Your “Not-So-‘Well’-Woman-Exam” at every decade: 50’s, 60’s, & 70’s
PART 3:
50’s
Happy 50th birthday! It’s time for your colonoscopy!
You may have worked hard to keep your colon healthy by eating a diet rich in fruits and vegetables and low in red and processed meats…if so, congratulations! Regardless of your diet, it is time for your very first colonoscopy.
Colon cancer screening starts at age 50, but only once every 10 years afterwards if the results were normal….whew! Otherwise, specific recommendations for future screenings will be made by the gastroenterologist who performed the exam. Don’t ever assume everything was normal….always follow up!
Menopausal women with symptoms like hot flashes, night sweats, insomnia, and mood swings should have a discussion with their gynecologist about hormone replacement therapy and the specific risks/benefits associated with them.
Hormone therapy has had mixed reviews in the past and the media doesn’t help. The bottom line is that this is a decision that needs to be made on an individual basis between you and your gynecologist. For most healthy women in their late 40’s and early 50’s, who do not have a history of breast cancer, coronary heart disease, previous blood clot, stroke, or active liver disease, hormone therapy is safe. Many woman suffer from severe symptoms and taking hormone therapy can make them feel human again. See your doctor if you know what I mean!
The only diapers you should be buying are for the grandkids! Leakage of urine or urinary frequency can often be an embarrassing topic for women to bring up with their doctor. But, there are some proven and safe procedures that can alleviate your symptoms. Don’t let your pride keep you from having a simple and honest conversation with your gynecologist about either medication or a sling procedure that can keep you dry and confident.
This is also the time to start up those kegel exercises again. You know…tightening those muscles you forget you had in your vagina…yeah those! Strengthening the vaginal musculature along with your core muscles will help prevent internal organs like your bladder, rectum, and uterus from herniating out into the vaginal space….No one likes the thought of that so start tightening!
60’s
So, you are hopefully over the menopausal honeymoon, and have settled into the new and improved you! Your 60’s are a culmination of how you have lived your life up to this point. It is not too late to rid yourself of bad habits such as smoking, drinking, and a poor diet. Any positive change now can still make a big difference in the decades to come.
It’s time to see if you have been taking that calcium and vitamin D we recommended back in your 40’s for bone health. A bone scan for osteoporosis should occur at the age of 65 unless you are high-risk or have undergone menopause much earlier than normal.
Vaginal dryness after menopause can cause painful intercourse, a paper thin and sensitive vagina, more frequent urinary tract infections, and yeast infections. Your doctor may recommend vaginal estrogen if this is appropriate for you.
If you have experienced post-menopausal bleeding this can be a warning sign for endometrial cancer and your visit will include an endometrial biopsy.
The median age for ovarian cancer is 63, however 25% can be diagnosed between 35-50 years of age. If you have signs of bloating, abdominal or pelvic pain, leg swelling, or a palpable mass on your bimanual (physical) exam, an ultrasound will be ordered during your visit to evaluate your ovaries for any masses.
Over half of all women in their 60’s will develop hypertension. That is a pretty striking statistic. So, this is the time to continue that healthy diet and exercise you started in your 40- 50’s and cut out the sodium in your diet. Make sure you are getting your cholesterol checked routinely.
Including exercise like yoga into your daily routine is a smart move. One of its most studied health benefits is the effects on the heart. Yoga has long been known to lower blood pressure and decrease heart rate. A slower heart rate can be beneficial to women with hypertension or a history of a stroke. So get your downward dog pose down and your blood pressure too!
70’s
A well-woman exam in your 70’s no longer involves a Pap-test as cervical cancer screening stops at age 65.
Concerns will focus on vulvar health and assuring there are no lesions on the labia, or “lips” of the vagina. Most vulvar cancer occurs between the ages of 65-75. Symptoms include itching, burning, pain, a cut or sore that doesn’t heal, or a change in color on the skin of the vulva. Any of these symptoms will prompt your gynecologist to perform a biopsy during your visit.
Nutrition is very important at this stage in your life and often women don’t get an adequate balanced diet. Constipation often affects women in their 70’s and 80’s due to a low fiber diet and a slowing in digestion.
Some women will start experiencing severe uterine prolapse and will feel a “bulge” in their vagina. If you have this problem your doctor may recommend surgery or the use of a vaginal pessary to help support your uterus within the vagina.
Stress is a big part of aging as is loss of loved ones. Pairing up with friends is very important during this stage of your life. Keeping yourself active and staying social with friends will allow you to maintain your emotional and mental health stable during those stressful and lonely moments and may help prevent depression.
Continue to visit your gynecologist on a routine basis to assure no serious health concerns are missed at any stage in your life. Your gynecologist has the unique experience of seeing you on a yearly basis through every decade of your life. Be sure to make the most of your visit by being prepared with questions and let your doctor know any concerns you are having…no matter how embarrassing or miniscule the issue may seem- that’s what we are here for!
As always,
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