They say fifty is the new forty and the current generation of fifty year old women are not about to hang up their boots with the onset of the menopause. They fully expect (quite rightly) to continue to function at the same high level both on a professional and personal level. The days of the "beige and greys" are over. Long live colour!
Approaching any big birthday gives people pause for thought and from a medical point of view, this is an opportunity to review womens' general health, both hormonal and non-hormonal. Before launching into any medical advice, I like to start with the basics.
Are they overweight? As oestrogen levels fall, so does the body's sensitivity to insulin so women can develop insulin resistance with central weight gain (I refer to this as "the dreaded thickening" or loss of a waistline!!) so it's important for them to follow a sensible low GI diet as well as incorporating exercise into their lives.
How much exercise? What type of exercise? Frankly, anything is better than nothing so in the first instance, I encourage people to wear a pedometer (or use an App on their phone- but women are disadvantaged as often wear dresses/ skirts with no pockets- it's difficult for their phone to measure their steps from your desk...) and aim for 10,000 steps a day- "live your life as if escalators and lifts hadn't been invented" i.e. Take the stairs wherever possible!
Weight bearing exercise protects your bones as does adequate levels of Vitamin D and calcium so outdoor exercise, be it walking or running, kills two birds with one stone.
More active patients might like to explore HIIT (high intensity interval training) to aid fat loss. There are plenty of free videos on You Tube and as one (now rather famous) trainer says- "no equipment, no excuses!" And these short bursts of exercise really can be done in their front room.
What to review medically? As well as taking baseline measurements such as height, weight, BMI, waist circumference, blood pressure etc., we also carry out a screening blood test, looking at their full hormone profile but also thyroid, blood sugar, vitamin D, calcium and lipid profile.
The aim should be to optimise all aspects of womens' health with a holistic, personalised approach. Some may need HRT, some may not need/want it- for those concerned about the risks of breast cancer with HRT, bear in mind that obesity increases risk to a far greater extent so before dismissing HRT as an option, some honest self appraisal of the reflection in the mirror might be an idea.
As well as helping with the obvious hot flush/ sweating symptoms, HRT can also address the less specific ones such as "brain fog", anxiety, irritability etc. Menopause can present in a myriad of different ways and the diagnosis is not uncommonly missed, sometimes for years. Hence the advice to encourage female patients to routinely take stock around the age of fifty to ensure they remain in peak condition for years to come. Given the proportion of women in high level roles, running multi-national companies etc. it seems to me to be pretty important to have them performing at the highest level possible, for as long as possible.