Women of all ages come under huge pressure to achieve unrealistic levels of perfection; personal, professional, physical, sexual, spiritual and psychological. I wanted to write a piece about how amazing women are, well, because we are.
I have an opinion that may horrify many; I don’t think our 1970s feminist sisters did us 2025 women a huge favour.
Don’t get me wrong; I am a militant feminist. I understand that the misbeliefs held by a patriarchal society with regard to women needed to be torn down. It was believed for centuries that women were less intelligent, less organised and were incapable of logic, math and problem solving. We were described as flighty, silly – in fact hysteria was an actual female medical diagnosis for many years. We were thought less able than men to do any particular work task so thus should be paid less. Etc, etc, etc.
The rhetoric of late 60s and 70s feminists was that women are able to do every thing. A cohort of feminists went further, opining that we do not need men. I understand the need at that time to direct this loud, oppositional argument to a patriarchal society.
And I agree entirely; women CAN do anything. We are intelligent enough to go to university and get a degree; we can compete for and get a high profile, high pressure, well-paying job to pay the rent/mortgage. We are creative enough to paint, design and build. We can grow human beings in our body, feed them, nurture them, teach them. We can manage money, shop, clean, and co-ordinate the logistics associated with running a household and home.
Has anyone spotted the flaw with 1970s feminism yet?
In modern society, women have ended up doing it all.
Most of us work and rear kids and run a household, plus end up in middle life being the main carers for ageing parents and relatives.
There was a benefit associated with the old societal attitude that women are frail beings prone to illogical thought processes and fainting fits; that we should be looked after, cared for. That concept has disappeared. The Red Tent – gone. Women and baby communal homes, places for women to rest, breastfeed, bond with baby, and recover from the bone-shattering trauma of childbirth for a few weeks – a thing of the past. Living in London, I was pleased to see this is still part of the Orthodox Jewish community.
The concept of society looking after women seems to have been lost; our status changed from frail shrinking violet needing looking after, to Wonder Woman.
In addition, over the last 10 years, with the arrival of social media, not only are we doing everything but we are being told that we are doing it all wrong.
Constantly we are told we are not the right shape; too thin, too curvy, too tall, too short, too much nipple showing, too much body hair, too sexy, not sexy enough.
The ideal body type seems to be a prepubescent, hairless, curve-free stick with large boobs. We are told that the natural signs of ageing are ugly and should be covered up or surgically changed. Oh, and your vagina is too loose/ugly.
We are told we are doing the wrong kind of exercise and are bombarded with advice by social media and celebrity ‘experts’ on what the ‘right’ diet or exercise is. No carbs, low carbs, no fat, good fat, intermittent fasting.
We are supposed to be the perfect working professional with an impeccably well-organised home, pristine children with 16 after-school activities each per week, have the perfect body and also be spiritually zen.
Oh, yes, and also deal with the maelstrom that is perimenopause, and menopause transition when that comes along.
There is a is a constant barrage of criticism that I do not see society directing towards men.
In fact the latest trend seems to be that our feminism and independence is emasculating our men and making them feel unvalued.
So I wanted to talk about self care for women.
Self care has become a bit of a buzz phase and most of us twitch and grind teeth when we hear it, as our inner She Wolf roars; Just where the fe*k am I supposed to fit that in?!
Women’s physical health – facts:
• One in two women over the age of 50 will suffer an osteoporotic fracture.
• One in three women, age 75, will die of a heart attack or stoke.
• One in two women over 60 years have high blood pressure and most are unaware. This is the lead cause of heart attack and stroke in women in later life, if left untreated.
• Women’s cholesterol changes through menopause transition, with total, as well as the bad LDL cholesterol, going up. High LDL is thought to be the strongest predictor of heart problems in women.
• A high BMI, 30 or over, increases a woman’s risk of heart attack by three. Unfortunately menopause transition results in weight gain; an average of 7kg according to studies, but in reality it is more. That weight, as we all know, sits around the belly; what is known as central obesity and is incredibly difficult to shift.
This combination of central obesity and lipid changes is called metabolic syndrome and is associated with much higher risk of developing diabetes.
The physiological changes that occur in our body as a result of falling, then low, oestrogen levels through menopause transition, cause these medical conditions, but they are not inevitable.
So, what can you do about it? Take control!
When I talk about self care I mean; stand up and take control of your body, your destiny. No one else can do it for you.
That, unfortunately does not happen by going for cupping, taking supplements, having a massage or Reiki session or wafting some crystals and incense around. Don’t get me wrong; I am not one of those alternative therapy-bashing doctors; there are huge benefits, but they will not prevent a heart attack or hip fracture.
The stuff you don’t want to hear:
If you read on social media that there are four simple changes you can make to your life that have been proven in studies to massively reduce your risk of heart attack, stroke, Alzheimer’s, diabetes, breast cancer, colon cancer and lung cancer, you would be all over it, right? We are talking evidence-based medicine here. Those four things are:
• Don’t smoke.
• Drink less alcohol – No harm in the odd beer or glass of wine, in fact small amounts of alcohol is beneficial to the heart.
• Eat a healthy diet – nothing weird; there is no ‘right’ diet. Eat more veg, fruit, nuts pulses and beans; eat less red meat, less trans fats. Be aware that over the age of 50, we get higher glycaemic spikes after eating, which then triggers more dramatic sugar swings over the day, causing cravings. So try go for less refined carbs/sugars. Aim for a slow carb in the mornings to avoid big swings in sugar. Yes eat cake; we all love cake! Just not every day. The timing of eating seems to be important. Don’t skip breakfast, it’s bad for your microbiome. Check you are eating enough calcium – 1200mg/ day if you are 50 or over or have gone through an early menopause (www.osteoporosis.foundation).
• Exercise – don’t kill yourself; it has been proven that benefits are gained from Exercise Snacking. This is a new phrase meaning short spurts of exercise. You don’t need to spend an hour in the gym or run 10K. Twenty minutes of fast walking, fast enough to get very out of breath, four or five times per week. If you can jog, great, if not, just walk fast. Regular weights exercise to prevent osteoporosis. Doing low-weight, free weights impact exercises – for 20 reps per exercise for 10 minutes every day – has been proven to increase muscle mass and strength in studies.
I did warn it’s not easy, but little changes will have a huge impact.
And I cannot finish an article emphasising what we, as women, can do to take control and prevent that heart attack, stroke or hip fracture, without adding a #5 to my essential things for overall good female health –consider using HRT for a few years. Evidence from recent studies and Cochrane analysis suggests that HRT started under the age of 60 or within 10 years of the last menstrual period is associated with a reduction in atherosclerosis progression, coronary heart disease and death from CVD causes, as well as all causing mortality.
In addition, four to five years HRT use is associated with almost halving of risk of osteoporotic hip fracture by the age of 65.
Current evidence around HRT use and risk of breast cancer suggests that oestrogen alone is associated with little or no change in risk of breast cancer while combined HRT can be associated with an increased risk of breast cancer, which appears to be duration, not oestrogen dose, dependent and may vary, depending on the type of progestogen used.
However, this risk is low, both in medical and statistical terms, particularly when compared with other modifiable risk factors such as obesity, alcohol intake and lack of exercise.
Current evidence suggests that being on HRT for four to five years does not significantly increase the risk of breast cancer over background population risk. However, longer term use may increase the risk.
Using oestrogen through the skin rather than in tablet form, will not increase the background risk of leg or lung clots, heart attacks or stroke, and will not affect blood pressure.
New Year, New You?
Give yourself a break; none of us are going out running marathons on January 1.
Enjoy your Christmas! Then…Decide you are going to start looking after yourself better in the New Year.
A good start is to book in and see your GP for a women’s health check. I suggest you ask for a longer, 20- or 30-minute appointment so the GP has time for a full check-up: Bloods, BP and BMI measurement. Cardiovascular risk assessment to calculate your Q3 risk score, which tells you your chances of having a heart attack of stroke in the next 10 years. You can work it out yourself on www.qrisk.org. Evidence base is rsk > 20pc or one in five should take statins. Many cardiologists would like to start a statin if LDL is two or more.
Do an osteoporotic fracture risk assessment on fraxplus.org.
You don’t automatically need a DEXA, and a normal DEXA can be falsely reassuring, as most of osteoporotic fractures happen to women with normal or near normal DEXA.
However if you are over 40 and have fallen over and broken a bone in the last few years or, have a female relative that had a hip fracture under the age of 65, you should have a DEXA .
That GP check will rule out existing problems like high blood pressure or pre-diabetes.
The rest is down to you: The hard work part – see the four life changes mentioned above.
In addition, if you are 50-plus, or under 50 and your periods have stopped, please book a separate appointment with your GP to discuss the pros and cons of HRT use for you.
