Essential health checks for women in their 40s

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These days, 40 doesn’t look like it did for your mother. For one thing, many women in this decade still have young children around, not to mention feel younger from eating well and exercising regularly. And really, how many of our mums were running marathons or doing 90 minutes of hot yoga at this age?

But the number is still meaningful when it comes to your health. At age 40 and beyond, a woman’s risk of developing conditions such as high blood pressure, heart disease, osteoporosis, diabetes and arthritis increase, and most primary care physicians encourage annual routine physicals. But there’s still plenty of good news: Many of these issues can be skirted or slowed if you maintain or start focusing on smart, healthy lifestyle habits.

Healthy habits in place, this is the decade to take a hard look at family history. Take colon cancer for example: While colonoscopies are not recommended until age 50, if you have a parent or sibling who had the disease, or had precancerous or cancerous polyps removed. So if your mother had colon cancer at 55, schedule a test for yourself when you're 45.


It is recommended that you begin annual breast-cancer screening at age 40 -- younger if you have risk factors such as family history.

The reasoning: The risks of a decade of annual screenings -- increased radiation exposure, higher incidence of false positives, possibly because younger women have denser breast tissue; unnecessary biopsies -- outweighed the benefits. That said, it should be noted that these new guidelines are based on clinical outcomes, not emotional concerns. Everyone knows a story about a woman younger than 40 or 50 woman whose breast cancer was found – and successfully treated – thanks to a mammogram.

The upshot is that while mammography can be an imperfect tool, it’s still the best available. To figure out what’s right for you, discuss your personal risk and history with your doctor.

Eye exam

So, you’re holding that restaurant menu farther away from your face. What you likely have is a predictable middle-age condition called presbyopia, a shortening of focus that’s also known as short arm syndrome.

If you already wear glasses, see your ophthalmologist to discuss whether you should have separate reading glasses or a bifocal prescription. Otherwise, just grab a pair of magnifying readers from the chemist.

Those who have never seen an eye doctor should make an appointment for a comprehensive exam, which can pick up early signs of age-related problems -- cataracts, glaucoma, diabetic retinopathy, age-related macular degeneration -- that may be lurking without symptoms.

The exam will also include an eye pressure test; pupil dilation so the doctor can look at your retina and optic nerve; and a test of visual acuity, reading letters on an eye chart.

Blood sugar/diabetes test

With the alarming obese rates, it’s not surprising that Type 2 -- formerly called adult onset -- diabetes is a huge and growing health concern, that makes it critical to find out if you’re in danger of developing diabetes.

If you haven’t already been screened, starting now is a must. Most commonly, you’ll be given a fasting blood glucose test. A normal fasting blood glucose reading is below 100 mg/dl. If your results come in between 100 and 125 mg/dl, you are considered pre-diabetic -- and you should think of this as a wake-up call. Talk to your doctor about other dietary modifications and recommendations. If your FPG is 126 mg/dl or above, you have diabetes, a chronic, irreversible condition with lifelong repercussions.

A more accurate screen for diabetes is the hemoglobin A1C test. Whereas a fasting blood test is a snapshot in time, the A1C examines a protein in the blood that changes in the presence of too much blood sugar, indicating a blood glucose level over a three- to four-month period. An A1C at 5.6 percent -- that means the percentage of sugar in your blood --is normal; a pre-diabetic range is between 5.7 and 6.4 percent. Anything over that indicates diabetes.

Rectal exam

Grin and bear it when your gynecologist inserts a gloved finger in your rectum during your regular pelvic exam. This on-the-spot test for fecal occult blood is important because blood in the stool is an early indicator of colon cancer, which can be diagnosed with further testing.