For almost all women, their 40s will be the last decade of their menstrual life, which can have significant implications for the health risks they face in the decades to come.
This is also the time when cardiovascular and cancer risks begin to increase. The year of forty is therefore crucial to take stock of one’s health and make the necessary changes to improve it wherever possible, urges Stacey Rosen, cardiologist at Northwell Health, the largest health care network in New York. .
“This is an important time to optimize your blood pressure, your cholesterol, your weight, your activity level, all of that, because frankly, a lot of that becomes more difficult and becomes a challenge once you hit menopause,” Rosen says. “The 40s are a time to really ramp up prevention.”
Exercising and eating a healthy diet also help reduce the risk of cancer when it begins to increase, during midlife for women. Prepare to add two more cancer screenings to your health care routine this decade.
The risk of cancer begins to gradually increase in your 40s. Women should therefore continue cervical cancer screenings every three to five years. They will also begin to be screened for other types of cancer. The US Preventive Task Force (USPSTF), an independent and impartial group that reviews all screening data, recommends that women start getting screened for two of the deadliest cancers for their sex: breast cancer and breast cancer. colorectal cancer.
“About 90% of deaths from colorectal cancer could probably be prevented if we could detect them early and perform a high-quality colonoscopy,” says Rajeev Jain, a gastroenterologist at Texas Digestive Disease Consultants, a professional association for gastrointestinal cancer. enterologists, in Dallas. Colonoscopies are not limited to the search for possible cancer; they also help detect and eliminate polyps that could turn into cancer.
There are other options for screening for colorectal cancer, including: a stool test every year; a fecal DNA-based test, called Cologuard®, every one to three years, although this has a higher false positive rate; and other types of imaging tests every five years.
These options may seem preferable because they are noninvasive, unlike a colonoscopy, which requires preparation before the exam. However, Dr. Rajeev Jain advises his patients to compare the latter with the alternative of chemotherapy and surgery for colorectal cancer. Noninvasive tests can only diagnose existing cancer, whereas a colonoscopy can not only diagnose cancer but also prevent it. “If you want to prevent cancer, you need a high-quality colonoscopy with polyp removal,” he says.
Recommendations regarding the age at which one should have their first mammogram and the frequency of this examination have been corrected numerous times over the years. The main reason for this is that these evolve as results accumulate in order to more clearly define the balance between the advantages and disadvantages of this screening.
Joann Elmore, an internal medicine major at the University of California, Los Angeles campus who specializes in the study of cancer screenings, says it’s important to understand that they have drawbacks in addition to benefits. Besides the discomfort of the procedure itself, there is a risk of false positives. “The test may say you have cancer when you actually don’t [et] lead to a cascade of numerous additional examinations,” she warns.
This is not to discourage women from getting tested, but it is essential that those at average risk do not do so more than necessary and are aware that false positives are common.
“In the case of breast cancer, one in ten mammograms will present an anomaly and the patient will be called back for additional examinations,” continues the specialist. “It’s part of the screening process and you shouldn’t get too upset when it happens. »
One way to reduce the likelihood of false positives is, if possible, to perform a tomosynthesis mammogram because it provides much more information, concludes Joann Elmore.
Although many women continue to get pregnant and give birth well into their 40s, most leave motherhood behind by their 30s. If you’ve managed to keep the same obstetrician-gynecologist for all this time, you’ve hopefully established a strong patient-practitioner relationship with them. This means you can ask it to help you optimize your overall health and prepare you for what comes with perimenopause, the period before menopause when the body gradually produces less estrogen and menstruation begins. to become rarer.
It remains to be hoped that he will also examine you regularly for depression, anxiety, excessive stress and domestic violence.
If you have had children, midlife is also a time to evaluate any problems that may have arisen with the pregnancy, such as: gestational diabetes; preeclampsia or hypertensive disorders; mood disorders, such as postpartum depression; premature birth; or even repeated fetal losses. These can increase your cardiovascular risk, so you’ll need to be more vigilant about your blood sugar, cholesterol levels and blood pressure.
The latter must be checked at least every two years if it remains below 120/80 mmHg, otherwise every year in the event of the development of high blood pressure. Likewise, cholesterol checks should only be carried out every five years, unless the numbers rise above normal, in which case they will need to be more frequent. As for diabetes, for which you should have started screening tests in your thirties, it is advisable to continue them.
According to Jill Rabin, an obstetrician-gynecologist at Northwell Health in New York, some women in their 40s can develop thyroid problems, sometimes revealed by pregnancy. Although no agency officially recommends it, it indicates that it is wise to consider having a blood test to know the levels of TSH, thyroid-stimulating hormone, and free T4, or free thyroxine, thyroid hormone. These help regulate metabolism, as well as other bodily functions, and their levels can be an indicator of whether the thyroid is functioning well or poorly.
If you have symptoms of an overactive or underactive thyroid, ask your doctor whether tests to check your thyroid function or whether to refer you to an endocrinologist is appropriate. Symptoms of an overactive thyroid, or hyperthyroidism, include unexplained weight loss, rapid heartbeat, excessive sweating or difficulty in heat, swelling in the neck, trembling hands, muscle weakness, trouble sleeping and nervousness or irritability. Hypothyroidism, an underactive thyroid, manifests itself as fatigue, weight gain, sensitivity to cold, joint or muscle pain, dry skin, thinning hair, depressive symptoms and slowed heart rate. heartbeat.
Everyone should have an eye exam at age forty and then repeat it based on what it reveals, family history and symptoms.
Continue dental cleanings twice a year, or even more often if you are neglectful when it comes to oral health, such as skipping flossing.
According to April Armstrong, a dermatologist at the University of California, Los Angeles campus, many women begin to notice changes to their skin during midlife, including the appearance of fine lines and expression lines that result. repeated contraction of facial muscles.
“Midlife is the time when we start to notice a loss of elasticity and visible dehydration of the skin. We notice that it is drier and that it is starting to become a little thinner,” she says.
“There is no universal recommendation regarding skin cancer screening in midlife,” specifies the dermatologist. However, she recommends the greatest vigilance for people who have risk factors, such as prolonged exposure to the sun or the use of tanning devices, or who have a family history of melanoma or non-melanoma skin cancers. She encourages women to self-check by following the ABCDE rule to detect any moles or discolorations that may appear suspicious.
Armstrong also recommends that, starting in your 40s, you incorporate a retinol or, ideally, a retinoid into your skincare routine to help reduce the effects of sun damage. As always, though, the most important step in your skincare routine is sun protection, including regular use of sunscreen. Even if your foundation contains sunscreen, it often contains filters that let the rays through, so she recommends applying a regular sunscreen to your skin first, then applying makeup on top.
Finally, it is important not to overlook the possibility of avoiding infectious diseases that can be prevented by timely vaccination. Continue to get vaccinated each year against influenza and COVID-19 to reduce the risk of complications and hospitalization related to these diseases. These vaccines are especially important for women with certain risk factors, such as obesity or high blood pressure. Even middle-aged people without health problems can end up hospitalized following infection with an influenza virus or coronavirus.
Quarantine is also the last opportunity for women to get vaccinated against human papillomavirus (HPV) to reduce the risk of infection with the nine strains responsible for almost all cervical cancers and many cancers of the vulva, vagina, anus and upper aerodigestive tract. Cervical cancer rates have increased among women aged thirty to forty-four, and it is only possible to get the HPV vaccine up to the age of forty-five.
