Mid-Life Health Tips for Women
Interview of Angela R. Thomas, M.D.
This is a transcript of the Audio: Mid-Life Health Tips for Women. To listen you may download Windows Media Player 
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Dr. Angela Thomas: My name is Angela Thomas. I am an obstetrician and gynecologist in the East Bay. I specialize in delivering infants and babies. I also specialize in preventative women's healthcare. I've been in the area for approximately seven years. My training is that I went to UC Berkeley, undergrad. I went to Harvard for medical school. I went to Georgetown University in Washington, DC for my residency training and I also spent a little bit of time in the United States Air Force, working within their system, taking care of the healthcare needs of soldiers and other family members.
We're going to talk about, a little bit about women's healthcare in midlife, what women need to do to take ultimate care of themselves and how you can elicit the right kind of care and have the right kind of discussion with your healthcare provider so that you can proactively manage your healthcare needs transitioning into the last half of your life. Women often feel that once they stop having babies and once they stop menstruating that maybe their healthcare needs shift, in the sense that maybe they don't need to go to the gynecologist as often and that's just not true. A lot of risk factors for certain conditions like breast cancer and uterine, ovarian cancer increase with age. Osteoporosis is a big problem in our community and women are not aware that their bone health is important. And not to mention a lot of hormonal changes occur to women during this time in their life and they experience a lot of different issues, hot flashes, difficulty sleeping, some emotional issues that go along with that and actually some sexual issues too; that a lot of times women are afraid to bring up that kind of, this transition period is actually very important for the well-being, their well-being, as well as their family's well-being because these healthcare issues actually affect other members in our families as well.
Screening tests for women in this time in their life are very important. The most well-known or the most obvious screen mechanisms are for breast cancer. Mammography is recommended for women annually after age 50. Between the ages of 40 and 50 it's recommended either annually or every other year.
There's some other tests that people are maybe not as aware of. For instance, bone density screening is very important for women as they transition to this part of their life. A lot of women have risk factors for low bone mass and are just not aware that they have these issues. And certainly what they do at age 50 will impact or decrease the chance of them having that hip fracture when they're 70 and that's very important.
And then there's some other issues too in terms of well-being for this is a time in their life where women are often dealing with teenage children or aging parents and then they're just dealing with their own issues in terms of mortality and their own healthcare issues and oftentimes the hormonal changes that occur during this time: hot flashes, mood swings. Some women develop depression or some issues with some sexual function, interacting with their spouse. It all ties into the family unit in terms of the unit being able to move well during this time in the life cycle of this family. So it's important to address those issues as well.
I have a favorite patient of mine who actually has a couple of reasons for having some abnormal bleeding in midlife and she was having some abnormal bleeding and she said, well, I think it's just I'm going through the change. And I said, yeah, you probably are, but let's just go ahead and do a biopsy. And she was concerned about the potential discomfort associated with the biopsy but it came in anyway and it turns out that she did have an endometrial cancer that was early stage and I believe it saved her life by her being proactive, just for her telling me that she was having these issues and for her not just contributing these issues to going through the change.
Then I've had several patients who have been very proactive in their own self-breast exams and have picked up lumps that turned out to be malignant and that we have been able to address those issues and quite frankly have saved their lives because they were very proactive with their healthcare.
For women in midlife there are often a lot of medical issues that the particular person should address with her primary care provider. Things like hypertension and diabetes are very prevalent and those should be monitored by a healthcare professional. The things that you would discuss with your obstetrician or your gynecologist at this point in life would be certainly the issues of hormone replacement, whether you use it or not and how long and what duration. Certainly issues of bone health, getting bone disease screening and whether you have low bone mass, either osteopenia, which is slightly low bone mass versus osteoporosis, which is severe low bone mass. That needs to be monitored during this time in your life.
Mammography is a large issue. For whatever reason, there seems to be a high prevalence of breast cancer in the Bay Area and certainly getting annual mammography and a clinical self-breast exam by a healthcare provider is very important.
HPV screening, which stands for human papillomavirus screening is something that's becoming more and more on the forefront. And HPV is a virus that's associated with cervical cancer and certainly there's now a way to screen for that particular virus. In your office you should certainly address that with your healthcare provider. And certainly the way we manage you in terms of how often you need to come to the office for a pap smear screening would depend on the results of this exam. The FDA is working on a vaccine for HPV, which can prevent them from having issues with the effects of this virus. So I think that's the healthcare issue that's on the forefront, in terms of women's health currently. Pap smear screening, how frequently, human papillomavirus screening and potentially a vaccine to prevent HPV, which would decrease the risk of cervical cancer.
A take home message is that women should be proactive with their healthcare, certainly have a dialogue with your healthcare provider about what your particular issues are at every stage in your life. And midlife is not a time to stop going to your gynecologist. There is a whole list of things that will impact your health and impact the health of your family that needs to be addressed during that time in your life. That's very important.
(Recording Ends)
- INTERVIEW CONCLUDED -Go to the Women's Health Audio Web Page
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