ounce.Read labels to help determine the fat content ofvarious foods.

Q)After menopause, what is theminimum amount of calcium Ishould have in my diet per day?

A. I don't need calcium; my bones have stopped growing.

B. 500 mgC. 1,200-1,500 mg

A) C. Post-menopausal women need from 1,200-1,500 mg. of calcium. Vitamin D helps the bodyabsorb calcium. Drinking fortified milk, eatingliver or tuna and taking a multivitamin aregood ways to get vitamin D.

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SmokingQ)When do most women start to

smoke?

A. during collegeB. as a teenagerC. under age 12

A) B. Women who smoke usually start asteenagers--before high school graduation. Theyounger a girl starts to smoke, the greater herchances of becoming a heavy smoker as an adult.

Q)True or False? I've smoked formore than half my life. It's toolate for me to quit now.

A) False. Former smokers live longer thanpeople who still smoke. Once you stopsmoking, you decrease your chance of lungcancer, other cancers, heart attack, stroke andchronic lung disease.

Q)What is the leading cause ofcancer deaths among women?

A. breastB. colorectalC. ovarianD. lung

A) D. Lung cancer is the leading cause of deathfrom cancer among women. The chance fromdying of lung cancer is 20 times higher amongwomen who smoke two or more packs ofcigarettes a day than for women who do notsmoke. One out of five women in Americasmokes and women are starting to smoke atyounger ages.

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Q)True or False? Secondhandsmoke is not dangerous.

A) False. Secondhand smoke contains morethan 4,000 chemical compounds. More than 60of these are known or suspected to causecancer. Children of parents who smoke havemore frequent respiratory problems.

Q)In addition to cancer, smokingalso can contribute to which ofthe following?

A. heart diseaseB. strokeC. osteoporosisD. problems during pregnancy

A) All of the above. Smoking can increaseyour risk of heart disease, heart attack, strokeand osteoporosis (thinning and weakening ofyour bones). It can affect your ability to getpregnant. Smoking when pregnant increasesyour chances of premature or early birth and ofhaving a baby with a low birth weight.

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Alcohol And Other DrugsQ)Which of the following are signs

of a possible drinking problem?

A. missing work or school because of ahangover

B. being arrested for drunk drivingC. feeling a need for a drink early in the

morning

A) All of the above. If one or more of thesesigns are true for you, you should consult yourhealth care provider.

Q)True or False? Alcohol affectsmen and women in the same way.

A) False. Though women generally drink lessalcohol, women do not absorb alcohol in thesame way as men do. Women become moreintoxicated than men drinking the sameamount of alcohol because of body size andcomposition. Late-stage complications ofalcoholism, such as liver damage, hypertension,anemia and malnutrition can develop sooner inwomen, even though they may not have beendrinking as much or as long as men.

Q)Finish this sentence: Drinkingduring pregnancy…

A. is dangerous for the baby.B. is no big deal.C. is OK if you have only one drink a day.

A) A. Drinking during pregnancy is dangerous.It's not known how much alcohol can causeproblems. A baby can be born mentallyretarded, or with learning and behavioralproblems that can last a lifetime.

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Q)Which of the following areconsequences of unsafe drinking?

A. Drunk driving is one of the leading causes ofteen death.

B. Drinking makes young women more vulnerable to sexual assault and unsafe, unplanned sex.

C. Girls who begin drinking before age 15 havea greater chance of developing alcohol abuseor alcoholism.

A) All of the above. Drinking is illegal foranyone under 21; however, the reality is thatadolescent girls drink. About 41 percent ofninth-grade girls report drinking in the pastmonth and more than 20 percent of these sameyoung girls report having five or more drinksonce during the previous month.

Q)Older women can experiencealcohol or drug abuse problemsfor which of the followingreasons?

A. They are unable to handle alcohol like they used to.

B. They mix alcohol with prescription drugs.C. They feel lonely or depressed.

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A) All of the above. As women age, theirability to handle alcohol changes, making themmore susceptible to effects of alcohol. The drinkyou barely noticed at age 30 will feel like two orthree drinks when you are 60. Mixing alcoholwith prescriptions or over-the-counter drugs isanother problem among older women.Drinking alcohol while taking other drugs canbe very dangerous or even fatal. Drinkingpatterns may change as women grow older andface certain age-related losses such as retirement,the "empty nest" or the death of a spouse orgood friend. Some women drink more or begindrinking to deal with these stresses.

Physical ActivityQ) Which type of exercise helps your

heart the most?

A. stretching B. aerobic exercise (walking, jogging,

swimming, riding a bike, etc.)C. weight training

A) B. To maintain good heart health, adultsshould engage in moderate-intensity physicalactivities for at least 30 minutes on five or moredays of the week. Research has shown you canget good health benefits from as little as 10-minute intervals three times a day for at leastfive days per week.

Q)Joan weighs 125 pounds: 38pounds (30 percent) is fat. Sallyweighs 140 pounds: 31 pounds(22 percent) of Sally's bodyweight is fat. Both women arethe same height. Which womanis more fit?

A. SallyB. Joan C. Neither is fit.

A) A. Even though she weighs more, Sally's bodycomposition is 22 percent fat while Joan's is 30percent fat. For women, the ideal percentage ofbody fat is 15 to 20 percent.

Q)True or False? The main reasonfor exercise is to stay slim and toimprove how you look.

A) False. There are many reasons to keepphysically active. Exercise reduces the chance ofdying from heart disease, high blood pressure,colon cancer and diabetes. It maintains healthybones, muscles and joints. Physical activityhelps control joint swelling and pain associatedwith arthritis. It reduces anxiety anddepression. Exercise does help control weightand reduce body fat.

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Q)Regular physical exercise is goodfor which of the following?

A. your heartB. your blood pressureC. your bones

A) All of the above. Not only is physicalactivity good for heart, bones and bloodpressure, but women who exercise regularlyhave more energy, less stress, are more relaxedand sleep better. They are also less likely todevelop breast cancer and have lower deathrates from all causes. Thirty minutes ofmoderate physical activity at least five days aweek is a great investment in your future.

Q)True or False? I don't haveenough time in my day toexercise.

A) False. Thirty minutes of exercise on five ormore days of the week is all it takes. There areseveral ways to include exercise into your day.These include taking the stairs instead of theelevator; walking during your breaks at work;leaving the car at home and walking to placesin your neighborhood; walking your dog;parking farther away in the mall parking lot;doing housework at a faster pace; raking leaves;cutting the grass; or doing other yard work.

Tips On How To Talk ToYour Health Care ProviderBefore you go to your health care provider --• Make a list of your questions.• Ask a family member or friend to come with you.

If you have medical tests done --• Ask how and when you will receive your results.• Ask who will be available to answer any

questions and when is the best time to call.

If your health care provider advises you to changeyour diet or lifestyle --• Ask how these changes will help you and what

will happen if you do not make these changes.• Ask him/her to be specific about the changes.

For example, if the health care providerrecommends more exercise, ask what type ofexercises and how often you should do them.

• If your health care provider suggests you loseweight, ask how much.

• Ask if there are support groups or programsthat you should join.

If your health care provider prescribes medicine-- • Ask why the medicine should be taken.• Ask how you should take your medicine:

• With food or without food?• Time of day?• How much and how often?• Can it be taken with other medicines?

• Ask about side-effects. What should you do ifyou have side-effects?

• How long should you take the medicine?• Be sure to bring a list of all medicines you take

and share it with your health care provider.

If you are treated for a condition --• Ask how your progress will be monitored:

• For example, if you take drugs to lower yourblood pressure, ask if you should buy a homeblood pressure kit to monitor yourself.

• Ask if you should make a chart of your progressand when you should report changes to yourhealth care provider.

• Ask when you should see progress and if youdo not, who should you call.

• Ask when you should return to your healthcare provider to be checked. 23

Your HealthPromotion Guide

Your risk for many health problems increases withage. So which checkups should you have, andwhen and how often should you have them? Thisdepends on the status of your health and therecommendations of your health care provider. Thischart can serve as a general guide. In addition to ageneral physical exam every one to two years, thefollowing are recommended:

Recommended Tests How OftenBreast self-exams Once a month, preferably at

the same time each month

Clinical breast exam Annually

Pelvic exam and Once a woman has had three Pap smear consecutive, negative pap

tests within a five-yearperiod, she may get screened every three years.

Mammogram Age 40 and older, every one to two years

Height and weight Annually

Blood pressure Annually, or more often if greater than 140/90

Dental exam Annually

Cholesterol Every one to two years

Eye exam Every two years or as directed(glaucoma screening)

Hearing Annually

Sigmidoscopy Age 50 and over, annually; then every three to five years after two negative tests

Electrocardiogram Baseline and as directed

Bone density As directed by physician

Vaccinations How OftenInfluenza vaccine Annually

Pneumococcal Once, usually aroundimmunization age 65

Resources

American Cancer Society

American Heart Association

American Medical Women's Association

Centers for Disease Control and Prevention

Illinois Coalition Against Domestic Violence

Illinois Department of Public Health

Mental Health Association of Illinois

National Osteoporosis Foundation

Y-ME National Breast Cancer Organization

Illinois Academy of Family Physicians

American Lung Association

Illinois Department of Human Services

U.S. Department of Health and Human Services

University of Illinois at Chicago

U.S. Food and Drug Administration

National Cancer Institute

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Illinois Department of Public HealthOffice of Women’s Health

535 W. Jefferson St. • Springfield, IL 62761217-524-6088 • www.idph.state.il.us

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Questions about women’s health can be directed to

Women’s Health~line888-522-1282

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