Q I am a 42-year-old married woman with two young children.

I have been feeling quite listless and tired of late. Although my diet has not changed, I noticed that I have been gaining weight.

I have not been vigilant about exercising or going for regular health screening. In fact, my last check-up was with the gynaecologist, after my second child was born seven years ago.

My mother's sister had breast cancer so I am not certain if that means I would be more susceptible to cancer.

What kind of health screening should I go for? How do I lose excess weight and get back to feeling more energetic?

A Health screening is important as it helps you find out if you have a particular disease or condition, even if you feel perfectly well and do not have any symptoms.

Early detection, treatment and good control of chronic conditions can result in better outcomes and reduce the risk of complications.

You should go for health screening as you are above the age of 40.

You should also do a mammogram screening, a low-dose X-ray examination that can pick up breast cancer.

Regular screening and breast self-examination are important for early detection.

Annual mammogram screening is recommended for women between the ages of 40 and 49. Do this once every two years from the age of 50 onwards.

Breast cancer is the most common cancer among women in Singapore.

All women are at risk and the risk increases with age.

If a second-degree relative (such as your aunt) has breast cancer, the risk increases slightly but it will be lower than those who have a first-degree relative (mother, daughter or sister) with breast cancer.

The good news is that early detection offers a better chance of successful treatment and recovery.

You are also advised to go for pap smear screening as your previous pap smear was done seven years ago.

Pap smear screening is done for early detection of cervical cancer and women are advised to do the screening at least once every three years.

Cervical cancer is highly preventable and curable when detected and treated early.

In Singapore, pap smear screening is recommended for women aged 25 and above who have engaged in sexual intercourse.

Your fatigue and listlessness could be due to a few factors, such as hormonal changes, hypothyroidism or weight gain.

The weight gain could be due to your sedentary lifestyle, hor- monal changes, lower metabolic rate and an unhealthy diet.

We will also have to exclude hypothyroidism, which can be detected through a blood test.

You can maintain a healthy weight by having regular meals and eating a diet low in fats but rich in fruit, vegetables and wholegrain.

Limit your intake of snacks and control the amount of high-sugar food or refined carbohydrates you eat.

Exercise regularly. Start with low-impact exercises, for example, 30 minutes of walking three to five times a week.

Increase the intensity and frequency gradually as you get fitter. You should aim for at least 150 minutes of aerobic exercises per week and strength-training exercises twice a week.

People above the age of 40 should also screen for diabetes, hypertension and hyperlipide- mia (cholesterol).

When you go for the health screening, let your doctor know if you have any concerns or symptoms. This will help him make a better assessment of your health.

Dr Lau Pik Onn

Resident doctor at Thomson Well Women Clinic

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