A Healthier World Starts with You!

The decline in estrogen that comes with menopause brings increased risk of developing osteoporosis, heart disease, weight gain, and vaginal dryness. A well-health check up each year, especially after 50, will help assure you are getting the health care you need — and will give you an opportunity to talk to your health care provider about life choices that can have a major impact on your health.

There are a number of medical tests that are recommended you receive on a regular basis post-menopause. Armed with knowledge about your health status, you can take further actions to ensure your post-menopausal years are as healthy and productive as possible.

Tests related to heart disease:

• BMI: Body mass index (BMI) is a widely used way to learn if you are overweight. A BMI between 18.5 and 25 indicates a normal weigh and persons with a BMI of 30 or more may be obese, which can lead to diabetes and cardiovascular disease. Another way to evaluate weight issues is to measure waist circumference; if it measures greater than 35, you are at greater risk for heart disease, diabetes and several cancers.
• Cholesterol: Have your cholesterol checked regularly, especially if you use tobacco, are overweight, have a personal history of heart disease or blocked arteries, or have a family member that has suffered a heart attack.
• Blood pressure: High blood pressure can lead to strokes, heart attacks, kidney and eye problems, and heart failure. Blood pressure should be checked at least every two years.
• Diabetes: If your blood pressure is higher than 135/80 or if you take medication for high blood pressure, get screened for diabetes

Tests related to cancer screenings:

• Mammogram: Women over 50 should have this test every one to two years. If you're at high risk, you should ask about a digital mammogram and an MRI.
• Colorectal: A yearly stool blood test or colonoscopy can detect this cancer. Your health care team can decide which test is best for you.

Tests related to bone health:

• Bone Density — Women should have an initial bone density test to screen for osteoporosis(thinning of the bones) at age 65, or earlier if you're at risk.

Tests related to gynecological health:

Many may think that past a certain age, you no longer need to go to an OB-GYN — but that's not true.

• Pap smear: You should have a pap smear to test for cervical cancer every one to three years if you have ever been sexually active.
• HPV test: You should also ask for the human papilloma virus (HPV) because a positive HPV test could mean you are a carrier of the virus that causes cervical cancer.

Tests related to mental health:

• Depression screening: Your emotional health is as important as your physical health. Talk to your health care team about being screened for depression especially if you have felt down, sad or hopeless or felt little interest in doing things.

After a screening test, it's important to ask when you will see the results and whom you should talk with about them.

People with good physical and mental health can enjoy their older years and continue to be productive, vital members of their families and communities. And you can play an active role in making those years after age 50 as healthy as possible.

One of life's more difficult conversations comes if you believe someone you love has UI but is too embarrassed to seek help. Why has grandma stopped coming to visit? No matter what excuse she gives, bladder problems may be the real issue. And it isn't just grandma — why did you stop finding time for tennis or aerobics? Progressive social isolation and restriction of physical activities are coping behaviors that can minimize UI in the short term but are not good for physical or mental health.

The time to seek help is sooner, not later. Visit a health care professional armed with information that will help with diagnosis. Keep a "bladder diary:" record trips to the bathroom and episodes of UI, as well as volume and type of fluids consumed, for at least a day or two prior to the visit. Be prepared to honestly describe how the UI is affecting your life. Most importantly, donýt be ashamed to ask for help and don't accept that UI just comes with getting older or having had children.

The first step in helping someone with UI is to help them understand they are not alone and that UI is treatable — often without surgery or taking a medication. Health care professionals can advise on both surgical and nonsurgical treatment options. In many cases, preventing and alleviating UI comes down to lifestyle changes.

• Obesity is linked to UI — still another reason to try and maintain a healthy weight.
• Some foods and beverages, including caffeine, carbonated beverages and foods with artificial sweeteners, may provoke bladder urgency or increase the amount of urine produced.
• Exercises called "Kegels" are easy to do and can help strengthen the pelvic floor muscles that are critical for keeping urine in the bladder.

As a physician, I know that dealing with incontinence is hard. As caregiver, I know this can be an even more difficult subject to talk about with your loved one. But if you or someone you care for is experiencing frequent UI, it's time to start some important conversations, including one with your doctor or nurse, about ways to tackle the issue.

The good news is that our knowledge is growing. New non-invasive imaging technologies are revealing the workings of the brain. Alzheimer's is now in the national spotlight. We're hoping to see new approaches to treatment within the next five years.

Last month, the Obama Administration announced a new national plan on Alzheimer's, with goals of better treatments by 2025, earlier diagnosis, and more help for caregivers. The plan will require new forms of partnership and collaboration to share information and speed advances. This call for what I call "meta-collaboration" is most welcome. Help is on the way, and for all of us who have seen Alzheimer's up close and personal, more help can't arrive soon enough.