For many women, the years between the ages of 40 and 60 mark the time when they begin seriously considering their own health concerns. New and often overdue media attention is increasingly focusing on women's health matters such as heart disease, hypertension, diabetes, breast cancer, osteoporosis and menopause.

For women in their middle years who want to discuss medical issues with a knowledgeable health care professional, undergo a thorough one-on-one health assessment or, if necessary, be referred to a physician or other health care provider, Froedtert & Medical College offer the Total Health for Midlife Women Program.

No two patient profiles are exactly the same. Empty nesters, women undergoing changes or challenges in their careers, those with concerns about their bones or their heart - that's fairly typical.

So far, most patients are women with problems maintaining their ideal weight, and women who are approaching menopause or are in menopause and they just don't feel like they used to. Also, now that fewer women are on hormone replacement therapy (HRT), they have concerns about how to manage their vasomotor symptoms (such as hot flashes and night sweats) and how to prevent osteoporosis.

Evaluation, Discussion, Health Assessment
A visit typically lasts between 75 and 90 minutes, and is not a physical exam but rather an evaluation of their current health status. The visit always begins asking two questions: "What brought you here?" and "Do you have any specific questions or concerns that I could help you with?" After addressing those topics, doctor conducts a wide-ranging health risk assessment with discussions about:

If the results indicate they have never had a mammogram or are overdue for one, we help set up an appointment for that. Doctors do the same if they haven't had a pelvic exam and Pap smear recently. Some women ask about that when they call for their appointment; if possible,doctors arrange the tests for the same day.

Women who have established physicians may continue receiving health care through that doctor's health system. If they do not have a relationship with a physician,doctor can help them find a primary care doctor through the Froedtert & Medical College network. If they have a problem that should be further evaluated by a dietician, social worker or psychological counselor, she can help arrange that, too.

Stress, Menopause and Health
Women often are juggling so many responsibilities - at home, at work, with children, with aging parents - that they neglect their own health. Some women have tell, 'I never realized how much stress I have in my life.'Other times they are aware of problems, but they have never discussed them with anyone before."

Women approaching menopause - those in the phase called perimenopause - may be undergoing changes they have never experienced before and are puzzled by them. These can include symptoms like changes in the menstrual cycles, accompanied by increased yeast infections, fatigue, headaches, and dryness or itching. They may be gaining weight for no apparent reason, and feel moodier than usual. They need reassurance. Many feel relieved to learn their symptoms are not unusual, who provides patients with materials they can take home and study.

In 2002, after results from the decade-long Women's Health Initiative study showed that women using hormone replacement therapy had slightly higher risks for breast cancer and heart disease, many physicians advised women to stop taking the drugs. Many women in menopause are questioning whether they can safely take HRT, both to relieve menopause symptoms and to help prevent osteoporosis. Along with alternative/complementary remedies, doctors discuss the pros and cons of HRT so women can make an informed decision along with their medical provider.

Recognizing Risks for Heart Disease
Many women in midlife and older remain unaware that heart disease is a great health risk for them. Doctors discusses possible symptoms of heart attack, which in women often differ significantly from men's symptoms. Where men might experience crushing chest pain that can radiate down the left arm, women's symptoms are often more subtle. They can include neck, jaw or shoulder pain, nausea, fatigue or shortness of breath.

Only 50% to 60% of women experiencing a heart attack report the chest pain or pressure of typical angina. (In men, the percentage is 80% to 99%.) Doctors helps women understand the importance of preventing heart disease with diet, exercise, and maintaining a healthy weight.