Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and joining me today is Carissa Bencito. She's a Family Nurse Practitioner at Henry Mayo Newhall Primary Care, and she's here to talk to us today about healthy aging for women. Carissa, thank you so much for being with us today. I would like to start by asking you how do women's health concerns change as we age?

Carissa Bencito, FNP-C: Well, as we age, there's a lot of things that we have to really take care about, especially if we have comorbidities such as diabetes or hypertension. So yeah, we really have to make sure that we see our provider regularly to make sure that everything is okay. So we have to start it with regular diet and exercise and to make sure that we eat a balanced diet, including eating the right amount of calories and nutrients to maintain a healthy weight.

Host: Well, let's talk about diseases as our health concerns change as they age. And Carissa, I'm a woman of 60, so I've seen these changes firsthand, but I know that our risk changes for certain diseases as we grow older. And we tend to think of men and heart disease, but really women are at a very high risk. Can you speak about some of the most common women's health issues that you see throughout the life stages?

Carissa Bencito, FNP-C: Well, I would say that two out of every three women who die suddenly is from a heart disease. And, unfortunately, they don't have any symptoms. But there are some signs to watch out for, like chest or arm pain or discomfort, those can be a symptom of heart disease or a warning sign of a heart attack.

So, women often describe a burning chest pain or pain in the back, neck, or jaw. And unfortunately, women do worse than men after a heart attack. So, researchers are not sure why this is, especially for younger women, but for women between 45 and 65 years of age who have a heart attack, they are more likely than men of the same age to die within a year of a heart attack.

However, heart attack is less common in younger women than in younger men, but this is partly because the hormone estrogen protects against heart disease in younger women. So, for women, older than 65 are more likely than men of the same age to die within a few weeks of a heart attack. So women usually have a heart attack about 10 years later than men. So the average age of the first heart attack for men is 64, but it's 72 for women. So it's kind of like that.

Host: Yeah, well, it certainly is different. And I remember when I was back in graduate school, all the tests and studies were always done on men. But now of course, we're seeing more interesting studies done on men. And you mentioned earlier diet and exercise. I'd like you to speak about some tips that you have for someone who's not physically active and having a hard time getting started. I, myself am an exercise physiologist and I know how hard this is for people to get going. What's your best advice?

Carissa Bencito, FNP-C: So diet and exercise really go hand in hand. They are both crucial components of a healthy lifestyle and have a significant impact on our overall health and wellbeing at any age. Physical activity, it's any form of movement that uses energy. So it's some physical activities better than none. So I would advise all the people out there who's listening, it's better to have some physical activity than none. And the more you do, the more benefits you gain. And of course, eating smart and being active have similar effects on your health.

Host: It sure does. We've seen that time and again. Now, what about screening exams, Carissa? When should women start getting their mammograms? How often? Tell us about some of the important health screenings that we really need to pay attention to, to make sure that we are our best advocate and healthy aging for women.

Carissa Bencito, FNP-C: Screening tests are used to find cancer before a person has any symptoms. Screening can often help find and treat precancers and cancers early before they have a chance to spread. According to the American Cancer Society, they recommend women ages 40 to 44, they should have the choice to start annual breast cancer screening with mammograms, which is an x-ray of the breast, if they wish to do so.

Now, women ages 45 to 54 should get mammogram every year, and women 55 and older should switch to mammogram every two years or can continue yearly screening. All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.

And other screenings that women should get are like cervical cancer screening with the PAP test. So, it depends on your age, but once the PAP test is done, we can additionally give the patient, especially younger people, you know, to have HPV vaccine or human papillomavirus vaccine to help protect against HPV infection that's most commonly linked to cervical cancer.

Also, I would recommend some bone density screening. Bone density screening is to check for osteoporosis. It's a disease that occurs when the body loses too much bone, which makes too little of it or both. So, these screenings can estimate your risk of breaking a bone before it happens. Typically it's done via a DEXA scan.

Host: Yeah, I love that you brought up HPV and the vaccine because that's going to be an interesting thing as we see what goes on in the future, Carissa; as far as the rates of cervical cancer. And women of my age who couldn't get Gardasil, we get our PAP smears, but also getting a test for HPV does definitely change those guidelines. So that's really interesting that you brought that up. Carissa, there are other things that are not so medically based, but things we women go through in the course of our lifetime, and depression is a big one that is under recognized. Can you speak about the importance of depression screening and discussing with our providers when we feel like we might be at risk?

Carissa Bencito, FNP-C: Women are nearly twice as likely as men to be diagnosed with depression, so depression can occur at any age. So some mood changes and depressed feelings occur with normal hormonal changes.

But hormonal changes alone don't cause depression. So other biological factors, inherited traits, and personal life circumstances and experiences are associated with a higher risk of depression. Just make sure you seek help if you have any signs and symptoms of depression such as ongoing feelings of sadness, guilt or hopelessness, loss of interest in things you once enjoyed, fatigue or unexplained pain, problems concentrating or remembering things, and physical aches and pains, and feeling as though life isn't worth living or having thoughts of suicide.

So, consider turning to your primary care provider first, for example, your family doctor, your internist, or nurse practitioner. If needed, your primary care provider can refer you to a mental health professional who specializes in diagnosing and treating depression.

Host: This is important information. Can you speak about stress management for us, Carissa? Because that's another important thing for women is we have to learn self care. We have to learn to be kinder to ourselves and stop with the negative self talk and really treat ourselves better than, you know, we treat other people great and then we don't always treat ourselves that well. Can you speak about the stress we're under and the things we worry about and that anxiety that contributes to some of these physical problems?

Carissa Bencito, FNP-C: So stress and anxiety, those are the big factors why women, you know, specifically, are having a hard time with their daily lives. So I would advise for people who are suffering from anxiety or stress to have a balanced diet, including eating the right amount of calories and nutrients to maintain a healthy weight.

And, of course, physical activity is going to help them a lot to improve that anxiety that they might be having. Because being active can improve your personal appearance, not only that, but encourage fun with family and friends, maintain the ability to live independently, and enhance fitness for sports. A healthy diet helps support not only our mental health, but also reproductive health, prevents bone loss, and reduces your risk for some cancers. So it's very crucial for you to have a healthy lifestyle, in general to make sure that your anxiety will be controlled.

Host: It really is such great information. Thank you so much, Carissa, for joining us today and telling women the things that we need to concentrate on because it is so important. Depression and stress, anxiety, diet, and exercise, and our screening exams. Really also important because we do need that to be our own best health advocate. Remember, they always say, put your own mask on before you put the mask of your loved ones on. So thank you so much for joining us today.

And to make an appointment at Henry Mayo Newhall Primary Care, you can call 661-200-1710. Or you can visit henrymayoprimarycare.com. You can always visit the free health information library at library.henrymayo.com for so much great information that you know you can trust.

That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. Thanks so much for joining us today.