Complete care for women can be complex. Your health needs change drastically from adolescence to childbearing age, through menopause and beyond. To safeguard and maximize your long-term health, invest in your well-being early.
“Prioritizing yourself and your health is an essential aspect of your care,” says Aruna Puthota, DO, a family medicine doctor and psychiatry specialist with The Christ Hospital Physicians–Primary Care. “Ideally, you would find a doctor you can trust in your 20s. Together, you can build a partnership that focuses on preventive care.”
In a webinar hosted by The Christ Hospital Health Network, Dr. Puthota joined Leanne Olshavsky, MD, an obstetrician-gynecologist; Jennifer Manders, MD, a breast surgeon; Odayme Quesada, MD, medical director of the Women’s Heart Center; and Janice Rafferty, MD, a colon and rectal surgeon, to discuss various health concerns women face.
“There’s not a one-size-fits-all answer to maximizing your health,” Dr. Olshavsky says. “The key is to focus on wellness and prevention so we can avoid some of the larger health issues that many of us can see later in our lives.”
Here’s what these experts from The Christ Hospital want you to know.
Breast health
Breast cancer affects one in eight women at some point during their lives. Annual screening mammograms are the best way to detect early signs of disease. According to Dr. Manders, women at average risk should start yearly testing at age 40. Women at high risk should begin mammogram screening earlier.
If you have a family history of breast cancer, genetic testing could help you take steps to avoid developing the disease or select the best possible treatment options.
“Every generation gets breast cancer younger than the previous generation,” she says. “So, if you have multiple people in your family affected with breast, ovarian or other related cancers, it’s worth bringing up genetic testing with your healthcare provider.”
You may also have concerns about breast cancer if you’re approaching menopause and need hormone replacement therapy. Research shows that some types of hormone therapy can increase your chances of developing breast cancer. Dr. Manders recommends talking with your provider about the risks and benefits of an estrogen-only treatment or one that combines estrogen with other hormones.
“It’s important to talk with your doctor about whether hormonal therapy is the right thing for you. There may be other non-hormonal agents that you can start with first,” she says. “That’s a common concern, especially among high-risk women who just want to try and feel better as they go through menopause.”
Heart health
Heart disease looks different in women than in men, Dr. Quesada says. According to the World Health Organization, roughly 80 percent of heart disease is preventable. Knowing the difference can help prevent long-term heart injury or save your life.
It’s a common misconception that you must have blocked arteries to have chest pain or suffer a heart attack. The truth is, many women who live with daily chest pain have clear arteries, Dr. Quesada says. Women are more likely to experience microvascular dysfunction, which can cause blockages in the smaller blood vessels. Standard diagnostic imaging exams such as angiograms often fail to detect microvascular dysfunction. As a result, doctors may attribute your pain to anxiety, stress or another mental health concern.
What you should know about heart symptoms
Just like overall heart disease, women experience unique heart attack symptoms, Dr. Quesada says.
“When you think of a heart attack, you may imagine a typical Hollywood-style event that causes pinching or severe chest pain,” she says. “But classic heart attack symptoms in women aren’t always like that.”
Women can also experience:
If you “know your numbers,” you can protect your heart health, she says. These numbers help you monitor your overall cardiovascular well-being:
Atherosclerotic cardiovascular risk score: This calculation estimates your likelihood of experiencing a cardiovascular event within the next 10 years. A risk score of 20 percent or higher may require intervention.
Blood pressure: Your blood pressure measures how hard your heart works to pump blood through your arteries. A healthy blood pressure is 120/80 mmHg. Doctors consider any measurement above 130/80 mmHg to be high blood pressure.
Blood sugar: Also known as glucose, a high blood sugar level increases your risk for heart disease. Maintaining a blood sugar level between 70 and 140 mg/dL can limit your risk.
Calcium score: This score measures the amount of calcium that builds up in your arteries. A higher score indicates a greater risk of a heart attack.
Cholesterol: This plaque builds up and can clog your arteries. Your total cholesterol should be below 200 mg/dL.
Lp(a): Lp(a) is similar to low-density lipoprotein (LDL), the “bad” cholesterol. A high Lp(a) level boosts your risk of blood clots, clogged arteries and inflammation. An ideal Lp(a) level is less than 30 mg/dL.
Pregnancy and heart health
During pregnancy, your heart works overtime. Your blood volume increases up to 50 percent, and this increased blood volume flows to the uterus allowing the baby to grow.
“Your heart already has a big job to do, and you give it 50 percent more work when you’re pregnant,” Dr. Olshavsky says. “That’s fine when you’re younger, but our hearts don’t tend to get healthier the older we get. So, being pregnant—especially at an older age—can put a huge strain on your heart.”
Overall, pregnancy can increase your risk for heart-related problems like high blood pressure and gestational diabetes (diabetes that develops during pregnancy). Some of these health concerns linger after giving birth, leading to other complications or death, particularly for Black women. Through a Cincinnati program called Mama Certified, local doctors collaborate with community leaders to reduce health disparities and improve outcomes for new Black mothers. The Christ Hospital Health Network is Mama Certified for advancing equitable maternal health.
Colorectal health
Colorectal cancer is the third leading cause of cancer-related deaths among American men and women, according to the American Cancer Society (ACS). The ACS also reports the detection rate is on the rise in people under 50, Dr. Rafferty says. That makes screening tests more important than ever because most colorectal cancers don’t cause symptoms.
What you should know about colorectal health
Like other cancers, colorectal cancer is easier to treat if you catch it early. Paying attention to your bathroom habits is the best way to catch possible problems.
“You’ve lived with your bowels your entire life, so be sure you know what your normal patterns are,” Dr. Rafferty says. “If you start to see significant changes or big shifts that stick around, you need to talk to your primary care doctor to start a more thorough investigation.”
Even if you don’t have symptoms, she recommends getting your first screening colonoscopy at age 45. If you have a first-degree relative (a parent or sibling) who had colon cancer, you’ll need your first exam 10 years prior to their age at diagnosis. For example, if they received a diagnosis at 43, you should have your colonoscopy at 33.
As an alternative, you can choose an at-home, mail-in screening kit, such as ColoGuard®. The test examines a small sample of your stool for tumor DNA. However, research shows these kits can miss up to 8 percent of cancers and more than 50 percent of precancerous polyps.
“A traditional colonoscopy lets your provider get a very good look at the entire lining of your colon,” she says. “It has a very low miss rate for polyps and cancers.”
Mental health
“Addressing mental health needs is just as important as addressing your physical health, especially as a woman,” Dr. Puthota says.
“It takes courage to speak up about how you are feeling,” she says. “I appreciate it when a patient comes in and is honest about how they are feeling, but I also know that sometimes it is hard to put those emotions into words or even to recognize them. That’s why it is key to have a primary care physician that you trust and feel comfortable with.”
Though your annual physical can be an introduction for discussing mental health, further visits can be helpful to develop a game plan for how to address it.
“It’s important to discuss your stresses and even go back as far as your childhood to understand why it may be difficult for you to prioritize your own health,” Dr. Puthota says. “If you address some barriers and learned negative behaviors, you may be able to do a better job of focusing on yourself.”
To nurture your mental health, Dr. Puthota suggests a multi-pronged approach. Identify 1-2 coping mechanisms that work for you, engage in counseling, have something on your social calendar monthly, and move your body and nourish your body well. If it’s important to you, embrace spirituality. If you are engaging in these habits regularly, but still find it hard to manage your emotions, then discussing medication options can be further helpful.
Long-term health
This expert panel offered these additional recommendations to improve your health as you age:
Boost your bone health. Your risk of osteoporosis—the weakening of your bones—increases as you age. That means you’re vulnerable to breaking a bone. To strengthen your bones, Dr. Olshavsky recommends:
Getting 1200 mg of calcium daily, either in diet or supplementation
Boosting vitamin D (to help your body process calcium)
Increasing weight-bearing exercise
Limit social media. “Doomscrolling”—spending too much time on social media—can damage your health, Dr. Olshavsky says. Non-professional influencers fill social apps with incorrect or dangerous medical advice. And research shows these apps cause stress and anxiety because you’re more likely to compare yourself or your life negatively to other people.
Pay attention to chest pain. If you have microvascular disease, Dr. Quesada says regular exercise can help you control chronic pain. Additionally, any prescribed anti-anxiety or anti-depressive medication can also decrease stress-related chest pain.
Take dietary fiber. Dr. Rafferty recommends adding psyllium husk to your diet. A daily fiber supplement reduces your LDL cholesterol, regulates your blood sugar and decreases the growth of polyps in your intestines.
Get the comprehensive care you need
Your healthcare needs will change over time. So, taking steps to protect your long-term health matters. Call 513-585-3000 or make an appointment online with one of our primary care or women’s health experts to get the preventive care you need.