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related symptoms, mood changes, sexual dysfunction, prob-
lems with memory and urogenital symptoms.
Among other findings, the recent research shows that the
risks and benefits of lifestyle, pharmacological and surgical
interventions may change as women age, that new non-hor-
mone therapies offering more options for prevention of com
mon menopausal conditions need to be tested in clinical trials,
that the long-term benefits and risks of HRT continues to be
assessed, and that the risk for many disease outcomes can be
reduced even in old age.

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Osteoporosis

Osteoporosis is one of the serious health conditions that
women face. It is characterized by reduced bone mass leading
to increased susceptibility to fractures.
"Women are four times more likely to suffer from osteo-
porosis than men," says Jane Frahm, physical therapist and
director of rehabilitation services at Hutzel Hospital. "It is an
insidious problem because there is no pain associated with it
and patients are not aware of their condition until they frac-
ture their hip or break their wrist.
"If untreated, a postmenopausal woman can lose 10-40 per-
cent of bone mass between the ages of 50 and 60. HRT, in
combination with weight-bearing exercise and adequate calci-
um intake, appears to be one of the better treatments to pre-
vent bone loss."
Cancer is the second leading cause of death for women. The
most prevalent types are lung, breast and then colorectal.
Breast cancer, however, is the most frequently diagnosed.
"Breast cancer survival is improving," says Michael S.
Simon, M.D., professor of medicine and oncology at Wayne
State and the Karmanos Cancer Institute. "Earlier detection,
more frequent screening and better treatment are responsible
for this improvement.
"Today we have different models for prevention, such as
focusing on women who are at higher risk because of family
history. We recommend to some that they take tamoxifen to
lower their risk. A research trial comparing tamoxifen with
raloxifene, which is used in women with osteoporosis and
showed a risk reduction of breast cancer as a side effect, is also
underway.
"Other progress is being made in better genetic testing
which is particularly important to a segment of the. Jewish
population."
Marc Lippman, professor of medicine and chair of the
Department of Internal Medicine at the University of
Michigan School of Medicine, points out that a new approach
to cancer research is taking place. "The latest model is not to
search for a cancer cure, but to locate where the cancers came
from and what happened to make them grow. This approach
is a by-product of gene therapy and the treatment is to target
those specific areas where the cancers originate."

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aging," says Lisa Finkelstein, D.O., a urologist with a private
practice in Farmington Hills.
"However," says Dr. Finkelstein, "there are many,-causes —
such as side effects from medications, childbirth itself which
can weaken pelvic muscles, and lack of estrogen — which
affect the muscles and ligaments around the bladder. All of
these predispose a woman for a prolapsed bladder and inconti-
nence."

Heart Disease

Although most women perceive breast cancer as their major
health threat, more women die from coronary heart disease
(CHD) and stroke than all the cancers combined. Heart dis-
ease is the No. 1 killer of women in the U.S.
The primary risk factors for CHD and stroke are high
blood cholesterol, high blood pressure, diabetes and cigarette
smoking. There is no secret to modifying these risks: not
smoking, increasing physical activity, eating a diet low in satu-
rated and trans fats and keeping the extra pounds off.
Urinary incontinence is another major issue affecting
women over 50, but it is "not an inevitable outcome of

.

Dr. Lisa Finkelstein talks with patient Melissa Pepper of
Westland.

The problem is that many women are uncomfortable talk-
ing to their physician about the problem. "There's a lot of
information available and different treatment approaches,
including making changes to a healthier lifestyle," says Dr.
Finkelstein. "It just makes more sense to have a dialogue with
a physician, rather than living with anxiety."
Jane Frahm, as a physical therapist, is very familiar with
some of those treatments. "Sometimes, it just takes simple
exercise to strengthen the patient's pelvic floor muscles and
help decrease or prevent leakage."

Alzheimer's Disease

The risk of developing Alzheimer's disease doubles every five
years through the ninth decade of life. Although some research
shows a common cause of cognitive impairment is overmed-
ication, there are no proven preventive measures for
Alzheimer's.
The idea of blowing out 100 candles is a good possibility
for many. It is expected that the average 65-year-old has
another 18 years to live. The ranks of people age 85 and older
are increasing and centenarians are the fastest growing seg-
ment of the population.. Joining that special group only looks
good with good health.
Successful aging does seem possible, although how and why
our bodies age is still debated among researchers. Scientists
who study genes have glimpsed some of the mechanisms that
trigger and accelerate aging. Their work proves it's possible to
extend life and prevent certain diseases by tinkering with genes
of fruit flies or worms. However, it will be many years before
effective applications for humans are available.
In the meantime, women over 50 need to be more aware of
the health risks they face. They can do much to ensure a long,
healthy life by accepting good health practices, including
attention to lifestyle and disease prevention efforts such as can-
cer screenings.

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