Wellness & Education

Wellness & Education

Women's Health and Prevention After 40

Most women don’t look forward to turning 40, hoping instead that the milestone will slide quietly by, unnoticed. Whether you fall into this category or not, there are important changes in disease screening recommendations that begin at age 40 that you should take notice of.

The biggest milestone in preventative health for women at age 40 is routine mammography to screen for breast disease. Screening mammography in women age 40 to 49 has been correlated with a 29% decline in mortality. (1) This topic has been a little controversial in the last several years, but the American College of Obstetricians and Gynecologists recommends that women with average risk begin having screening mammograms at age 40. You should discuss your personal risk for breast cancer with your provider and decide whether it makes sense to begin screening for breast disease before age 40.

Women's Health after 40Pap tests to screen for changes in the cervix that may lead to cancer have been an annual staple of a woman’s visit to her gynecologist for decades. Recently revised Pap test guidelines, however, mean you may be able to decrease the frequency of Pap tests based on your history. At age 40 you may be able to go as long as three years between Pap tests, depending on your personal history and risk. Yearly pelvic exams are still an important part of your annual wellness appointment.

There are several screening recommendations that begin at age 45. These include a fasting glucose test to screen for diabetes and a lipid profile assessment to determine cholesterol levels, which are risk factors for heart disease. At age 50, we also recommend beginning thyroid-stimulating hormone testing to screen for thyroid disease. We may recommend earlier screening for any of these diseases depending on a woman’s health history and risk.

Regardless of some of the changes in recommended screening, what remains the same after 40 is the value of a woman’s annual appointment with her OB/GYN. The annual appointment itself is a very important preventative health measure. The physical exam, combined with the detailed health history that your provider obtains at the annual visit, allows us to more accurately determine your risk for certain diseases. This could lead us to recommend that you begin earlier or more frequent screening for certain diseases. For example, colonoscopies are not recommended until age 50, but a woman’s family history of colorectal cancer may lead us to recommend she start screening earlier.

In addition to obtaining a detailed health history, the annual exam also allows us to discuss exercise, diet, nutrition and supplements, as well as depression, all of which are important to maintaining optimal health. We also talk about libido and incontinence, which can have a big impact on quality of life but are not necessarily topics a woman will bring up on her own.

Making an appointment to see your OB/GYN each year can get lost in the shuffle of daily life for many healthy women, especially if your family is complete and you’ve chosen a permanent method of birth control. But the annual OB/GYN appointment may be the only visit a healthy woman has with a health care provider during the year. You take care of your family every day – make sure you take this important step to maintaining your health after 40.

Contact a Women’s Healthcare Associates office to schedule your annual Women’s Wellness Exam >. Women's Wellness Exams are provided by OB/GYN phyisicianscertified nurse midwives and women's healthcare nurse practitioners.

Jennifer Kelly, MD, OB/GYN Tualatin, OregonJennifer Kelly, MD is a board-certified OB/GYN physician and surgeon who sees patients in the Tualatin, Oregon office of Women’s Healthcare Associates. Her clinical specialties include general obstetrics and gynecology with special interest in laparoscopic surgery and adolescent healthcare. When not at work, Dr. Kelly enjoys hiking and outdoor activities with her husband and their young son. She also plays the piano and loves to read.

Sources: (1) Hellquist, B. N., Duffy, S. W., Abdsaleh, S., Björneld, L., Bordás, P., Tabár, L., Viták, B., Zackrisson, S., Nyström, L. and Jonsson, H.: Effectiveness of population-based service screening with mammography for women ages 40 to 49 years. Cancer, n/a. doi: 10.1002/cncr.25650.

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