Real answers to women’s health questions
Interview with Nancy Goler, MD, by Lynn Mundell
Stress. Cancer scares. Sexual questions. Women’s health concerns run the gamut. Some advice is unchanging. But other times, individuals hold the key to their own health solutions, according to Nancy Goler, MD.
An obstetrician-gynecologist, Dr. Goler is Kaiser Permanente’s regional medical director of the Early Start Program for Northern California, as well as Kaiser Permanente’s clinical director for both the Wellness Coaching Center and the Vallejo Call Center.
What are women’s top health concerns?
Although a woman’s age tends to affect her health concerns, breast cancer remains the number one worry, with every lump causing major anxiety.
Young women tend to be most interested in pregnancy and birth control, as well as sexually transmitted diseases. Women in their 40s and 50s are more concerned with perimenopause and may be most nervous about breast health because they know women who are being diagnosed. By the 60s and 70s, breast cancer starts to fall more in the background as a greater array of health worries arise, such as colon cancer, hypertension, and stroke.
Weight seems another hot topic. What’s your advice?
Make moving around a priority, not just to control weight but to keep muscles toned and bones strong. Women’s bone loss happens from the mid-30s onward, so choose exercise that will help bone density as well as heart health. Maintain a moderate lifestyle by eating across the spectrum of food in order to get needed protein.
I tell my patients to try having their regular portion of food and then removing one-quarter of it. Second, slow down. If you take 20 minutes to eat a meal, try 30. That will make you more mindful of what you are eating and of when you are actually full.
What are women reluctant to talk about, but should?
Sex and relationship topics sometimes come last on the list when perhaps they should come first. For example, couples need to go on dates and have time together. If you don’t, the libido will be the one taking the vacation.
It’s also important to discuss with your doctor any bad or unhealthy relationships with anyone you live with, even your children.
All of the sexual questions you are too embarrassed to ask, bring them in. Physicians are there to address substance abuse, too. Kaiser Permanente has many health resources to help people stay healthy.
How did stress become a top health concern?
I’ve noticed that rarely do my patients say they are not stressed out. I think the causes are stacking up: taking care of young children and aging parents, working hard jobs for long hours, our 24/7 technology diet. If you have adult children, some of them are returning home to live — and that is a stress.
Finally, studies show that the division of housework is not 50-50 in most homes. So a woman might work all day and go home to work some more.
There are so many health concerns. How do you begin to address them?
I spend a lot of time listening to my patients to find out what is important to them.
Often for women, the motivation is children, a partner, friends, parents — loved ones. That can be the key to getting a woman to stop smoking, for example. She needs to be there for those people in the future.
Really, though, I would like my patients to stay healthy for themselves. Make your doctors’ appointments — mammograms and Pap smears, but also eye checkups, flu vaccinations, anything you need. Then keep those appointments.
Ask yourself, what brings you joy or makes you laugh? I urge you to make time for those things during the day or week or month. If you don’t know what these things are anymore, start small to find them — and build from there.