Well before your AARP card comes in the mail, a woman in her forties should begin to take a good look at her health care needs. Most women spend a huge investment of time and care in monitoring and maintaining the health of their families. Whether caring for children, spouses, or parents, women have developed great skill at attending to the needs of others before themselves. Your fourth decade is a great time to evaluate where you are health-wise and start preparing for a healthy future. Your health care provider is a valuable resource for helping you assess your current health picture and letting you know what tests are appropriate for your 40s.

Forty is a great age to begin changing some unhealthy habits you were able to “get away with” in your twenties and thirties. It’s also a good time to cultivate healthy new habits like better nutrition and exercising. A good first step is to make an appointment for a complete physical. Many women see their health care provider often during their twenties and thirties as they explore birth control options or receive obstetrical care. Some women feel that after their reproductive years are over that they really don’t need annual healthcare. However, your medical visits are just as important after your childbearing years.

As we age, gynecological health changes and other health concerns begin to develop. For instance, diabetes and hypertension begin to develop in our forties, and early detection is paramount to maintaining good health. Likewise, high cholesterol becomes more prevalent as we age. Additionally, it is easier to gain weight as we enter our forties because our metabolism begins to slow.

Health care providers will check your blood pressure, weight, blood sugar, and cholesterol profile. Breast exam and pelvic exam, along with a check for moles and other skin irregularities, are also part of a routine health exam. Many providers will recommend follow up with an ophthalmologist to check for common eyes problems that can develop as we age including glaucoma and macular degeneration. Routine gynecological check ups will include a Pap test to check for HPV (Genital human papillomavirus) and cervical cancer. Some providers will also recommend an HIV test depending on sexual history. Breast exams by a provider check for cancer, and a mammogram is first performed when a woman turns forty.

Changes in menstrual cycles during your forties can be an indicator of perimenopause which is the time when the ovaries gradually start to produce less estrogen. Sometime perimenopause can be associated with irregular periods, decreased sex drive, mood swings, difficulty with sleep, and other symptoms usually linked with menopause. Your health care provider can discuss these symptoms with you and offer suggestions for handling them.

Besides the gynecological exam, health care providers can order blood tests that let you and them know critical details about your overall health including your cardiac health. A lipid profile includes testing blood for high density lipoprotein or HDL-C and low density lipoprotein of LDL-C and triglycerides. This test is often done following a fast to ensure accurate results. Total cholesterol optimally should be under 200 and not greater than 240. LDL should be less than 100 and not greater than 160 while HDL cholesterol should be greater than 60 and not less than 35. Triglycerides should be less than 150 and not greater than 200. Sometimes dietary changes and increasing exercise can help get your cholesterol numbers where they should be. Cholesterol lowering medications like statins can be prescribed to help with your lifestyle changes to bring cholesterol to an acceptable level.

Blood pressure is another factor that your health care provider can monitor to make sure that you stay heart healthy. As we age, blood pressure may increase slightly from the normal 120/80 to around 125/83. Lifestyle choices like smoking and caffeine intake may affect blood pressure, as will extra weight and the onset of menopause. Women with a family history of high blood pressure may also be prone to hypertension. Your health care provider can counsel you on how to manage your blood pressure with dietary choices and exercise regimens. Medications can also help you achieve an acceptable blood pressure.

Finally your provider will want to test you for diabetes or prediabetes. Several different tests can be offered including fasting plasma glucose (FPG) or an oral glucose tolerance test (OGTT) or a random plasma glucose test. Both the FPG and OGTT can be used to detect both prediabetes and diabetes; however the random plasma glucose test will only confirm diabetes. If you are symptom free, most providers will begin routine testing at age 45 unless you have certain risk factors to include: family history, being physically inactive, history of gestational diabetes (during pregnancy), polycystic ovary syndrome, or have symptoms of cardiovascular disease like hypertension, high cholesterol, or obesity. In the case of any risk factors, your health care provider may want to test for diabetes well before forty. Additionally if you exhibit any common symptoms of diabetes like increased thirst and urination, fatigue, increased hunger, blurred vision, unexplained weight loss, or wounds that will not heal easily, testing will be done immediately.

Dr. Hardy is a solo physician in practice with Atlantic Ob/Gyn with locations in Chesapeake and Va. Beach. Call 757-463-1234 or visit www.atlanticobgyn.com.