• Hormones, still?

  • How you doin’?
  • Let’s be breast friends.
  • Wait, is that…?
  • Other health issues.
  • Time for some primary care.

  • How you doin’?

    Nearly all people in this age range will be on the other side of the menopause transition. Conventional wisdom holds that symptoms, if you have them, tend to be the worst in the year leading up to menopause and the year following it. Although you may be outside of this range, you can still get help for symptoms if they’re troubling you. This could include hormone replacement therapy or alternative remedies, depending on what and how bothersome your symptoms are.

  • Let’s be breast friends.

    Your breast cancer risk increases with age and our attention to your breast exam does, too. Mammography has been shown to detect around 90% of breast cancers and a breast exam by a health provider has been shown to be a good addition to that.

  • Wait, is that…?

    Ah, yes. If you haven’t experienced urine leakage before, it’s not uncommon to experience it during and after menopause as estrogen continues to decline and cause changes in the tissue and muscle of the vagina, urethra and pelvic floor. The good news: urinary incontinence tends to respond very well to treatment and there are a wide range of options. Even though it can feel awkward to bring up, trust us—it’s worth it! Your clinician may have some initial suggestions to address what you’re experiencing or may recommend seeing one of our urogynecologists – a.k.a., pelvic floor health superheroes.

    Urogynecology at WHA

  • Other health issues.

    We want you to continuing living a full and healthy life as you age. Your provider will probably want to talk about the things that could be most likely to affect that as you age, such as smoking, obesity, your family history and other risk factors for heart disease and stroke.

  • Time for some primary care.

    If they haven’t already, it’s likely that health issues will come up that have nothing to do with your reproductive health, and we want you to have a go-to primary health provider to help you—and us—address those things. If you need a recommendation, just ask!

A Simple Guide to Screenings and Prevention

Breast cancer screening
Cervical cancer screening
Early osteoporosis screening
Colon cancer screening
General health screenings
Vaccines

Breast cancer screening

Beginning at age 50, all guidelines agree: mammograms should be done annually.

Cervical cancer screening

You know the drill: a Pap and HPV test every three to five years as recommended by your provider until age 65 if your results are normal. If you have a track record of normal results from both the Pap and HPV test, your provider will likely recommend a frequency of every five years.

Early osteoporosis screening

Screening for osteoporosis is recommended for people of average risk beginning at age 65, but talk to your provider about starting earlier if you have had broken bones as an adult; you have a biological parent who has had a hip fracture; or if you smoke, drink excessively or are underweight. Also discuss screening frequency, which can vary from person to person.

Colon cancer screening

Talk to your primary care provider about his or her recommendations for how often to be screened for colon cancer, which will depend on your risk factors, the type of screening tests you’ve had in the past and your past results.

General health screenings

We may be able to help with some of these when we see you. Otherwise, see your primary care provider for screening related to:

High blood pressure. Get your blood pressure tested every year. Optimal blood pressure in healthy women is less than 120/80.

Diabetes. Screening for diabetes is recommended if you are overweight or obese, have high blood pressure, high cholesterol or have had diabetes during pregnancy.

Thyroid disease. Periodic screening is recommended beginning at age 45.

Cholesterol/lipids. Screening tests for high cholesterol are recommended periodically for all people, but may be done more frequently if you are overweight, obese or have other risk factors.

Vaccines

Yep, still. We can help with seasonal flu and Tdap if you’re in for a visit; otherwise, see your primary care provider for:

Seasonal flu vaccine is especially important for people with chronic health conditions, pregnant people and older adults.

Tdap vaccine (if you’ve never had one) or a Td (tetanus, diphtheria) booster shot every 10 years.

Shingles vaccine. Healthy adults aged 50 years and older should get a zoster vaccine to prevent shingles and the complications from the disease.

COVID vaccine. Stay up to date with current guidelines here >

Is This Normal?

Answers you want, questions you may not want to ask
See all provider articles

Let's Talk About It

Here are some topics your provider may bring up

  • 1 Menopause

    Menopause

    Menopause is defined as the absence of spontaneous periods for 12 months. The average age of menopause in the U.S. is 52. Symptoms of the menopause transition (called perimenopause) can begin as early as 10 years before menopause and continue for several years after. Learn more >
  • 2 Health and disease screening

    Health and disease screening

    Screening means looking for signs of disease or assessing risk factors for developing disease before you have any noticeable physical symptoms. Mammography is one way we screen for breast disease. Pap tests screen for cervical cancer or changes that could lead to cervical cancer. DEXA scanning screens for osteoporosis. Measuring blood pressure, weight, cholesterol and blood glucose helps us screen for risk factors that can lead to heart disease and diabetes. Learn more about recommended screening by age range.
  • 3 Emotional wellbeing

    Emotional wellbeing

    Emotional health and wellbeing refers to our ability to cope with the stresses of everyday life in a positive way and recognize and manage negative emotions, like stress, anger and sadness. Emotional health is very important to physical health because when you’re not able to process negative emotions or manage stress, it can impact sleep or lead to unhealthy coping strategies—such as substance abuse, emotional eating, etc. If you’re having a hard time sleeping, your relationships are suffering or you’d like help finding healthier coping strategies, talk to your provider about a referral to one of our behavioral health specialists.
  • 4 Bladder control and function

    Bladder control and function

    The bladder is a muscular sac located in the pelvis just above and behind the pubic bone. It stores urine as it is a produced by the body until we go to the bathroom and release it on purpose in a controlled way through the urethra and out of the body. Loss of bladder control is called urinary incontinence. Urinary incontinence can occur when the muscles of the bladder squeeze uncontrollably or when the muscles holding the bladder or opening to the urethra become weakened. Other types of bladder function problems can include bladder overflow and the retention of urine. There are a variety of ways we can help with urinary incontinence, so talk to your provider if this is an issue for you. Learn more about urinary incontinence.
  • 5 Sexual comfort and enjoyment
  • 6 Hormone replacement therapy
View all topics

Ways We Care

See the complete list of our services

More Resources for You

What to Expect During a Physical Exam

This resource from the Oregon Medical Board provides more information on what to expect from various types of physical exams at the doctor's office, including how to advocate for your rights and what to know about medical chaperones.

GoodRx

A website to compare the cost of prescription medications.

Up to Date

A searchable database of current medical information for both patients and providers.

CDC.gov

The website of the Centers for Disease Control and Prevention – this is a great resource for vaccination and disease screening and prevention recommendations.

MiddlesexMD Blog

A good resource for articles on sex after 40. Also includes various products, but this is not a specific endorsement of those.

Office on Women’s Health

Articles, fact sheets, resources and infographics on staying healthy throughout your life from the U.S. Department of Health and Human Services. Excellent breastfeeding information!

Women’s Healthcare Associates, LLC – Gateway

10566 SE Washington Street
Portland, 97216
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Lauren S. MacKenzie, CNM, MSN - , Midwifery, Portland, OR Lauren S. MacKenzie, CNM, MSN
Midwifery
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Insurance

If you’re pregnant and want to begin care at WHA–or need to schedule an appointment during your pregnancy, call us! Find a provider and location here.

Please have your insurance information handy before you begin scheduling.

This will allow our teams to check whether your plan may require a referral for the care you need or to prepare benefits information to share with you at your visit. If you do not enter insurance information when scheduling, you may be asked to pay a $200-$500 deposit before receiving service.