When it comes to your health, there are some things Mother told you that are right on the money: Wash your hands, eat your veggies, get eight hours of sleep, brush your teeth after every meal. Then there are the things she might have said that you have permission to drop from your adult repertoire. Not because they’re wrong, exactly, just highly unpleasant: eating liver, waiting 30 minutes after lunch to swim, wearing unattractive rain gear. What’s left is the large area of health-related information that your mother never told you. And God bless her, it’s not necessarily because it has to do with sex (although some of it does). In her defense, modern science hadn’t come up with some of this stuff yet. Mom wasn’t privy to the latest details. But luckily for you, we are. This month, we expose the 10 health secrets your mother never told you.
Secret No. 1 – Heart Disease Is the No.1 Killer of Women
Mother wasn’t alone in neglecting to warn you about heart disease—until recently, everyone did. Most women go through life oblivious to the fact that their biggest health risk is cardiovascular, not (as surveys show women fear the most) breast cancer. “Only 8 percent of women know that heart disease is a greater threat than cancer,” says Diane Sobkowicz, M.D., medical director of the women’s heart program at Sutter Health. “And women [actually] have a higher chance of dying from heart disease than men do.”
Being aware of this danger is critical to women’s health, experts say. “What women don’t know is killing them,” says Amparo Villablanca, M.D., director of the women’s cardiovascular program at UC Davis. “They need to pay attention to risk factors.”
Sobkowicz and Villablanca insist those risk factors can be altered. “There’s this misperception that you’re doomed [to heart disease] because it’s in your family,” says Villablanca, when in fact the majority of cardiovascular cases are preventable, if women make “therapeutic lifestyle changes.” This includes eating a heart-healthy diet, giving up cigarettes (which are a greater risk factor for women than men), and getting some exercise, all of which help lower cholesterol and blood pressure levels, as well as your risk for developing diabetes.
Secret No. 2 – Diabetes Is About More Than Sugar
Diabetes is a significant health risk—and one to which women need to pay particular attention. “It’s the next epidemic,” says Villablanca, who adds that women with Type II diabetes have a two- to three-times greater risk of developing heart disease than their male counterparts. “The American Heart Association considers diabetes to be a heart-disease equivalent,” she says, “and we treat diabetes patients as though they are heart-disease patients.”
Yet, like heart disease itself, Type II diabetes is almost entirely preventable, and many experts attribute its alarming increase in recent decades to the average American diet—and its resulting American obesity. Again, this unfortunately has more relevance to females than males. “Women have a higher prevalence of weight gain and obesity as they age,” says Villablanca.
Secret No. 3 – A Little Weight Loss May Be All You Need
Mother may have told you to “keep your figure,” and it’s true that obesity raises your risks: for heart disease, stroke, diabetes, even some cancers. But most women don’t need to lose as much weight as they think they do to gain health benefits. “Even a 5 to 10 percent weight loss can dramatically improve a woman’s health risks for heart disease and diabetes,” says John Hernried, M.D., an internist at Kaiser Permanente and the medical director of the Obesity Treatment Center. “For example, many patients—after a 10 percent weight loss—can go off their diabetes or blood pressure medication. So if you have a 200-pound woman, and she loses 20 pounds, she’s still at 180 pounds, but she has greatly improved her health.”
Hernried also warns women to be wary of how they control their weight. “Diets will lead to weight loss, but . . . weight loss is not the cure for obesity,” he says. In fact, he says, most people regain what they lose—and more—unless they have a supportive maintenance program. This is even true for patients who choose more radical options, such as obesity surgeries. “About 25 percent of patients who go through these surgeries regain the weight,” he says. What should you do if you’re committed to making at least a modest weight reduction? Look for local programs such as Weight Watchers or Kaiser’s Healthy Ways, where you’ll learn to make changes you can stick with for life.
Secret No. 4You Don’t Have To Look Like a Magazine Model
Ask a doctor to describe the ideal woman, and he might say this: a strong, vigorous woman who eats well and keeps active. But after a lifetime of Madison Avenue images, many women find this a hard sell—they can’t feel good about themselves or their looks if they fail to reach that (virtually unattainable) ideal smiling back at them from every magazine cover. “The average healthy American woman is 5 feet 4 inches tall and weighs 140 pounds,” says Hernried. “But the average American supermodel is 5 feet 11 inches tall and weighs 117 pounds.”
As for Mother, the difference between her body and the model on the cover of Vogue wasn’t so great. “Twenty years ago, supermodels weighed 10 pounds less than the average [woman] on the street,” says Fran Fisher, Ph.D., a clinical sexologist in private practice and a frequent guest educator for Sutter Health. “Now it’s more than 20 pounds. [This contributes] to the really tragic display of patients’ anxiety around the way they look.”
Secret No. 5 – Exercise Isn’t Just for Girls
Under Mother’s approving eye, you probably hopscotched and jumped rope as a girl. But in her day, it’s likely that grown-up women weren’t supposed to sweat much. Today, health experts say even modest exercise brings a plethora of health benefits. “Exercise like walking is not all that good for weight loss,” says Hernried, who adds that his patients often complain about this fact. “They say, ‘I’m walking 45 minutes a day and I haven’t lost a pound,’ but I say, ‘Good for you—you’re doing a lot for your health.’ Exercise is a preventive tool. Walking, for example, is known to prevent the onset of diabetes.” Research also suggests it helps prevent osteoporosis.
But how much exercise is enough? Do you need to kill yourself at the gym? Do what you can, say experts. But for average, healthy women, “what’s recommended now is 150 minutes a week—or 30 minutes five times a week,” says Villablanca. “And it doesn’t have to be consecutive—10 minutes three times a day is all right.” How does that translate to real life? Walk your kids to and from school—and take the golden retriever out for a romp around lunchtime. Or take up bike riding or tennis; garden; do your own housework. And work up a sweat.
Secret No. 6 – The Baby Clock Is Ticking
Mother may have bugged you for grandchildren, but she also may have urged you to finish your doctorate, buy a house and “settle down” before starting a family. Many modern women do just that, delaying motherhood significantly from generations past, believing they still have lots of time for making babies. But do they? “You basically hit the peak of fertility around the age of 28,” says Carlos E. Soto-Albors, M.D., director of the Northern California Fertility Medical Center. “Between the ages of 30 and 35, it starts to drop, and between 35 and 40, you see a very steep decline.”
Soto-Albors, who specializes in fertility medicine, adds that even with the most advanced technology available—IVF, or in vitro fertilization—“the age of the female is still a significant determinant of pregnancy rates.” He says that by age 38, IVF pregnancy rates decline by nearly half, and after age 40, there is even a more significant drop. “After age 43 or 44, the IVF pregnancy rate is near zero, and after age 45, it is zero,” he says. What about those movie stars having twins in their late 40s? “What they’re not saying is they used donor eggs,” he says.
In fact, Soto-Albors believes these less-than-forthcoming media stories contribute to women’s misunderstanding the reproductive risks they take when delaying motherhood. “It’s one of my pet peeves,” he says. “People have extremely low knowledge about their bodies in general, and in terms of reproductive issues, this is even more the case.” Adolescent girls, for example, are taught how to avoid pregnancy, but not given much information on how best to achieve it, if and when they want to become mothers. “I’d say in the late high school years [girls could use] a good physiology about reproduction,” he says, adding it would also be helpful for primary care and Ob-Gyn doctors to give out fertility information, along with Pap smears and birth control. “No one stops to tell them how to get pregnant.”
Secret No. 7 – There’s a Thing Called Perimenopause
Mother likely gave you some information about “the change of life,” but what about those years beforehand, now known as perimenopause? “This is the time when the ovaries decrease or cease to produce eggs,” says Richard L. Sweet, M.D., professor of obstetrics and gynecology and director of the UC Davis Women’s Center for Health. “And patients begin to notice some change. Usually it’s difficulty with their periods—either irregular periods, spotting between periods or very heavy periods. If women aren’t told to expect this, they freak—they think it’s cancer.” Or they think they’re pregnant, not necessarily a desirable condition when you’re sending your youngest to college in the fall. “And that’s something, too—the assumption that between 40 and 45, you can’t get pregnant,” says Sweet. “It’s not the time to stop contraception.”
As for other perimenopausal or menopausal symptoms—hot flashes, irritability, low libido—doctors have not closed the books on hormone replacement therapy, despite recent reports that the risks of HRT outweigh the benefits. “The pendulum is actually swinging the other way,” says Sweet, “and according to a report in JAMA (The Journal of the American Medical Association), about 50 percent of those women who stopped taking HRT have come back.” The American Menopause Society also is recommending alternatives to HRT such as diet and exercise, soy, the herb black cohosh and, in some cases, antidepressants.
Secret No. 8 – Older Women Like Sex
Mother may have been too embarrassed to tell you this one, but experts claim she may have experienced it nonetheless: You don’t have to be 20 to have an active sex life. “For many middle-aged women, this is the best sex of their lives,” says Fisher. She suggests many older women, free of the daily demands of motherhood and with the wisdom of their age, begin to say, “I am who I am.” “Why would it not be true in their sex lives as well?” she says. “The wink and nod you saw your grandparents giving each other meant they were still enjoying an intimate life.” New reports suggest younger men increasingly are interested in older women. “There was a piece in The New York Times that said many men are looking for more mature women instead of younger women who don’t know who they are or what they’re doing yet,” she says.
Secret No. 9 – You Still Need To Drink Your Milk
In the middle of the 20th century, it was common knowledge that kids needed to drink milk for strong bones and teeth. Mother knew this, and she poured you those big glasses several times a day. But what experts now tell us is she needed her calcium, too.
“Women think about osteoporosis when they’re 50 or 60,” says Adaf Najmabadi, M.D., an internal medicine specialist in private practice in Lincoln. “But what many women don’t know is you build bone up to only about the age of 35. After that, you can either keep it or lose it—but you won’t add to it.” What this means is it’s critical to build healthy bone structure long before your middle years, when it may already be too late. “What you go through menopause with is your baseline,” says Sweet, adding many women don’t realize they are already borderline osteoporosis cases. “Even if you’ve never had a fracture, you think you’re not at risk, you need to understand it’s a lifetime of diet that determines [the health of your bones]. Even women who’ve been superathletes, to the point where they stopped ovulating or menstruating, are at very high risk.”
What’s the answer? Get adequate calcium intake long before menopause—through calcium-rich foods such as broccoli, kale or sardines, or through supplements. “Vitamin D also contributes to calcium being absorbed by the body,” says Najmabadi, “so I tell my patients to choose a supplement with Vitamin D as well.”
Secret No. 10 – You May Not Need That Annual Physical
Lastly, Mother dutifully went to the doctor once a year—and took you for a checkup as well. But is this necessary? Increasingly, doctors are saying no. Even the Pap smear doesn’t need to be done as often as many women think. “If you’ve had a series of normal tests, every three years is all you need,” says Sweet. This advice is especially true if you add the new HPV (human papilloma virus) test, which looks at a bit of DNA from the cervix to determine if you’re carrying the virus. “This starts to be of value for women 30 and over,” says Walter Kinney, M.D., a gynecological oncologist at Kaiser Permanente. “Most young folks who have started having sex are exposed at some point to HPV.” It can be problematic because certain strains of the virus cause cervical cancer.
What do women need on an annual basis? “Women need their cholesterol checked once a year,” says Villablanca, and they should keep track of their blood pressure and sugar levels. And it’s generally agreed women older than 50 need annual mammograms.