5 Questions To Ask Your Physician For Women Over 40

I was trained in the classic medical school tradition: each patient visit begins by asking the patient her "chief complaint" or the most important reason she has come to consult her physician that day. Now, in the era of shortened medical visits on the one hand and much more highly informed patients on the other, it often seems more appropriate for the physician's first question to be "What book or article are we here to discuss?"

All medical conditions, including wellness, can be discussed in terms of five primary areas: prevention, screening, diagnosis, treatment, and follow-up. In this article, we discuss five general questions that all women in their 40's should discuss with their physicians, one in each of these areas. These relate to general health, specific medical screening tests, contraception, compliance, and menopause, areas in which there are unfortunately too many prevailing myths, misconceptions, and misunderstandings.

• Doctors are offended by patients coming in with lists of questions. While patients tell me there are physicians who react badly to bringing in a list of questions, they are in the minority. If your doctor does not respond well to answering your legitimate medical questions, it may be time to find another physician. The most important factor for a successful doctor-patient relationship is comfortable and trustworthy communication.
• Women over 40 can't get pregnant. Nonsense. If you have not yet reached menopause and you have a uterus, you can still get pregnant, regardless of your age. See section 1 below.
• Women over 40 can't take the pill. For women who do not smoke and who do not have certain other major medical risks, taking birth control pills after 40 is now considered safe and effective. In fact, many women now take birth control pills until they're ready to switch to hormone replacement therapy! Discuss this with your physician if you are interested in this form of contraception. See section 1.
• The more tests you have, the better. This is not true- and not just because of concerns about costs. See section 2.
• I'll worry about menopause when I get there. Just as menopause doesn't begin in a day, you shouldn't prepare for it in a day. See section 5.
• Menopause begins after my periods have stopped for a year. While you are officially "in menopause after your periods have stopped for a year, we now know that many of the symptoms and problems related to a decreased estrogen level may begin long before then. See section 5.