For women: Staying healthy in your 40s, 50s and beyond
Doctors at Advocate South Suburban Hospital respond to common health concerns raised by women in midlife and beyond

Do I really need to do breast self-exams?
Women in their 40s should perform self-exams every month, says Edgar Del Castillo, M.D., an obstetrician/gynecologist at Advocate South Suburban Hospital. “The more women do self-exams,” he says, “the easier it is for them to detect abnormalities, like lumps.”

Self-exams are important for early cancer detection after age 40—when women’s risk of developing breast cancer starts to rise. In addition, women should have a mammogram—an X-ray of breast tissue that can reveal tiny tumors—every one to two years, depending on their doctor’s recommendation.

When reading mammograms, physicians at South Suburban Hospital now use a new tool—a computer-aided detection (CAD) system—that provides an electronic second reading of mammograms to support physicians’ findings.

Can I still build bone mass in my 40s?
Yes, as long as you get plenty of exercise and calcium. “Women in their 40s should get 1,500 milligrams of calcium a day, the equivalent of five 8-ounce glasses of milk, as well as vitamin D to help them absorb calcium,” says Chandra Curry, M.D., an internist at South Suburban Hospital.

Protecting bone mass at this time is critical to help prevent osteoporosis, a disease that thins the bones and can lead to fractures. While osteoporosis typically strikes older women, women in their 40s can be susceptible.

The following factors increase your risk for osteoporosis: small bone structure, high consumption of alcohol or caffeine, smoking, some medications (including anticonvulsant medicines), some diseases (including thyroid diseases), low dietary calcium, lack of exercise, being of Caucasian or Asian descent, and menopause or early menopause.

“If your mother had osteoporosis,” Dr. Curry warns, “chances are you’ll get it too.” Depending on risk factors, Dr. Curry advises women in their 40s to have a DEXA scan, an X-ray that measures bone mineral density. Women who are losing bone mass can take medications to help guard against crippling fractures.

What should I be doing to prevent heart disease?
Everything you can, experts say, from maintaining good nutrition and an ideal weight to exercising regularly, quitting smoking and managing chronic conditions, such as high blood pressure and diabetes.

“Heart disease is the number one killer of American women,” says David Looyenga, M.D., a cardiologist at South Suburban Hospital. “Women in their 40s are losing estrogen, which protects their hearts,” he explains. “While younger women have a much lower risk of heart disease than men, those odds change after age 40.”

To learn their risk for heart disease, women in their 40s should have a heart risk assessment (HRA), a collection of tests that together determines your risk for heart disease. From an HRA, which includes an EKG-monitored exercise test and a complete cholesterol, triglyceride and glucose screening, South Suburban Hospital’s HRA team can develop an individualized health and lifestyle profile that can point to potential problems.

Should I be worried about colon cancer?
Colon cancer is the third-leading cancer killer of women in the United States. After age 50, women run a much higher risk of developing colon polyps, non-cancerous growths that can become malignant. “Colon cancer can develop without early warning signs such as unexplained weight loss or bleeding,” explains Jeffrey Goldman, M.D., a gastroenterologist at South Suburban Hospital. “But if caught in its earliest stages, colon cancer usually can be successfully treated.” That’s why screenings are so important.

A fecal occult blood test can check for early signs of the disease. For additional protection, your doctor may recommend a colonoscopy (which uses a scope to examine the entire colon) every 10 years. “Early screenings with a colonoscopy can break the cycle of polyps growing and turning into cancer,” says Dr. Goldman.

My father had a stroke. Am I at risk?
Unfortunately, the risk for serious medical conditions, such as high blood pressure, high cholesterol, high triglyceride levels, diabetes, sickle cell anemia and protein deficiencies can be inherited. “If you or your parents had any of these conditions and a history of stroke, you’re at high risk,” says Kenneth Holmes, M.D., medical director of neurology at South Suburban Hospital. Families also share environmental risk factors for stroke, such as smoking and being overweight. Because chances of having a stroke increase with age, it’s critical that women with risk factors be assessed.

During a stroke risk assessment (SRA) at South Suburban Hospital, a blood pressure test, cholesterol test, carotid artery ultrasound and EKG rhythm strip test are performed. Afterward, the data is compiled and reviewed by cardiologists and vascular surgeons, then forwarded to the patient’s primary care physician.

Why do my knees crack and feel stiff?
The stiffness and popping sounds are probably due to osteoarthritis, a process of wear and tear over time on your joints. Osteoarthritis is especially prevalent as more women over age 50 stay physically active.

If stiffness turns to pain, however, women should seek treatment. Treatment can include modifying your physical activity or taking pain medications. Patients with severe knee pain can receive joint injections or be treated by the experts at South Suburban Hospital’s pain management clinic.

Source: The National Women’s Health Information Center and Advocate Health Care