As if turning the big 4-0 wasn’t hard enough on me, I remember being at my Dr’s office and when she noticed my birth date, she explaimed, “Oh wow! It’s time for some testing.”
Next thing I knew, I was signing myself up for blood tests, mammograms and thyroid checks. Truth be told, once the results were back and I started taking the supplements suggested, it was as though someone turned the lights on! Breezy Mama turned to Dr. Diana Bitner of Spectrum Health Medical Group, Women’s Health Network, to find out common supplements most women need, why forty is a milestone birthday for needing extra testing and more.
Why do some doctors recommend women have their blood checked after 40? What are they looking for?
Routine health check-ups are being challenged by the new guidelines for PAP smears and pelvic exams, however blood work is recommended to screen for common disorders than can be treated, and in doing so reduce the risk of chronic illness. The most common tests are for blood levels of thyroid stimulating hormone (TSH), and cholesterol (total cholesterol, HDL, LDL, and triglycerides). Chronic illness such as diabetes and heart disease can be silent in the early phases; screening tests help alert us to a problem that is best solved early in the process.
Why is 40 such a magical age for stepping up care, such as mammograms, blood test, thyroid testing, etc.?
40 is an age where risk factors start to add up such as inactivity, obesity, age, and family history to a point where there is a likelihood that the tests might start to be positive in that they show an abnormality in someone who otherwise looks healthy. If a woman has increased risk factors earlier, such as high blood pressure, then the blood tests such as blood sugar and cholesterol levels should be checked earlier.
What are some common supplements most women need to start taking after 40?
Most experts agree the most important supplement is Vitamin D. Vitamin D is crucial for bone health and research is showing also an important role in immune function. Perhaps also women with low Vitamin D levels are at higher risk for diabetes. A large clinical trial called the VITAL Trial is underway to help us arrive at the best dosage recommendations. Calcium is also very important for bone health but best to get from diet with dairy products, non-dairy products such as soy or almond milk with calcium added, or with leafy greens. If a woman’s diet has fewer than 4 servings per day, it can be smart to supplement with a low dose but too much calcium (more than 1200 mg per day) can increase the risk of a heart attack in someone with early heart disease and also increase the risk of kidney stones. A multi-vitamin never hurts, and I recommend my patients take a daily multi-vitamin of whatever brand they choose.
When will menopause start and what are the initial symptoms to look for?
When a woman is in “menopause”, it means she has not had a spontaneous period for more than 12 months. The average age for this to occur the US is 52, and most women have menopause start at the same time as it did for their mother. Perimenopause can start as early as 35 and can last for an average of 6 years. Perimenopause is a time marked by irregular periods and inconsistent but predictable symptoms of hot flashes, night sweats, mood changes, low sex drive and sleep disturbances. Many women also complain of weight gain at this time of life. Perimenopause weight gain has many factors, more so caused from poor sleep, increased stress, less frequent and less intense exercise, and a diet dominated by more refined carbohydrates like fast food, bread, cereal, potatoes, and sweets. Women who have diabetes in pregnancy or have obesity as they enter perimenopause are more likely to see increased weight gain in this phase.
For women who are just getting started having kids at this age (or continuing to have more) does your advice change?
At 40, there is a higher chance of having spontaneous twins (without fertility meds), of having a child with Down’s syndrome, and of having a pregnancy complicated by high blood pressure and diabetes. My point is, there are many joys of having a child in later life but it is important to be prepare and talk to your doctor before or as soon as possible when pregnant, and to be in the best health possible before getting pregnant. Of course it is important to be taking folic acid and a prenatal vitamin whatever age a woman chooses to become pregnant. I advise my patients who are pregnant and over 40 to have regular ultrasounds to watch for adequate growth of the baby, and to have regular appointments to check for signs of diabetes and toxemia (pre-eclampsia).
Anything else you’d like to share on changes in women after 40?
Many patients talk about feeling like they start to fall apart after 40. I think about it like life starts to catch up with us if we are not careful. Our younger selves could tolerate less sleep, more calories, more stress, and less stretching and exercise to maintain daily function. Many women who can eat most anything and not gain weight will notice a big change at around 40. The consistent factor is loss of lean body mass, or muscle mass.
The only way to combat big negative health changes is to maintain muscle mass, flexibility, and take care of our body basics. I came up with a checklist for my patients we call the SEEDS™, or “The Seven Essential Elements of Daily Success” which include water (80 net oz. per day), Sleep (50 hours per week, Vitamins (multi- and Vit D), Balanced Diet (Complex carbohydrates, protein and fats), exercise (aerobic, strength training and stretching), fiber, and a daily practice of gratitude and metered breathing or meditation. Women who practice these SEEDS are more likely to feel better and are more prepared for inevitable aging processes such as perimenopause and menopause. I see women every day in the office who prove my point.
ABOUT DR. BITNER:
Dr. Diana Bitner is a board certified in obstetrics and gynecology and has special
interests in women’s wellness and prevention of heart disease, menopause,
perimenopause, libido concerns, metabolic syndrome, pelvic surgery, and
minimally invasive surgery including daVinci robotic surgery. She has been
interviewed for various print publications and was a monthly guest on
Broadminded Radio with a monthly segment called 5 Questions with Dr. Bitner
discussing topics a midlife changes and menopause and she contributes to
Spectrum Health Women’s Health blog