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How to stay healthy in your 40s

the most important thing that I want

women entering their 40s to consider is

their general health habits I want women

to go into their 40s at a healthy weight

and so I want them to start developing

the habits of exercise and a good diet

the first thing that I want women to get

is their annual physical exam and during

that exam I’d like for them to get a pap

smear and a pelvic exam it depends on

the woman as to whether you need to get

annual pap smears or you could spread

them out every two to three years if a

woman still has her uterus and her

ovaries then she needs to get a pap

smear every two years but if she’s had a

hysterectomy for any reason she may not

need pap smears depending on the reason

why she had the hysterectomy

I think breast cancer screening is

probably one of the things that is the

most important for women in their 40s

and there’s a lot of confusion over it

my general recommendation is that any

woman coming in for an annual exam

should get a clinical breast exam which

is an exam done by me just to kind of

familiarize a woman with what their

breasts feel like to teach them how to

do one and to make sure there’s no lumps

or masses and then I always recommend a

mammogram for women over 40 now I know

that there have been a few guidelines

that have come out that have suggested

that women in their 40s and 50s may not

need annual mammograms and those have

confused a lot of women I really don’t

agree with those guidelines I agree with

the cancer guidelines which start annual

screening at age 40 because breast

cancer if caught early is curable and

it’s treatable

and you just don’t want to miss one in a

40 year old woman most of my patients

who come in who gained weight they are

concerned that it’s their thyroid it

usually is not the actual guidelines for

thyroid testing started in the 50s but

women are so concerned about thyroid

testing that I do start annual screening

with thyroid and women in their 40s but

the thyroid is generally not the reason

why most women are gaining weight their

forties most of the time it’s their

metabolism is slowing down they’ve

gotten busy they’re not exercising their

diets have kind of gone off kilter and

really getting them back on a healthy

diet and exercise plan is the way to go

to lose weight some women actually are

at higher risk in their 40s of heart

disease when

heart disease actually goes up after

menopause but the 40’s are a great time

to start mitigating those factors that

increase their heart risk such as high

cholesterol hypertension and obesity

so hypertension is one of the most

common conditions that we see in people

and it often does start in women as well

as the men in their 30s and their 40s so

it’s important for me to make sure that

women have blood pressures somewhere

around 120 over 60 and when it climbs up

above 140 over 90 that’s when I start

treatments including medications diet

and exercise part of the general health

swing that I do with my female patients

as a general blood panel and during that

panel I do test their blood sugar

because diabetes risk is starting to

increase in younger women and so even

when their blood sugars aren’t in the

diabetic range I often will counsel them

put them on diets help them lose weight

so that they don’t develop diabetes

later on the current guidelines are to

start cholesterol testing about every 5

years or more often if needed and women

and men over the age of 20 so in the 40s

most of my patients get cholesterol

testing just about every year and what

you’re looking at is a breakdown of the

cholesterol you have a total cholesterol

which is a calculated number so if it’s

high it’s really kind of hard to

determine what that means so I kind of

ignore the total cholesterol and I look

at the fractions there is the

triglycerides which is a blood fat

that’s often related to obesity or

diabetes the goal for that is a number

of less than 250 if you don’t have

diabetes but if you have diabetes you

want it less than 150 the good

cholesterol or the HDL is the kind of

cholesterol that you want it as high as

you can get it because it actually

lowers your risk of heart disease in

women I look for a number above 50 if

it’s below 50 I want them to watch their

diet increase the amount of fish that

they eat in order to lower that number

and then the most important fraction of

cholesterol is the LDL or bad

cholesterol that is the one that is very

closely related to heart disease it’s

related to stroke kidney

and overall cardiovascular death that

number needs to be less than 160 and a

healthy premenopausal woman but if you

have any other risk factors such as

obesity hypertension diabetes you need

that number even lower such as 130 and

some women I need it as low as a hundred

and in some women I even push it as low

as 70 and in those cases you often need

medications what I usually find at

around age 40 is that women need to make

adjustments to their lifestyle what

worked for us in our 20s and our 30s

will not work for us in our 40s and 50s

a lot of times we need to kind of look

at different ways to exercise a lot of

us have kids we have busy lifestyles and

we have to figure out how to integrate

exercise along with raising our children

and our careers I find that women’s

diets change as they get older so it’s

never too late to start healthy I’ve

seen women go from being very unhealthy

to healthy within a year or two and

developing lifestyles that they can

stick with through their 50s