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Quick Health Check for Women Over 40

Marta Saj, M.D.
Obstetrics/Gynecology, Rush Copley Medical Group

Q: I am a woman turning 40 this year. What health concerns, like menopause, do I have to worry about as I enter into mid-life?

A: Many women think they are immortal before their 40th birthday. Then one day it hits you. You're aging.

No matter how young you look or feel, the reality is that every woman entering her 40s or 50s faces a new set of health concerns. In addition to the anxiety women have about entering menopause, they also have an increased risk for a number of chronic diseases including cervical and breast cancer, osteoporosis, heart disease and diabetes.

The good news is that you can take some control of aging. While eating right and exercising are an important part of wellness, getting an annual physical by a general practitioner or gynecologist is essential to maintaining good health. Screenings performed by a physician can help early detection of many health issues.

Screenings that women should have conducted after 40 include the following:

Cancer: Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable. Women should have their first mammogram at age 40, or earlier if there is a family history of breast cancer. This test should be performed annually.

Pap Smear: This test checks cells collected from the cervix for cancer or pre-cancerous changes. Pap smears should be repeated once a year if they're normal, and more often if they are abnormal. Even women who no longer have a uterus benefit from what is known as a vaginal cuff smear because cells lining the area have been known to change. Women who are no longer sexually active are still susceptible to cervical cancer. Talk to your physician about how often you should be screened.

Osteoporosis: Bone Mineral Density Test: Women comprise 80 percent of the population suffering from osteoporosis. They reach their peak bone mass between ages 25 and 30. After this time, bones begin to decline in size and density. During menopause women lose bone mass at a faster rate due to drops in their natural estrogen level. A woman should have a bone mineral density test performed when she reaches menopause.

Heart Disease and Hypertension: Cholesterol levels can indicate your risk for heart disease or a stroke. Cholesterol should be checked at least every five years or per your doctor's recommendation. There are no symptoms associated with having high cholesterol so many people are unaware that their cholesterol levels are too high. Lowering your cholesterol decreases your risk for developing heart disease.

To assess your cholesterol level, a blood test called a lipoprotein profile is performed and evaluates your LDL (low density lipoprotein cholesterol, also called "bad" cholesterol), HDL (high density lipoprotein cholesterol, also called "good" cholesterol), Triglycerides and total cholesterol level.

Blood Pressure Test: Blood pressure should be checked every two years if it is normal and every year if prehypertensive.

Diabetes: Blood Glucose Test: According to the American Diabetes Association, more than nine million women aged 20 years or older have diabetes although nearly one third of them do not know it. Diabetes needs to be closely monitored so it is important to get yourself checked. In this test, glucose levels can indicate whether you have or are at risk for diabetes.

The "M" Word: Menopause is a natural and expected part of a woman's development and does not need to be prevented. However, there are ways to reduce or eliminate some of the symptoms such as hot flashes or vaginal dryness that accompany menopause.

One big concern I hear from women who are pre-menopausal is the decision whether or not to take hormones to relieve these symptoms. There are many steps women can take to reduce symptoms of menopause without taking hormones.

  • Practice slow, deep breathing whenever a hot flash hits you
  • Dress in light fabrics and in layers
  • Avoid caffeine, alcohol and spicy foods
  • Use relaxation techniques like yoga or meditation
  • Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis

There are also some medications available to help with mood swings, hot flashes and other symptoms. As with any medication you take, it is important to discuss these decisions with your physician.

Remember that even though you need to monitor some new health concerns in your 40's, you should celebrate your health at any age.