Retirement on the horizon

To add to our woes, 33 per cent of women develop thinning scalp hair by the age of 50, increasing to over 50 per cent in older women. In as many as two out of three cases, this is linked with reduced iron stores, so a good iron intake (from shellfish, red meats, sardines, wheatgerm, wholemeal bread, egg yolk, green vegetables and dried fruit) will help minimise this effect. The incidence of facial hair increases with age and by the age of 65, 40 per cent of women have a noticeable moustache and 10 per cent have hair on their chin.

The tendency towards facial hair is partially inherited. Some cases are linked with raised levels of circulating male hormones (androgens), but up to 30 per cent of cases have no known cause. Diet may play a role so an increased intake of foods containing oestrogen-like plant hormones, or isoflavone supplement (e.g. derived from soy, red clover or Japanese arrowroot) should help.

Women are four times more likely to develop foot problems than men because they wear high-heels: as a result, only 14 per cent of men suffer from corns and bunions compared with 30 per cent of women. The answer is to wear sensible flat shoes, most of the time at least.

A woman reaches her intellectual peak at the age of 26 but average intelligence starts to drop after the age of 45, unless you are in an intellectually demanding job and keep your mind active. Around 2 per cent of women aged 65–70 have some form of dementia, increasing to around 50 per cent by the age of 80 years, with Alzheimer’s accounting for up to two-thirds of cases. Women are more affected than men, and it is thought that a lack of oestrogen after the menopause may play a role. Doing crossword puzzles and quizzes helps to maintain your mental agility.
 
Folic acid supplements may help to protect mental prowess by lowering levels of an amino acid, homocysteine, which damages arteries and is linked with coronary heart disease, stroke and dementia. Ginkgo biloba supplements boost bloodflow to the brain and can improve memory, as can isoflavone supplements. Women now live significantly longer than previous generations, and the quality of our life is enhanced, too. In 2001, female life expectancy at birth was 80.4 years (compared with 75.7 years for males) and the good news is that we can expect to live most of this time – on average, 68.8 years – in good health. It really is true that 50 is the new 40!  

When things go wrong

An estimated one in two women over the age of 50 will develop a bone fracture due to osteoporosis. Once oestrogen levels fall after the menopause, bones start to thin so that, by the age of 70, many women lose up to 30 per cent of their premenopausal bone mass. Those most at risk are women who have a family history of the condition, have had many pregnancies (which drains calcium from the body), who experience an early menopause before age 45, or who have been on prolonged courses of oral corticosteroid tablets. Risk factors only predict one in three people who go on to develop brittle bones, however.

Take regular exercise and ensure a good intake of calcium (dairy products, eggs, green leafy vegetables especially broccoli, tinned salmon including the bones, nuts and seeds, pulses and bread made from fortified flour) and vitamin D (oily fish, fish liver oils, fortified margarine and breakfast cereals, liver, eggs, fortified milk and butter). Taking calcium supplements reduces the risk of an osteoporotic fracture by 20 per cent, while taking both calcium and vitamin D supplements reduces the risk of fractures by as much as 40 per cent.

Most cases of endometrial cancer occur in older women over the age of 50 years. In women who are still having periods, menstrual bleeding may become heavier than normal, and there may be bleeding between periods or after sex. In menopausal women whose periods have stopped, there may be unexpected vaginal bleeding or spotting, which may occur at any time, including after sex. Unexpected vaginal bleeding should always be reported to your doctor.

Women now have a one in nine chance of developing breast cancer by the age of 85, but if a first-degree relative (mother, sister or daughter) has breast cancer (especially if this was before the age of 50 years) your risk more than doubles. Most women diagnosed with breast cancer are over 50 years of age. Maintain a healthy weight and do not drink excess alcohol. Remain breast-aware by following the 5-point code:

1. Know what is normal for you.
2. Know what changes to look and feel for.
3. Look and feel.
4. Report any changes to your GP without delay.
5. Attend for routine breast screening if you are aged 50 or over.

Cervical cancer is one of the few cancers that can be detected before it has developed, via a cervical smear. This picks up early, pre-cancerous changes in cells that – if left untreated – might develop into cancer at some stage in the future. Attend for your cervical smear as often as your doctor advises. The recent development of a vaccine against a type of wart virus linked with cervical cancer means the incidence of this disease is likely to decrease in future.

The risk of ovarian cancer increases with age and most cases are diagnosed over the age of 50 years. Risk factors include family history, never having children (three times greater risk), having your first child after the age of 30 and experiencing the menopause after the age of 50. If you have breast-fed or used the oral contraceptive pill, however, your risk is slightly lowered.

Unfortunately, as the ovaries are hidden deep in the pelvis, ovarian cancer often produces no early warning signs until the disease is quite advanced when you may notice abdominal pain or discomfort, abdominal swelling, urinary frequency or occasionally abnormal vaginal bleeding. Women with a close family history of the condition may be offered screening tests such as a trans-vaginal ultrasound. Ask your doctor for advice.

The tendency towards high blood pressure, coronary heart disease or stroke increases after the menopause. Stopping smoking reduces your risk of a heart attack by 50 per cent – 70 per cent within five years. Maintaining a healthy weight can reduce your risk of a heart attack by 35–55 per cent, while exercising for 20–30 minutes, at least five times a week, can halve your risk. Eating oily fish regularly (or taking fish oil supplements) can reduce your risk of a fatal heart attack by a third.

Eating at least five servings of fruit and vegetables per day reduces your risk of premature death from any cause at any age (but especially from coronary heart disease) compared with those who eat less. If everyone reduced the amount of salt in their diet, at least one in seven heart attacks would be prevented. If high blood pressure runs in your family, have it checked annually.