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A new report from Harvard Medical School says middle-aged and older women need to worry about particular health concerns - osteoporosis, breast cancer, ovarian cancer and microvascular disease, a type of heart disease more common in women.
The report, A Guide to Women's Health Fifty and Forward, is available for $18 from health.harvard.edu/special_health_reports.
What makes it special is the attention it gives to the small changes women can make to create significant health improvement. Things like replacing animal fats with vegetable oils, which can cut the risk of heart attack almost in half. Four lifestyle changes - stopping smoking, becoming more active, reducing blood pressure and controlling diabetes - greatly reduce the chances of a woman landing in a nursing home.
Dr. Celeste Robb-Nicholson, medical editor of the report, says "one thing I'm learning from my patients is that every woman is unique, not only in her genetic endowment but in her life experiences as well. And each woman ages differently. As a result, your health concerns aren't likely to be the same as they were 30 years ago, nor are they likely to be identical to those of your friends."
Among the most interesting sections in the book is one labeled "managing bothersome problems."
These include persistent menopausal symptoms. And while estrogen was prescribed for decades for these problems, by the late 1990s studies were showing the hormone therapy might actually increase the risk of heart attacks.
Non-hormonal approaches to menopausal symptoms the study suggests include:
- Dressing in layers to easily shed clothes and alleviate hot flashes.
- Sleeping in a cool room to avoid sleep disturbances from hot flashes.
- Using lubricants and moisturizers to relieve dryness and vaginal itching.
- Use prescription antidepressants to relieve depression and hot flashes.
- Regular exercise, such as brisk walking, has been shown to improve memory and help sleep problems in women 50-63 years old.
Of course, the report also includes understanding such health risks as Alzheimer's and stroke. Meanwhile, for all women - even those beyond menopause - the report suggests 10 steps to a longer and healthier life.
They include:
Shun cigarette smoke, separate yourself from smokers. Become a nag and tell anyone you know who smokes to stop.
- Keep moving. The U. S. Department of Health and Human Services suggests every adult get at least 150 minutes of moderate aerobic activity a week. Sessions should be at least 10 minutes long.
- Eat like an Aegean. Follow the Mediterranean diet pattern of mostly plant foods, limiting animal protein to fish and poultry, using olive oil as the principal fat and use wine in moderation.
- Mind your body mass index. Obesity increases the risk of diabetes 20 times and substantially boosts the risk of developing high blood pressure, heart disease, stroke and gallstones.
- Lift a glass, but only one. Alcohol's effects become more insidious as women age because the body's water-to-fat ratio declines over the years.
- Don't run up a sleep debt. Medical evidence suggests we need seven to nine hours of sleep daily, but more than 60 percent of women regularly fall short of that goal.
- Be your own best advocate on health issues.
- Keep connected. Older women who remain socially active live longer and healthier lives than their solitary counterparts.
- Avoid stress. Find techniques to reduce stress and its effects.
- Use supplements selectively. Experts agree the best way to get nutrients is through food. Only calcium and vitamin D, essential in preserving bone density, are recommended supplements. And that includes 1,200 mg of calcium and 1,000 mg of vitamin D.
But what makes this Harvard report special, to my mind, is the notice is pays to usually overlooked midlife health concerns, including wrinkles and hair loss.
As Dr. Robb-Nicholson notes, the report won't tell you how to get the best treatments for serious conditions, but it will help you determine the conditions for which you are at greatest risk and help you avoid them.