Women's health in midlife

If you’re a woman approaching your mid-forties and fifties, your body may be undergoing various changes – some which may be unnoticed. These changes are comparatively different to changes that occur midlife in men; with studies showing women aged 55 to 70 years experience changes in their kidney, breasts, ovaries and bones. 

Importantly, health issues can begin in midlife in women, and this time period offers an opportunity to optimise your health and functioning to avoid long term issues. 

By understanding the changes that occur in your body during midlife, you can make any early adjustments to your lifestyle and maintain your health for the years that follow.

What causes midlife changes?

As women enter their late reproductive years leading up to menopause, changes occur in the levels of hormones produced by your hormonal glands. Hormones are like chemical messengers that control the function of many tissues and organs in your body. Fluctuations in hormone levels in your bloodstream can signal a change in function in your body. 

During menopause, your body may make less of the reproductive hormones oestrogen and prolactin. These hormone changes can affect your ovaries, breasts and bones. As women age, organs and tissues in the body can also begin to age naturally, losing their muscle strength and normal function.  These changes can begin around midlife, with most changes occurring unnoticed in the heart, lungs and kidneys. 

What women in midlife have to consider

Higher levels of cholesterol

Women’s total cholesterol levels change after menopause. Levels of low-density lipoprotein (LDL) cholesterol raise significantly in the two years around menopause increasing total cholesterol levels. LDL cholesterol, also known as “bad” cholesterol, is the main source of cholesterol buildup and blockage in your arteries. 

Higher levels of total cholesterol means you’re at a higher risk for a build-up of cholesterol deposits in the walls of your arteries. If left untreated, this build up can narrow the arteries, and reduce blood flow. 

Watch your weight

As you age, your body metabolism slows down and the fat distribution changes from your hips to your waist. A large study of women aged between 42 to 52 years old over three years found on average, women experienced a 2.1 kg weight gain and an increase in waist measurements.

The good news is regular physical activity has been found to help prevent weight gain, especially if you’re nearing midlife. 

Choose exercise

Research has found in the one to two years before menopause, bone density decreases until up to five years after menopause due to bone loss.  After the age of 60 years old, women experience bone loss faster than men partly due to the hormonal effects during menopause. 

You may need to consider the type of physical activity you choose to ensure risks for bone fractures are kept to a minimum during exercise. 

Weight bearing exercise, such as walking and weight training can help bone strength, especially after the age of 60 when women have lower levels of musculoskeletal strength, it is important to do regular resistance exercise with dumb bells, weighted bars or resistance machines.

Resistance exercise such as weights increases muscle mass and reduces insulin sensitivity (a precursor to midlife abdominal fat), whilst interval training and sustained cardio such as biking, running or swimming are excellent for cardiovascular health.

Even getting yourself a pedometer to monitor your steps and ensuring you do 10,000 steps a day can improve your overall health. 

Increase in recurrent cystitis

Another reason to watch your weight is that a lack of exercise and obesity are major contributors to urinary incontinence after menopause, which occurs more often in older women than in men. 

Research has shown that urinary incontinence, which is uncontrolled loss of urine from your bladder, can increase your risk for developing recurrent cystitis after menopause. 

Part of the reason is that oestrogen, which declines in older women encourages a more acidic environment and increases the growth of good friendly bacteria, and decreases E. coli colonization in the genitourinary sytem. Therefore these declining oestrogen levels can increase the chance of recurrent cystitis in women.

Cystitis is a bacterial infection of your bladder and can be more common in postmenopausal women. 

Even in women who do not have urinary incontinence, there is an increased incidence of recurrent cystitis in postmenopausal women compared to men due to this lowering of oestrogen levels in the body. 

Breast changes

The decrease in oestrogen production at menopause means your breasts can lose fat, tissue elasticity and mammary glands, making the breasts sag and soften. Abnormal growths may also become more noticeable in the softer breast tissue and if you notice any lumps, make sure you have them checked.

Checklist for midlife women

A checklist for the midlife woman

Its always a good idea to meet regularly with a trusted healthcare professional, use this handy checklist to guide your discussion:

-Breast Check. Breast self-examination monthly. A mammogram or breast ultrasound every two years from 50 years of age or younger (as with early menopause). 

-Weight bearing exercise. 30 minutes at least every second day. 

-Bone Density. Check at 50 years of age, or younger in cases of early menopause, and especially if there is a strong family history or risk factors for osteoporosis. Re-check in 2-5 years, depending on result.

-Cholesterol and triglycerides. Check for high density lipoprotein (HDL – the good fat) and low density lipoprotein (LDL – the bad fat) ratio. Also check triglycerides. Repeat yearly or as advised by your doctor.

References available upon request.

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