I interviewed Dr. Charlotte Yeh, MD, about what older women need to know about post-menopause. She is the Chief Medical Officer for AARP Services, Inc., the wholly-owned taxable subsidiary of AARP and is a board-certified emergency physician.
Dr. Yeh has more than 30 years of health care experience. She is an expert in health care delivery in the areas of quality, safety, and efficiency. From 2003-2008, she served as Regional Administrator at the Centers for Medicare, Medicaid, and SCHIP programs across six England states. Dr. Yeh has a deep commitment to and passion for the consumer in health care on a range of health issues, including hearing loss, the impact of isolation on health, and underserved populations.
I want to thank AARP THE MAGAZINE for giving me this opportunity to share the following information with all of you, my readers.
Interview with Dr. Charlotte Yeh, MD – Post-Menopause
R: Dr. Yeh, my audience is active Baby Boomer women, so their ages range from 55+ and I’ve written about menopause in some of my articles. However, what I’m most interested in knowing about is what older women experience when they are in post-menopause and how they would distinguish what might be a menopausal symptom as opposed to something that would be more serious.
Dr: I would be happy to talk about older women who have been through menopause. It’s important to remember, even though menopausal symptoms are really, really common, and virtually every woman goes through menopause, sometimes they could represent something else.
Think about hot flashes. We all know that kind of hot feeling you get in your chest that spreads throughout the body and then you get chilled, and then feel cold. Those kinds of hot flashes are typical for menopause, but sometimes, they could represent a thyroid disorder. A thyroid that is overactive and hyperthyroidism can give you somewhat similar symptoms. There are other kinds of endocrine disorders, very rare, carcinoid and other kinds of endocrine tumors, that can give you that same rapid heart rate, and flushing that you feel with hot flashes.
So, if it doesn’t seem typical, or occurs at unusual times, it’s something that you should talk to your doctor about to confirm whether it’s truly post-menopause or potentially a thyroid or endocrine disorder.
And oh, by the way, while this may not be very common, but it can happen, you may also be pregnant. If you stop having a period and have symptoms of bloating and nausea, it could represent an unexpected pregnancy.
R: Oh, that would be scary! (giggle, giggle)
Dr: Again, not common, but it can happen.
R: That’s interesting. I never had hot flashes, but recently I’ve been feeling a little warm, so I was wondering about that. It’s something that isn’t often talked about. Is there anything else to look for?
Dr: Those are the main symptoms. One thing to also think about is a potential risk for ovarian cancer. The symptoms of ovarian cancer are typically very general and not specific such as bloating or a sense of fullness. These are not things you typically feel with menopause. But if you are feeling a gradual discomfort in the abdomen, a sense of bloating, some weight gain in the abdomen, even though that can happen with menopause, again, it’s worth checking with your physician, especially if there’s a family history of ovarian cancer in the family.
R: I know someone who runs the Ovarian Cancer Circle and she was suggesting that you should ask for a transvaginal ultrasound.
Dr: Right, that’s one of the ways it can be diagnosed. It’s not common enough that we recommend this for routine screenings and there is a lot of work going on to see if we can develop a screening test for ovarian cancer.
But again, if you’re having abdominal bloating, non-specific feelings, and especially if you have a history of breast or ovarian cancer, it is worth talking to your doctor.
R: You mentioned weight gain, especially in the middle. I’m an apple shape, so I’ve been really concerned with that. I always used to be thin, but after about 50 I started putting on weight in my stomach. It’s one of those things where you feel like you’re doing everything right. I walk usually about 10,000 -15, 000 steps a day, eat real food, cut portions, have cut out bread, and sweets and my weight doesn’t budge. Is there anything you recommend that would help?
Dr: Well, it sounds like you’re doing all the right things. Exercise and good nutrition are all part and parcel of achieving a healthy weight. But when you start dropping your estrogen when you hit menopause, it doesn’t just change. Even if you don’t have periods or gynecological symptoms, it affects your whole body. It changes your cardiovascular, metabolism, cholesterol, and digestion. All these things can lead to an imbalance and changes in weight gain. Your metabolism may slow down and that’s partly why you gain weight.
So, it is something to be aware of and conscious of. Exercise and good nutrition are good for you, especially when you’re post-menopausal.
R: What kinds of exercise do you recommend for women over 60?
The most important thing is that you move, even if you can’t do “cardio workouts” or “spin cycles.” Just walking ½ hour a day or even 3 times a week has shown to be good, not only for your heart and physical health but for your brain health as well.
It’s also important that you do a variety of things. Some of it should be strength training so you can maintain your muscles, and muscle mass. Exercises that give you balance training, whether it’s yoga or tai chi, are really important, because, again – when you’re in post-menopause, and you lose estrogen, your bones get thinner, and are more prone to break. You want to maximize your balance so you reduce your risk of falling.
And then finally, have variety in how you exercise. If you only do one kind of exercise, it’s good for those muscles, but if you have a variety of activities, then you are really making sure you have whole-body improvement, in your strength, balance, and core capabilities. It’s all good for your body and your brain.
R: I was told that working on balance is important because it helps you reduce the risk of falling. And to do it you need to work your gluts, meaning your butt muscles.
Dr: And don’t forget that in addition to balance it’s also really important to have good eyesight. Make sure you get regular eye checkups and the same for your hearing. If you don’t hear well, and you don’t treat it, meaning you don’t get hearing aids or other kinds of devices, you actually can increase your risk of falling.
R: I talked to an ophthalmologist and he said that sometimes bifocals give you more of a risk of falling. He recommended getting cataract surgery if you can and having your eyes fixed during the procedure if that is possible.
Dr: Again, total body conditioning, total body health, especially when you’re post-menopausal, can really matter to reduce your risk of falling. That way you can stay as active as you want for as long as you can.
R: With all the changes in healthcare, what type of tests do you recommend for older women?
Dr: As you probably know, we recommend having an annual physical with your doctor even if everything seems to be going well. Because that way your physician gets to know your baseline. So, if something does come up, they will be able to compare it to the way you normally are. And, it also allows you to pick up problems that you don’t feel such as blood pressure or cholesterol. Making sure you get your lipids, glucose, and blood pressure checked, at least at your annual visit is important.
I’ve already mentioned your eyesight and hearing. Think of it as a total body tune-up. And, then, of course, for women, a mammogram screening is very important. Breast cancer is one of the most common cancers for women.
R: You also mentioned metabolism. Are there certain tests you should take? Because sometimes the typical thyroid tests don’t always show that you have a thyroid problem. Are there other tests that will tone that down a bit?
Dr: Unless you have symptoms, you don’t necessarily have to be checked for thyroid or checked for other conditions like even metabolism. Unless symptoms are coming through, you really don’t want to have tests that aren’t necessary. What’s worth checking are silent like blood pressure, cholesterol, or your blood sugar. That’s why we talk about annual screenings.
We want to make sure you’re not pre-diabetic or moving into diabetes. I wouldn’t say get everything tested because it’s unnecessary and they might find abnormalities that turn out once. You may end up going through more batteries of tests and in some cases even biopsies, which are unnecessary.
It’s really important to go through your history with your physician and get an annual physical. By the way, it’s the season now – always get a flu shot.
R: Right – the flu shot and then, after 65, it’s pneumonia too, right?
Dr: Right. Starting in your 50s there are 2 other vaccinations that are important.
- Shingles – There’s a newer version out that’s much more effective. It’s important to get the shingles shot because it’s a miserable condition if you get it. It can be prevented or certainly mitigated against with a shingles shot.
- And then, as you said, there’s a pneumonia shot to reduce your risk of getting pneumonia.
Those are vaccinations. Flu, shingles, and pneumonia are all worth getting, especially when you’re older.
R: Is there anything you’d like to add that we didn’t cover?
Dr: Just one thing: We covered a wide range of topics about women and women’s health, if you need more information about menopause and post-menopause, click here.
Visit the health section of the AARP website here: AARP.org/health