Regardless of their stage in life, women can and should be vigilant about their health, says Robert Rubino.

Question: What can young women do to stay healthy?

Robert Rubino:  Well, I think part of my standard speech now is I talk to them about the HPV vaccine because I really think it’s important to protect them going forward, I look at their habits as far as social habits, drinking and alcohol always comes into play and smoking, and then dietary wise I think there’s always a lot of social pressure on women for their diet.  Calcium, I’m always driving home that point because you build your peak bone mass up to age twenty-five or thirty so if your calcium intake isn’t great up until that time, then you start, you know, losing bone mass so you really have to kind of stock up in your teens and your early twenties.  And I think the physical and emotional benefit of a regular exercise routine can’t be overstated.  So I really do kind of audit their personal health habits as far as exercise.  I think the women who are routinely active do a lot better cognitively and emotionally than folks who have sporadic physical activity or none at all.

Question: When is it bad to diet and exercise?

Robert Rubino:  Yeah, and that ties into, you know, the social pressures that we see.  I think we can stress that more in the educational environment during health class.  You are what you eat sounds like a cliché, but I think we can go a lot deeper into healthy eating habits when kids are in high school because it’ll be something that they’ll be much more in tune to when they get more of the age of reason in college which, you know, I’m sure you went to college, our habits aren’t the best when we’re in the college years.

Question: What can middle-aged women do to protect their health?

Robert Rubino: Well, if they have kids, to reinforce the messages we just talked about with their kids.  I think teaching that kind of makes them think well, I better practice what I’m preaching so I think teaching gives a certain sense of responsibility to the parents so they will follow their own advice.  And then I think screening is more important as you get into your mid to late thirties so, you know, mammography, cardiovascular disease.  I think everybody’s always worried about the scary monster of breast cancer because it’s so sinister or any kind of cancer because it lurks out there in the background, but tenfold women die of cardiovascular disease than they do for breast cancer and that’s something very much in your control as far as diet and exercise and going to your doctor for annual checkups.

Question: How does aging affect a woman’s sexuality?

Robert Rubino: Well, I think the sexuality is much more apparent than people think.  You know, I think they see a postmenopausal woman; most folks I think will make the presumption that they’re not sexually active.  And I can assure you that it’s not the case.  I think it comes down to the relationship.  If they’re in a stable, monogamous relationship, that’s the key to continued sexual activity and I see that a lot.  Now, sometimes they’ll run into trouble with vaginal dryness and things like that to where the physical activity is somewhat of a discomfort and, you know, with local estrogen creams and things like that, we’re able to help them.  But I think a vigorous sex life usually persists well into the eighties if people are lucky enough to have their spouse with them that long.

Question: What is the biggest health-related mistake aging women make?

Robert Rubino:  Well, I think they tend to focus more on their families and not maintaining themselves.  And also there is I think a health misconception that gee, I’m getting older, my metabolism is slowing and things of that sort, almost kind of giving into I’m getting older so therefore I shouldn’t be as healthy.  There’s not a lot of good data out there that suggests that your metabolism does slow.  It’s more the sedentary lifestyle sets in and kind of that nickel and dime eating, you know, not your major meals, but a friend comes over for coffee.  We bond over coffee and cake, let’s face it.  So small things like that accrue over time so, you know, little things like diabetes, high blood pressure, things that are very much lifestyle diseases start to creep into the picture.  And I find women will kind of say, “Well, I’m getting older and it’s kind of expected,” so again, one of the social norms that we’ve been kind of taught to accept, but it’s not true.  And I always try to counsel my patients in that direction that no, it doesn’t have to be that way.  It’s a little harder because you kind of feel like well, I’m fifty; I deserve to have that piece of cake.

Recorded on: 04/29/2008