The Midlife MOT: 8 Health Checks You Can’t Miss

Women usually prioritise everyone’s health over their own. In 2020, it’s time to put our health first. A midlife checkup will provide you and your General Practitioner (GP) with an opportunity to discuss your family medical history, evaluate your current health condition and screen for potential future problems. It also provides a valuable baseline for monitoring the many “normal” physical and hormonal changes you go through as you age.

Get checked out

The number of health tests and screenings you need to keep track of in your 40s may seem overwhelming, but they are an important regimen to establish. Most GPs will offer ‘over 40s’ a free health check in the UK, the so-called ‘M.O.T.’ (a test designed to check that your car meets the minimum acceptable road safety and environmental standards requirements). It usually includes measuring and evaluating your weight, height, BMI, blood pressure and cholesterol but is also an opportunity to chat with your doctor about any health concerns you may have.

Here are the most important exams you should not skip if you want to keep ‘your engine’ running smoothly.

Blood pressure

Hypertension does not exhibit symptoms, so it is important to check your blood pressure regularly, especially at midlife, as its the risk of high pressure increases with age. If your blood pressure is above 120/80mmHg, it’s too high. If you’re over 40, have your level checked at least once every five years by your GP or practice nurse. Hypertension is a fairly reliable indicator of cardiovascular disease, especially in women who have used oral contraceptives or who are in the post-menopause. Fortunately, you can lower your blood pressure through diet, exercise, and medication.

Cholesterol

It should be tested every five years. Cholesterol tests typically measure the total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Measured through a simple finger-prick blood test, your total cholesterol level should be below 5mol/L. Equally important is the ratio of bad (LDL) cholesterol to good (HDL) cholesterol. Protect yourself by changing your diet and taking your medications.

Glucose/Insulin Tolerance

Sugar levels should be low. For anyone who is overweight or has a family history of diabetes, a midlife check-up should include glucose/insulin testing. Impaired glucose function (diabetes mellitus) is associated with and a known contributor to many other health problems, including excess weight, hypertension, hormone imbalance, and accelerated ageing. According to Healthline, Prediabetes and Type 2 diabetes (formerly called adult-onset diabetes, but now found in younger age groups as well) have become so common that they are considered to be nearly epidemic. In non-diabetics, readings should be 4.0 to 5.9mol/L before meals, rising to no more than 7.8mol/L 90mins after eating. Also, work out your Body Mass Index (BMI). A high waist measurement is also a risk factor for diabetes: women should measure less than 31.5in; men less than 37in.

Ovarian Function

Most women associate menopause with a decline in ovarian function, primarily resulting from decreasing estrogen levels. But the transition from pre-to post-menopause can be longer than you expect and is far more complex than that. In addition, most healthcare practitioners agree that reproductive ageing precedes menopause by at least 10 years.

A midlife check-up can help you evaluate your reproductive and hormonal health, as well as establish a baseline to prepare you for the changes ahead. As you age, estrogen levels fluctuate and decline, other hormones fluctuate and rise. Knowing if or when you are menopausal is not as important as accurately assessing your ovarian function, because that will play a far greater role in your overall health and well-being. Hormone testing, in conjunction with keeping track of symptoms such as irregular bleeding and hot flashes, will help you and your healthcare practitioner monitor your ovarian and hormonal health at midlife.

Breast exams

Breast cancer is still relatively rare, affecting about one in every 68 women. But because treatment is most successful when the disease is diagnosed early, you should start mammograms now. Starting in your 40s, your GP will perform yearly breast exams. Doctors will visually and manually check your breasts for differences in size or shape, rashes and dimpling, and lumps. They may also check to see if your nipples produce fluid when gently squeezed. You should be aware of how your breasts look and feel and report any changes to your physician. In the UK, women aged 50-70 are automatically invited for screening every three years, but you may be eligible before the age of 50 if you have a family history of the disease. All women should regularly have a mammography to screen for breast cancer. How often you seek treatment varies by age.

Pelvic Exams

An annual pelvic exam, including a Pap test and a rectal exam, is very important during midlife. The primary purpose of a smear test is to screen for cancerous or pre-cancerous conditions in the cervix and vagina. The tests may also be used to evaluate hormonal changes or their effects. In the UK, women aged 25 to 64 are invited for a free cervical screening test at their GP’s surgery – every three years for those aged 25 to 49, and every five years for those aged 50 to 64. Over 65s are only screened if they haven’t been screened since the age of 50 or have recently had abnormal tests.

Thyroid Exam

During a midlife check-up, your healthcare practitioner will probably examine the area near your thyroid (on your neck) to see if it is enlarged. If you exhibit any symptoms that could be thyroid related, your GP may also request lab tests to assess your thyroid function. Typically, a thyroid test measures your TSH level. If it is out of range (either low or high), further evaluation of your T3 and T4 hormone levels may be necessary.

Skin checks

Screenings by a medical professional are based on a patient’s risk factors. These risk factors may include significant sun exposure, family history of skin cancer, fair skin, the presence of multiple unusual moles. Moles that change shape, size or colour, which have ragged edges or are itching or bleeding, could be the first signs of malignant melanoma.

Keep a healthy lifestyle

According to the latest BMJ Research, modifiable lifestyle factors including smoking, physical activity, alcohol intake, body weight, and diet quality affect both total life expectancy and the incidence of chronic diseases. Therefore, it is recommendable to enjoy a balanced diet and stay away from processed foods, making sure every meal has a varied intake of fruit and vegetables (which will provide a healthy abundance of vitamins, minerals, and antioxidants). Keeping physically fit with a mix of yoga, resistance training and low-intensity weightlifting, and exercising your brain regularly through learning something new will also be beneficial for your general health. A healthy body will promote a happy, positive mind as well. This will allow you to enjoy everyday activities to the fullest and be at the prime of your life, at every step of your midlife years.

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