Key things for physicians to keep in mind about women patients as they age

The medical community has made great strides in women’s health in recent years. But even today, gaps persist, and certain conditions are still commonly overlooked in women patients.Ahead of International Women’s Day, the Medical Post sat down with family physician Dr. Vivien Brown, author of The New Woman’s Guide to Healthy Aging, to talk about what physicians need to keep in mind about their women patients as they age.Pregnancy historyWhen dealing with older female patients, Dr. Brown says many physicians overlook the pregnancy history—but their experiences in pregnancy can indicate risk factors for later in life. For example, Dr. Brown points out that women who have had hypertensive episodes during pregnancy such as eclampsia, pre-eclampsia or HELLP syndrome are more at risk for cardiovascular disease later on in life.“When you're seeing a woman later on in life, one of the things to ask her about is the history of pregnancy, and that's something that's often overlooked,” Dr. Brown said. “When you see a woman in her 50s, you're not asking her about her pregnancies 25 years ago, but this is really important.”Brain health and bone healthBrain health is another aspect of health that is often overlooked in women.“Changes in brain health are often picked up later in women than they are in men because women tend to have excellent verbal skills and it's not until some of your verbal skills start to fail that you fail some of the testing that's done,” Dr. Brown explained. “So, women often get overlooked in terms of brain health.”Similarily, Dr. Brown says bone health for women is also often overlooked “because it's not high in the priorities.”“We worry about bone health because we know with menopause and the changes in estrogen bone health is a significant disease for women and again may be overlooked.”Immunizations Immunization is another area where Dr. Brown says there are different considerations for women compared to men, especially as they age.For example, while shingles affects patients of all genders, women are more likely to develop the disease, especially during perimenopause.“I think immunization is really important for men and women at this age because we want to prevent the preventable diseases, like pneumonia, like RSV, like shingles. And some of these diseases, like shingles, for example, are more common in women than in men,” Dr. Brown said. “I think we have to be vigilant and look at the whole picture when a woman comes in and says, ‘I just don't feel good.’”On top of that, Dr. Brown says physicians also need to keep in mind that women can often have more reactedenicity and side effects to vaccines compared to men.“We're no longer thinking about a woman as being two-thirds of a man when we look at drugs, because women react to drugs differently. Women react to immunizations differently and we're starting to appreciate those gender and sex differences in terms of response in diseases and also in response to medications,” she said.Every woman is differentAbove all, Dr. Brown says physicians need to take into account that every woman is different. “When we're looking at any given woman and we're thinking about some of the standard things we worry about brain health, cardiovascular health, bone health, we also need to take into account her situation—whether she's premenopausal, perimenopausal, postmenopausal . . . we need to talk about what the options are for treating those symptoms so that she can get on with her life,” Dr. Brown said.“Really, I think the take-home point is that everybody's different.”The other point that Dr. Brown stressed was that the different aspects of women’s health, whether it’s menopausal health or mental health, shouldn’t be looked at “in a silo.”“When we look at hormones in women and menopausal symptoms, that overlaps with mental health, that overlaps with brain health. And so, what I think is really exciting is that we're starting to have a greater focus on women's health in general rather than just a single disease state,” she said.

Key things for physicians to keep in mind about women patients as they age

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