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Our series with Dr. Melanie Santos continues with a focus on women in their 40s, and common health issues to discuss with their primary care providers.
Women of this age may begin the perimenopausal phase, which means they are approaching menopause and may have decreased estrogen levels.
Heart disease and breast cancer are significant health concerns for women over 40.
Our women’s health series focuses on conversations women may want to have with their primary care providers about their changing bodies. Last month, we covered heart health questions they can ask their providers. This month, we’re concentrating on women in their 40s, and we will continue to focus on key health issues facing women as they age.
As part of our series, we spoke with Melanie Santos, M.D., FACOG, FPMRS, medical director of pelvic health for St. Jude Medical Center in Fullerton, California. While Santos is a urogynecologist who specializes in treating women with incontinence and other pelvic floor disorders, she is very well acquainted with many of the other health issues women encounter throughout their lives.
How is a woman in her 40s different from a woman in her 30s, health-wise?
Santos: Women experience many changes as they transition to their 40s, especially as they enter the perimenopausal status (the time leading up to menopause). During this time, women’s estrogen levels decline, which can lead to:
- Memory issues
- Decreases in bone density
- Menstrual cycle irregularity
- Vaginal dryness (this is one of the first signs of lower hormone levels)
- Pelvis floor dysfunction
Aside from hormonal changes, women in their 40s can see other changes both mentally and physically that affect their overall health, including:
- Slowing of metabolism
- Decline in muscle mass
- Increased stress with worries about children, parents, health, career, finances
- Periods of depression
- Decreased sex drive, which is affected by both hormonal changes and stress levels
What are women most concerned about health-wise in their 40s?
Santos: As women age in general, their risk of developing disease increases. For women over 40, they can be at increased risk for the following:
- Heart disease
- Breast cancer
- Accidental pregnancy
- Blood clots
What’s great about being a woman in her 40s?
Santos: Women in their 40s tend to be more confident and know what they like, need, and want. They may have less dependence and self-criticism, and more decisiveness that can help them take proactive steps toward improving their health. They can promote good health by:
- Scheduling annual check-ups with their health care provider.
- Sleeping for seven to nine hours every night.
- Exercising regularly – Exercise should include cardio for heart health, weight training for bone health, and adequate stretching.
- Eating healthy foods and drinking plenty of fluids.
- Confronting vices and seeing the benefits of reversing bad habits.
- Meditating is important for the mind and body alike.
What are four topics women in their 40s can discuss with a primary care provider at an annual checkup?
Santos: During an annual checkup, here is a quick reference checklist to keep on hand:
- Weight management
- Signs and symptoms of perimenopause
- Sexually transmitted diseases
- Mental health including depression, anxiety, or stress
What are the most important screenings and checks women should undergo?
Santos: The following are the most important checks for women and general recommendations for frequency:
- Eye exam – every two to four years
- Blood pressure – every two years
- Pelvic examination and PAP smear – every one to three years
- Thyroid – every five years
- Skin mole checks – yearly
- Mammogram – every one to two years
- Blood glucose – every three years, starting at age 45
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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