Well-Woman Care Ages 40-49: Navigating Hormonal Changes

By rachel.cole, 28 March, 2024
doctor reviews notes with female patient

Oh, the places your hormones will go! In your early 40s, your reproductive hormones (estrogen and progesterone) will start fluctuating, leading to a variety of body changes. This is due to “perimenopause” which is all the years leading up to menopause, the precursor to menopause. 

“During well-woman visits, we want to know if patients are having problems with intercourse or vaginal dryness, any pelvic pain, or have hot flashes, weight changes, and menstrual changes so we can begin treatment,” says Dr. Beasley. Many women don’t realize there are many treatment options that can help them manage these uncomfortable symptoms.

One of the other big areas of focus in your 40s: getting your mammogram every year starting at 40. “When we find breast cancer early, there are less invasive treatment options available and an excellent chance for survival,” explains Dr. Beasley. 

Perimenopause  

Many women don't realize that some of the new symptoms they begin experiencing in their 40s are likely related to perimenopause, also called pre-menopause. Between your 30s and 40s, your body gradually transitions out of the reproductive years, and estrogen produced by the ovaries fluctuates. 

Common signs of perimenopause include changes in your menstrual cycle (longer, shorter, or missed periods; lighter or heavier flow), hot flashes, painful intercourse, vaginal dryness, mood swings, and sleep disruption. It’s important to know that even with irregular periods, you can still get pregnant in perimenopause.

Perimenopause can last anywhere from about four to 10 years. That doesn’t mean you’ll have all these symptoms that entire time. Everyone experiences perimenopause differently. Whatever you’re dealing with, you don’t have to grin and bear the annoyance. There are hormonal and non-hormonal treatments that can offer relief. Just ask your doctor!

Yearly Mammograms  

A mammogram is an essential screening done through imaging (or X-ray) of the breast that can detect early signs of breast cancer. A breast MRI may be used along with a mammogram for women with an increased risk of breast cancer, family history of breast cancer, or dense breasts.

Most medical societies recommend mammograms yearly starting at age 40, including breast MRI and ultrasounds.

Colorectal (Colon) Cancer Screening 

Used to be, colon cancer screenings coincided with your 50th birthday. Now, for people at average risk, they’re recommended to start at 45. This screening can help prevent colorectal cancer or find it early, when it may be easier to treat. 

If you have a family history of colorectal cancer or other potential risk factors be sure to speak with your provider about when you should begin colon cancer screening.

  • Colonoscopy: In this minor procedure, you will be under sedation or anesthesia while a physician visually examines your colon and rectum. If you do not have an increased risk of colorectal cancer, you should get a colonoscopy every ten years through age 75. 
  • Stool-based test: This is a colon screening test that looks for signs of cancer in a person's stool. You collect the sample at home and mail it into a lab for analysis. Unless there are concerns, it’s recommended you repeat the stool-based test every one to three years.

The benefit of a colonoscopy over a stool-based test? If your doctor finds any polyps that may lead to cancer, they can remove them then and there.

Some of the changes that may appear during this time can turn things upside down.  Your provider can support you through these adjustments.

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