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training and years of practical experience caring for women patients. It shows
on every page of this excellent book.”
--The Honorable Glenda Hatchett, star of the nationally syndicated television
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Authors' Blog
The Doctor is Human By Dr. Robin Miller
Healthcare has become a maze of insurance companies, regulations and lack of access to providers. Part of what makes it so complicated is all the charting and coding doctors must do. All of this takes away from patient care. Doctors spend more time on their computers than with patients. In my opinion, it has caused […]Read More
Not Just For Kids -- The Surprising Health Issues of Midlife Women
One of the advantages of reaching midlife is that we are finally
finished with all those issues that make childhood and adolescence such
a pain in the neck, such as needing set bedtimes as well as
regular dental and eye checkups; having to worry about using protection
during sex and about cigarette smoking; getting all those shots to
prevent diseases and wearing helmets to prevent sports injuries;
needing to eat all our vegetables and avoid sugar as well as not
missing gym class. What a relief to let these issues fade right along
with our memories of tetherball on the school playground!
Not so fast. Would it surprise you to know that you still have to be
aware of each and every one of the above so-called "child/adolescent"
health issues?
For instance, what about set bedtimes? The obvious reason that we
needed enforced, regular bedtimes each night was so that we would
get enough sleep. Being tired and sleepy the next day in school caused
everything from lousy concentration to crabby moods. Now that we're in
midlife, many of us believe that sleep is no longer an issue. This is
not the case at all. It's still essential to our health and wellbeing.
Recent studies have shown that not only do sleep disturbances often
indicate a serious health problem, but that lack of sleep can actually
cause health problems, such as weight gain. Polls have shown that
nearly two thirds of adults over the age of sixty-five have sleep
complaints, but that less than 15 per cent of them have been formally
diagnosed with a sleep problem. Why? Because we don't mention sleep
problems to our health care providers. Our mothers were right -- we
still need to be concerned about our bedtimes.
Once we've gotten the glasses we need and all our baby teeth are gone,
we no longer need to get regular eye and dental checkups as we did in
our younger years, right? Again -- no. Although our vision does remain
stable from young adulthood until we need bifocals, there are common
eye diseases that begin to occur in midlife, and that can lead to
blindness if not diagnosed. And even though we no longer have our
baby teeth, other dental issues take the forefront upon reaching
midlife, such as gum inflammation which has been shown to be associated
with diabetes and heart disease. So, continued regular dental and eye
checks are as important as in our younger years.
And what about sex at midlife and beyond? We've moved from
groping and being groped in the backseat of the car to more
sophisticated maneuvers in a comfortable bed, and finally, finally no
longer have to worry about pregnancy. So we don't need protection; or
so many of us think. Although it's true that once menopause arrives one
can't get pregnant (warning: make sure you have completed menopause
before assuming this as diagnosing menopause can be tricky),
protection is still needed during sex because of sexually transmitted
infections (STIs). Yes, we can still get those, and in some cases are
even more prone to becoming infected after menopause, even after a
hysterectomy. And even though we're past the childbearing years and our
reproductive organs seem to have no further use, we still need regular
pelvic exams and Pap smears. It is also important at that exam to
discuss with our healthcare providers the need for testing for STIs; if
there is a new partner or the worry that the current partner is not
monogamous, this testing is a must.
STIs are not the only threat held over from our adolescent years; so is
cigarette smoking. Many women in midlife think that there is no reason
to stop smoking cigarettes at this age, since they wrongly assume that
the damage is already done from all the prior years of smoking. This is
not the case. No matter how many years one has smoked, stopping can
prevent further damage to the heart, blood vessels, and lungs, and in
some cases can reverse some of that damage.
Also relevant to the lungs is the fact that asthma can begin in
midlife, where once it was thought to only begin in childhood.
The two major causes seem to be occupational exposure to substances
that damage the lungs, and the recreational exposure to air pollution
by adults who run predominantly outside. So, a new onset of shortness
of breath at this age -- even if it occurs only with exercise -- does
not necessarily mean heart disease; remember that we can develop asthma
now.
Did you think you were finished with all those horrible shots you had
to have in childhood and adolescence? Sorry, you're not. There is a
recommended immunization schedule for adults in midlife and beyond,
just as there are for children. At certain ages over 50 and at certain
intervals, you'll need shots against the flu, certain types of
pneumonia, tetanus, and in some instances, shingles and
hepatitis. Ask your primary care provider about these.
And did you pack away your helmet when you gave away your bike with
training wheels? Probably ok to have done this since now you will need
a bigger size helmet. But you do need a helmet. A recent report by the
U.S. Consumer Product Safety Commission stated that sports-related
injuries in the Baby Boomer population was on the rise, with over 1
million injuries in this age group in 1998 alone, most of the injuries
being due to bicycling and basketball. The same report said that
the many head injuries associated with bicycling were probably due to
the fact that Baby Boomers use helmets less than younger people do.
The fact that exercise and proper nutrition are as important in midlife
and beyond as in childhood may not come as a surprise. Regular exercise
at this age has been shown to increase longevity and wellbeing,
postpone and possibly prevent dementia, strokes, heart disease, and
diabetes, and aid in the treatment of depression. Important to know as
well is that several different types of regular exercise are
recommended at this age, including aerobic (cardio) exercise,
weight-bearing exercise or strength training, and exercises to improve
balance and flexibility.
What we eat as we get older is every bit as important as it was in our
younger years. One particular healthy way of eating, the Mediterranean
diet, has been shown to stave off dementia, prevent heart disease and
diabetes, maintain a healthy cholesterol level, and improve longevity.
One study showed that this diet even improved sexual function in
certain women! This diet is exactly as expected given its name: lots of
natural whole foods, like vegetables, fruits, and nuts, lots of fish
and olive oil, moderate amounts of wine, and limited amounts of foods
containing refined sugar. Controlling the portions of the foods we eat
is even more important at this age. Our metabolic rate decreases with
age, making it easier to gain weight while eating the same amounts of
food as in our younger years.
So, as you are rummaging through your mother's attic looking at your
old dolls, baseball bat and Ouija Board, and breathing a sigh of relief
that you no longer have to worry about being picked for a baseball team
or that your best friend copied your paper doll's dress, don’t
get lulled into complacency about your health. Although you once may
have thought that taking care of yourself health-wise would get
easier as you get older, you know now that that's not true. Make your
appointments for regular checkups, get more than 5 hours of sleep a
night, use protection when having sex, particularly with a new partner,
stop smoking no matter how old you are, get the recommended
immunizations, be careful and wear your helmet and seatbelts, and
exercise regularly and eat well. Your mother’s recommendations
from your childhood continue to apply!
©2008 Janet Horn, M.D.