No more periods means no need to see a gynecologist every year, right? Actually, no. While menstrual problems and pregnancy planning and support are no longer part of the picture, the need for a gynecologist remains, but the reasons change as you age. Following is a brief rundown on why you still need to see your gynecologist regularly.
1. Bladder Problems Increase with Age
Urinary incontinence affects 26% of older women in the US. Contributing factors include:
- Obesity, which places excessive physical stress on the pelvic organs;
- Low estrogen levels lead to weakening of the pelvic muscles, resulting in decreased bladder control;
- Increased risk of diabetes – high glucose levels increase risk for UTIs and can damage nerves that control the bladder;
- Increased risk of high blood pressure, which increases risk for urinary incontinence by 50%, likely due to damage to nerves and blood vessels that control the bladder;
- History of childbirth, particularly vaginal deliveries, due to the associated physical stresses on the bladder;
Bladder problems are intrusive, uncomfortable, and can be a source of embarrassment, with symptoms such as increased frequency and urgency, uncontrollable leakage due to stress or urge incontinence, and increased risk for urinary tract, bladder, and kidney infections. Seeing your gynecologist regularly at all stages of life, including as you age past childbearing years, can increase the likelihood of detecting bladder issues in the early stages so that appropriate and effective treatment can be started before serious complications arise.
2. Risk for Certain Cancers Increases
The likelihood of developing ovarian, endometrial, and breast cancers increases with age and early detection is critical for improving your chances of long-term survival.
Endometrial cancer is the most common cancer among women in developed countries and rates are projected to increase by more than 50% over the next twenty years. The average age of diagnosis for endometrial cancer is 60. Though there are currently no screening tests, the disease can be detected on PAP smears in about 50% of cases, which is another reason why checking in with your gynecologist to manage your risk factors and having regular PAP smears is important. Additionally, advancements in genomic technology are expected to increase detection capability to about 80% in the near future.
Breast cancer is the most common cancer among women worldwide. Numerous genetic, environmental, and sociodemographic factors affect a woman’s breast cancer risk and prognosis. The average age at diagnosis is 61 and diagnosis rates are on the rise; however, survival rates have increased dramatically, by 60%, in recent decades, due largely to early detection and improved treatments. Annual gynecological checkups provide the opportunity to stay on top of in-office screenings such as mammograms and to receive training and updated techniques for performing breast self-exams.
Ovarian cancer affects 1 in 78 women, and risk quadruples between the ages of 40 and 70. Some forms of hormone replacement therapy increase ovarian cancer risk, requiring close monitoring.
3. Bone Density Declines
In many ways, the aging process can creep up gradually, with some important signs going unnoticed until it’s too late. Bone loss is one of those aspects of aging and it needs to be properly managed because, along with increasing age the risk of falls increases and recovery from a fall becomes longer and more complex. A 2018 study found that frailty, a measure of functional decline that includes parameters such as loss of muscle and bone mass, cognitive changes, and decline in neurologic function, increases by 6%–7% per year in women between the ages of 75 and 85.
With yearly visits, your gynecologist can pick up on subtle health changes that may impact bone health and can order the right laboratory tests to help you avoid functional declines that can contribute to frailty and impact bone health.
4. Problems With Sex Can Arise
Though sex drive may decline with advanced age, it doesn’t disappear, nor does the need for physical and emotional intimacy. Older couples can still maintain a robust sex life, and many do. Additionally, older single people are entering into relationships at increasing rates and this means increased transmission of STIs. In recent years, diagnoses of some of the most common STIs, including herpes, gonorrhea, syphilis, chlamydia, hepatitis B, and trichomoniasis, increased dramatically among patients over 60. These conditions can progress more rapidly in older patients, whose immune systems may not be as strong as they once were. Your gynecologist can provide guidance to help you avoid STIs and early detection and treatment to prevent serious health complications, if they occur.
Gynecological health issues occur in all phases of life. You can rely on your gynecologist to be a valuable ally as you age.