Health Is Wealth: The Ultimate 2026 Women’s Health Checklist for Your 30s, 40s & 50s

We talk a lot on Get Rich about how to prevent a financial crisis, building buffers, having the right insurance, and not leaving things until it’s too late.

In this episode, we apply that same thinking to something just as important: your health.

Because a medical crisis doesn’t just affect your body, it can impact your income, savings, super, career, and long-term financial security.

Molly is joined by women’s health GP Joanne Helen Mackson to create a practical, decade-by-decade health checklist for Australian women in their 30s, 40s and 50s, covering what to screen for, what symptoms to take seriously, and how to advocate for yourself in a system that hasn’t always been built with women in mind.

In this episode, we cover:

• What health checks actually matter in your 30s, including cervical screening, skin checks, fertility conversations, mental health, and when period pain isn’t normal
• What changes in your 40s, including the Medicare 45+ Health Assessment, perimenopause symptoms, bowel cancer screening from 45, and breast screening decisions
• What to prioritise in your 50s, including mammograms, bowel screening, bone health, heart health, and chronic disease prevention
• Why women often need to push harder for answers, and how to do that effectively
• How prevention is one of the smartest financial and life investments you can make

This is the episode to listen to with your notes app open, then book the check-ups you’ve been putting off, and send to a friend who needs it too.

General information only. Always speak with your GP or healthcare professional about what’s right for you.

Health is wealth, and this episode shows you how to protect both.

CHAPTERS

00:00:00 - Welcome to Get Rich, health is wealth, and why this episode matters
00:01:34 - Meet women’s health GP Dr Jo Mackson, building a 30s, 40s and 50s checklist
00:02:36 - Personal story, why early detection matters
00:02:49 - Dr Jo joins the show
00:03:12 - The 30s checklist, what to screen for and why
00:03:54 - Skin checks and daily SPF tips
00:04:26 - Cervical Screening Test (CST), what it is and how often
00:04:58 - Bulk billing vs longer appointments, how to book the right consult
00:05:53 - Medicare rebates for skin checks, how GP billing works
00:06:36 - Fertility in your 30s, when to start thinking about options
00:07:50 - Mental health “servicing”, when to get support
00:09:02 - Breast checks in your 30s, what to watch for and when to investigate
00:10:15 - Pelvic pain and heavy periods, what’s not normal and endometriosis delays
00:12:53 - STI screening, why it matters and how simple it is
00:13:29 - “General bloods”, when they’re useful and when they’re not
00:14:15 - Contraception options, why a review matters
00:16:14 - The 40s checklist, the decade to get proactive
00:16:51 - Medicare 45+ health assessment, what it covers
00:17:56 - Perimenopause, symptoms you might not expect
00:19:42 - Managing symptoms, lifestyle, supplements and MHT
00:21:29 - Breast screening decisions in your 40s, mammogram vs ultrasound
00:22:17 - Bowel cancer screening from 45, why the kit matters
00:25:09 - Exercise in your 40s, why restarting now makes your 50s easier
00:26:14 - The 50s checklist, key screenings and priorities
00:26:24 - Mammograms from 50, the free BreastScreen program
00:26:44 - Menopause metabolic changes, belly weight and health risk markers
00:28:08 - Heart health in women, risk factors and early warning signs
00:29:26 - Bone density (DEXA), why it’s worth doing earlier
00:30:52 - Advocating for yourself, the three visit rule and longer consults
00:32:31 - Telehealth options for rural and regional women
00:33:56 - Final reminder, you know your body, keep pushing for answers
00:35:03 - Where to find Dr Jo, Sydney Women’s Wellness, resources and socials

LINKS FROM THE EPISODE

Cancer Council, skin checks info: https://www.cancer.org.au/cancer-information
Cervical Screening Test (CST), every 5 years from 25 to 74 - National Cervical Screening Program: https://www.health.gov.au/our-work/national-cervical-screening-program
Cervical Screening Test (CST), every 5 years from 25 to 74 - Healthdirect explainer (incl. self-collection info): https://www.healthdirect.gov.au/cervical-screening-test?utm_source=chatgpt.com
BreastScreen Australia program page: https://www.health.gov.au/our-work/breastscreen-australia-program
Cancer Council summary (ages + eligibility): https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/breast-cancer-screening?utm_source=chatgpt.com
National Bowel Cancer Screening Program: https://www.health.gov.au/our-work/national-bowel-cancer-screening-program
If you’re 45–49 and didn’t automatically get a kit yet, request one here: https://www.ncsr.gov.au/bowel-program/manage-your-participation-in-the-bowel-program/request-a-free-bowel-test-kit?utm_source=chatgpt.com

CONNECT WITH JOANNE HELEN MACKSON

Website: https://www.sydneywomenswellness.com.au/
Instagram: https://www.instagram.com/sydney.womens.wellness/
Facebook: https://www.facebook.com/p/Sydney-Womens-Wellness-61561182664873/

CONNECT WITH LADIES FINANCE CLUB

Join our free Facebook group - Ladies Finance Club Money Chat
Website: https://www.ladiesfinanceclub.com/
Instagram: https://www.instagram.com/ladiesfinanceclub/
LinkedIn: https://www.linkedin.com/company/ladies-finance-club/

TAKEAWAYS

• Health is wealth, and women should prioritize their health.
• In your 30s, start being proactive about health screenings.
• Mental health check-ins are crucial during busy life stages.
• Fertility considerations should begin in your mid-30s.
• Regular health check-ups become more important in your 40s.
• Breast cancer screening starts at age 50.
• Women should advocate for themselves in healthcare settings.
• Regular exercise is essential for maintaining health in your 40s and 50s.
• Bone density screenings are important in your 50s.
• Finding a good GP is key to effective health management.

SOUND BITES

"Health is wealth."
"You need a really good GP."
"Make yourself a checklist."

TRANSCRIPT

[00:00:00] Molly: Welcome to Get Rich, the podcast that helps you do just that. Get rich and stay rich. Hey, I'm Molly Benjamin. I'm the founder of Ladies Finance Club, one of Australia's largest financial education platforms for women. But before I started helping thousands of women take control with their money, I was a hot financial mess when it came to my own finances and not the fun kind of hot, more like crying in a supermarket, wondering where all my money went kind of hot.

[00:00:29] But here's the thing, if I can go from financial mess to owning a share portfolio, investing in property, and building wealth. Then you can too. My mission is simple to make women rich because when we have financial freedom, we have choices, confidence, and control over our future. Every week on Get Rich, I sit down with some of the best experts in the industry to break down how we can all start investing, growing our money, and creating long-term financial security without the jargon, boring bits or overwhelm.

[00:01:02] Because when women get rich, we don't just change our lives. We change the world. So if you're ready to start making some Smart Money moves, hit that subscribe button and let's get Rich together

[00:01:16] on our podcast. We talk a lot on Get Rich about how to prevent a financial crisis. You know, having your emerge. D fund your OMG fund, having the right insurances in place, not leaving things till it's too late. But in this episode, I want us to apply the same thinking to something just, if not more important, your health.

[00:01:34] And honestly, health is a wealth. So when Women's Health GP, Joe Maxon, reach out to me. Was like, Hey, there's so many important female health issues that we just don't talk about, and I would love to come on the podcast to discuss them. I was like, amazing. Let's create a checklist for women in their thirties, forties, and fifties, and just cover like, what do they need to be screened for?

[00:01:57] What symptoms do we take seriously? How do we advocate for ourselves in a system that maybe hasn't always been built for women in mind? So in this episode, it's all about. Breaking it down. So when you do listen to this, I want you to listen to it either with a notepad and pen or get your phone notes app and actually take note of like what checkups do you need to book in for what have, maybe you've been putting it off.

[00:02:20] And also then like tell your girlfriends, be like, Hey, have you done your skin check? Have you had your breast cancer screening? You know, we need to be talking about this stuff as well. And as always, please note that this information is general only. Always speak with your GP or healthcare professional about what's right for you.

[00:02:36] I talk about it in the episode, but my beautiful sister when she was 32, was diagnosed with a stage four blood cancer, and so we really know that health is wealth. And in this episode, we're

[00:02:46] gonna show you how to protect both.

[00:02:49] Joe, welcome to the Get Rich podcast.

[00:02:52] Jo: Thank you for having me, Molly. Excited to be here.

[00:02:54] Molly: Now we talk a lot about wealth at Ladies Finance Club. Obviously yes, that's the name, but really health is wealth. So. What I wanted to chat with you today about is we have a lot of women listening in their thirties, their forties and fifties, and we also love a good checklist here at Ladies Finance Club.

[00:03:12] So I would love if we could go through the different like generations and just chat quickly about like what are the things we should be checking, what should we be testing for, and what should we be looking out for? So maybe if we start with the millennials. Yes. Uh. My group.

[00:03:31] Jo: Yes.

[00:03:31] Molly: So what should we be looking out for in our thirties?

[00:03:36] Jo: So your thirties is a really good time to start thinking about seeing the doctor a little bit more. So for most 20 year olds, you're fit, you're well. The doctor is something that you see occasionally when you get unwell or it's unexpected. But once you get to your thirties, it's time to start being a little bit more proactive about your health.

[00:03:54] The first thing would be making sure that all your screening is up to date. So in a 30 something. We would be thinking about making sure that we're getting a skin check annually. We wanna make sure that we're doing good SPF every day in our, in our daily face care routine, as well as making sure that we are getting it all the way down to our breasts and thinking about your hands and arms.

[00:04:14] Putting some sunscreen on there as well, but getting into see the doctor to get those spots and dots checked over.

[00:04:20] Molly: The skin check. I think it was Zoe Foster Blake who said, your face finishes at your boobs,

[00:04:24] Jo: correct? That is right.

[00:04:25] Molly: All down there. Yeah.

[00:04:26] Jo: All the way down. Yep. That's right. And also on the screening front, you wanna be making sure that your VCAL screening is up to date as well.

[00:04:34] So that used to be called a patch. Which one was that? Your VCAL screening. So looking for cancer of the cervix. That used to be called a Pap smear, but now it's called a CST because the test that we do is actually a little bit different. That starts from age 25 and it's due every five years. So if you didn't quite get around to it in your twenties, your thirties is a good opportunity to get to your doctor and get your first one done.

[00:04:58] Molly: And with the skin cancer check and the CTS screening, can they be bulk build? Like can you go to a bulk billing doctor for that?

[00:05:05] Jo: Yeah, so you can go to any GP to get, at least start the discussion about that. Now, depending on your signs and symptoms, it might be that they need to refer you out for further investigational testing.

[00:05:17] What I would say though about seeing a bulk billing doctor is. Often the bulk billing clinics are set up in anywhere from a six to 10 minute appointment, so they might be trying to get through even up to 10 patients an hour. You don't wanna be rushed for either of those appointments. You want someone that's gonna take the time to examine you properly, have a discussion with you about your options.

[00:05:37] So if you are going to go to a bulk billing clinic, I would strongly recommend that you call them and talk to them about what kind of appointment type you need to book. To make sure that you've got lots of time to be thoroughly assessed for those two checkups.

[00:05:50] Molly: Such a good tip. And with the skin check as well.

[00:05:53] Do we get any Medicare rebate with that one?

[00:05:56] Jo: Yeah, so you will get a Medicare rebate for a skin check. In particular, there isn't a dedicated Medicare item, so most of the Medicare rebates are now, lots of people will have seen. In November. There was lots of discussion about see your GP for free. And the government was changing how the bulk billing system was working.

[00:06:14] Now that may or may not change how much money you get back and what the gap is for your doctor visit. It depends on how the practice is set up. Most practices are what we call time-based billing, so you'll pay for however much time you're in with the doctor and if they're bulk billing, the amount that they will charge for Medicare will be time-based as well.

[00:06:36] Molly: Awesome. So we've got skin checks, we've got the CST. What about when it comes to fertility? So I know I froze my eggs in my mid thirties. Is this something women should be thinking about in their thirties?

[00:06:51] Jo: Absolutely. That's the perfect time to be thinking about it. So we know that your fertility really starts to decrease around age 35.

[00:07:00] Now, that's not to say that if you're 35 start panicking, but it's certainly about the time that you. Want to be thinking about it. Now, if you've got lots and lots of money and you've been doing great investing with Ladies Finance Club, then by all means come in your early thirties. But I think you do have to be sensible about, well, what is the cost outlay versus the benefit, and particularly a bit of a plan around are you planning to try and use those.

[00:07:22] Eggs or embryos that you might freeze in the next couple of years versus is this a 10 year plan? But I would certainly say that if at age 35 you haven't got a family underway and it is something that you would like to do, that is absolutely the window that we would like to be seeing you to start talking about what your fertility options are.

[00:07:40] Molly: Awesome. And what about our mental health? I feel like in our twenties we're like, woo, life. And then in our thirties we're like. Oh God, life is harder than we

[00:07:50] God.

[00:07:51] Yeah. I guess are there any kind of like, how do you know when to get help from the mental health perspective?

[00:07:56] Jo: Look, I am a big believer in prevention is better than cure.

[00:07:59] And I think our mental health is something that often gets put on the back burner. It's on the to-do list for later, particularly women in our thirties. We're either at the peak of our careers, we are still climbing the lateral. We've just got to the top and or we've also started a family or we're thinking about starting a family.

[00:08:15] And all of those things are really. Busy, stressful times. Even if your mental health is in what you think is great condition. People often get a lot of benefit from engaging with a mental health professional just to just to do a bit of a check in and a tune up. I often say to people, it's a bit like getting your car serviced.

[00:08:30] Your car will keep driving if you don't see a mechanic, but often if you take it to the mechanic and get a bit more put in your tires and get your oil changed over, you will find that it. It's working better and your mental health is no difference. Coming in to see someone for just a little bit of a fine tune, a little bit tweak, talk about where the challenges are for you at the moment.

[00:08:48] Tends to put you in really good stead for the future rather than waiting until it's all falling apart and then you're trying to piece your mental health back together.

[00:08:55] Molly: Yeah, I love that. And we love analogies at Ladies Finance Club, so I love that car analogy too.

[00:09:01] Jo: Yep.

[00:09:02] Molly: And so breast screening. Cervical screening.

[00:09:04] So what is the guidance for women in their thirties, and do they need to be worried about that? Is that something they need to check in with?

[00:09:11] Jo: So women of all ages should be examining their breasts regularly. There's lots of different ways you can do that, and it doesn't really matter as long as you are thinking about it and, and if you find a lump or a bump or something that has changed, you come in and see us.

[00:09:25] So the recommended. Routine screening for women at the moment starts at age 50. However, women who are at higher risk because of a family history of breast cancer or other cancers that they've had personally, the advice might be that their screening needs to start earlier. Yeah. Screening by definition is for people who have no symptoms.

[00:09:47] So for breast screening, CSTs skin checks, it's for people who don't have anything that they're worried about. The takeaway message for any of those conditions is that if you find something that is different, we are no longer screening, we are investigating. So if at any point you find a lump or bump in your breast, the skin is changing color, you're getting discharged from your nipples that you didn't have before, that is something that you.

[00:10:12] Absolutely must see your GP about as a priority.

[00:10:15] Molly: Fantastic. And then the other thing I just wanted to chat about and please let me know if there's anything else we should be screening for like in our thirties, but around the pelvic pain and heavy periods. I guess, when are they not normal and when should women start kind of.

[00:10:32] Start looking at like investigating it further and also maybe even budgeting for it.

[00:10:38] Jo: What we know in Australia is that unfortunately lots of women, somewhere around one in nine experience, bad pelvic pain or heavy periods. That's a really high number, and of that group, women who do have things like endometriosis or adenomyosis, the average time it takes to get diagnosed is six to eight years.

[00:11:00] Unfortunately, that is far too long. Yep, the classic story. So what we also know is that women who do have painful periods tend to miss at least one day every time they have a period of their normal daily activities. So whether that's school or work, so across 12 months, that means they're missing 10 to 12 days of school or work.

[00:11:23] Now we know then that financially that's a huge loss of productivity. So you're either burning through your sick leave, or if you're casually employed, you are missing out on income every day that you have painful periods. I think women only know what they know in terms of what a normal period looks like.

[00:11:41] So I would say to you that if you are having pain that is stopping you from doing what you need to do, that is abnormal. If you've got bleeding that is heavy enough that you are bleeding through your underwear or your clothes, or it's again stopping you from what you need to do, particularly if it's stopping you from doing your regular exercise, that is abnormal.

[00:11:59] If you are getting terrible changes in your mood in the days immediately before your period or during your period, that is abnormal and all of those things can be improved and managed. But the key there is that you need early diagnosis and early intervention, and we wanna try and bring that average down.

[00:12:17] Ideally in my world, I would like to think it's one or two visits to a Dr. Max, but we know that we're a long way off that.

[00:12:23] Molly: Yeah, I know once I got my surgeries for my endometriosis, it really did change my life. Like the pain I was experiencing. Yeah. Just like disappeared. So I was very, very fortunate there.

[00:12:36] It was, um, crazy.

[00:12:38] Jo: Yes, and I think it's just, I'm unfortunate that it's taken you nine years to get to that point. Wouldn't it have been nice if someone had said that to you eight years ago? You'd had your surgery and your pain was gone?

[00:12:48] Molly: Oh, I know what women go through far out.

[00:12:51] Jo: I know.

[00:12:53] Molly: Anything else we should be thinking about in our thirties before we move on to gen?

[00:12:58] Jo: I think the other thing that's worth having a think about is making sure that you've had an STI screen. We know that the rates of chlamydia in particular are really high in women under the age of 25. You can have it done at the same time that you get your CST done. And the good news about most s STIs is we can either cure them completely or we can.

[00:13:17] Manage the symptoms really well. So it's a quick, easy test. You can either do a self collected vaginal swab or you can wee in a jar. Minimally invasive. Doesn't take long. We get the results back and we can do something about that.

[00:13:29] Molly: Awesome. And what about general bloods? Is that something that is just good to do every few years or only unless you have worries?

[00:13:37] Jo: Yeah, so we often get patients coming in saying that they'd like a checkup and they wanna do bloods for the, the general checkup. Bloods, there isn't such a thing. When we are ordering a blood test, we're personalizing it for you depending on what are your risk factors, and a risk factor is always your age.

[00:13:52] So in most healthy 30-year-old women, I wouldn't be routinely ordering a blood test for you. But let's say you've already had a couple of babies and you've had gestational diabetes, then we know that you are at increased risk of developing diabetes later in life. So in your thirties, then we would be looking at.

[00:14:09] Things like your fasting glucose or your HBA one C to just check to see what your insulin levels are doing.

[00:14:15] Molly: Okay, awesome. All right. Actually, that just reminded me when we're talking about the STI checks around contraceptive as well, and I don't know if there's, this is like even the right question to ask, but is there like the best contraceptive out there?

[00:14:30] Like is it the pill, is there a marina? Is there like, I guess from a doctor's perspective.

[00:14:35] Jo: Yes. What I would say is there's lots of choice these days in November, they've added a couple of extra contraception options to the PBS, which makes it significantly cheaper. I think often what happens is it's in your early teens, sorry, your late teens or your early twenties.

[00:14:51] You head down to your local GP who's got six minutes to talk to you and you say, I need to be on the pill, and the GP says to you. Okay, here's a script for the pill, and that's the end of the discussion. And so certainly in our clinic, because we're seeing, we're a specialized women's health clinic, we have lots of people come in and they say, I'm here for my repeat pill script.

[00:15:09] But when we talk to them about how and why they're on contraception, what they like to get out of it, and in particular what the contraindications are. So the reasons that maybe they couldn't take the pill. We often find that the contraception that people are on is not the best fit for them. So I think the most common one that I see is that women who have migraine with aura, so the type of headache where you get the visual flickering and changes when you get a migraine, they're at increased risk of having a stroke.

[00:15:36] In particular if they're on the combined oral contraceptive pill. And we find lots of those women that have been on the pill long term, no one's ever said that to them. And then they come to us and we say, you probably shouldn't be on that. And we swap them over. It to something else.

[00:15:50] Molly: Wow. That's really important to know.

[00:15:53] Jo: It's really important. Yep. So if you've been on the pill long term, I would strongly recommend you find a, a GP that's interested in doing good contraception discussion with you and check that whatever contraception you're on is still the best option for you. 'cause there are plenty of different options out there.

[00:16:09] Molly: Fantastic and great that so many are now on the PBS as well.

[00:16:13] Jo: Yes.

[00:16:14] Molly: Alright, so let's move on. We've kind of got our checklist for our thirties. Now we're coming to our forties, kind of the decade where hormones shift our Yes, meta, what is it our, yes.

[00:16:25] Jo: Your metabolic

[00:16:26] Molly: system.

[00:16:27] Jo: Mm-hmm.

[00:16:28] Molly: Slow down system changes a little

[00:16:29] Jo: bit.

[00:16:29] Yep.

[00:16:30] Molly: And invisible symptoms start showing up. So I guess. What should we be thinking about in our forties?

[00:16:37] Jo: So this is probably the decade where you do need to start seeing the GP a little bit more for that regular checkup concept. It is certainly the decade though, where the women that I see are really, really busy and they're often putting themselves last.

[00:16:51] So they're. Busy working women. They're busy family women, and they're busy getting everyone else sorted and they'll get around to a booking, a doctor's appointment for themselves, but they never quite get there. So particularly in your later forties, there is a, a Medicare, uh, an MBS item number for a health assessment over the age of 45.

[00:17:09] There are some other health assessment numbers available for. Other chronic diseases and for Aboriginal and Torres Strait Islander people that people can access when they're a little bit younger. But for everyone, I would recommend that they book in for that health assessment. And that's an opportunity to check your blood pressure, talk to you about your cardiovascular risks, so things like smoking, exercise, alcohol, any history of diabetes in your family, things like that.

[00:17:35] And this would be the decade where we do start doing. What might feel like more routine blood tests. So in particular, we are looking for your fasted sugars, your hba one C for diabetes, checking your cholesterol, seeing what that's doing, your kidney function, your full blood count, things like that. And as you said, the other thing that happens in this decade is that your hormones do start to fluctuate.

[00:17:56] That can be a little bit, that can be a lot. It can start in your early forties. It can start in your late forties and everything in between. I think women sometimes, again, are told that it's normal. You're going through perimenopause. Everyone expects you to be cranky. Everyone expects you to be yelling at the kids.

[00:18:11] But actually, I would say that's not normal. And commonly in our patients, what we see and hear is people say they just don't feel like themselves anymore. And if that's the feeling that you're getting, or if your loved ones or your colleagues are saying to you, are you okay? You seem a bit more cranky these days.

[00:18:29] That might be a good prompt to be like, Hmm, might be time to head off to the GP and just have a bit of a discussion.

[00:18:34] Molly: Okay. Interesting. And as far as the night sweats and the symptoms of menopause, yes. Um, will we see any of those in per, like in that earlier stage menopause?

[00:18:46] Jo: Yeah, absolutely. So by definition, menopause or being post-menopausal is not having had a period for 12 months or more.

[00:18:54] The average age of that in Australia is age 51. But what we know is perimenopause, which by definition just means the period adjacent to menopause. The symptoms can and do start many years prior to that. So for some women who go through menopause at age 51, they can be perimenopausal from 44, 45. There's lots of different symptoms with perimenopause.

[00:19:17] I think the one that people talk about a lot is that they get hot flushes, night sweats, that their periods become irregular. But you can have other things like achy joints, crawling of your skin, sleep disturbance. One that people talk about a lot is brain fog. You're just not quite as sharp as used to be.

[00:19:33] You're forgetting things at work. You are having trouble finding words in presentations, things like that.

[00:19:40] Molly: God, women get it all, don't they?

[00:19:41] Jo: They really do.

[00:19:42] Molly: Um, as far as like prevent, not prevention 'cause you can't obviously prevent menopause. But with those perimenopause symptoms, are there supplements tablets people can be taking or is that when they should kind of see a doctor to work out how to best manage it?

[00:19:58] Jo: Yeah, there is lots of things that you can do to support yourself in perimenopause, and that's certainly something that, again, finding a GP or a doctor who's got an interest in helping you in menopause is really important. I always say to people, I can examine your knee, but I'm not great at it because I'm not passionate about knees.

[00:20:14] I'm not up at night reading journal articles about knees or going to conferences about knees. I'm doing things about perimenopause, fertility, family planning, so I think it's really important that you do find a doctor that. Wants to help you through that phase because we just are experts about it. We do it all the time and we're passionate about it.

[00:20:32] There's lots of simple lifestyle things that you can do, and it's all the boring things that you've heard a doctor say before trying to reduce your alcohol, prioritizing your sleep hygiene, getting some exercise, trying to think about where the stress points are in your life and going back to your mental health.

[00:20:47] If you need a little bit of fine tune of your mental health, it's a good time to do it. There's definitely some supplements on the market that can help support some of those symptoms, and then moving through the spectrum of things you can do, there's absolutely prescription medications. So the common one that people would've heard about is hormone replacement therapy or MHT.

[00:21:06] People hear both. Both definitions. The goal of anything perimenopause. Menopause is very much about supporting you through that period and managing your symptoms. So there's no cure. We can't make it go away, but we can help you feel better.

[00:21:20] Molly: Yeah. Love that. And I guess, what else should we be thinking about for our forties when it comes to our health?

[00:21:29] Do we need to kind of up that breast cancer screening or is it more, if you haven't had anything like kind of red flags, then it's not as like, you don't need to put on the list.

[00:21:40] Jo: Yeah, I think it's certainly worth asking the question in your forties about should I be going for a breast screen? One of the things with your breast screening in your forties is sometimes your density of your breast is still quite high.

[00:21:53] So the funded screening program for breast screening is for a mammogram. That works really well in breasts that are a little bit older because the density of your breast thins out as you age. So in your forties, sometimes a mammogram isn't the best method of imaging. You and your GP might say to you, let's send you off for an ultrasound, plus or minus a mammogram because you do have a family history, or you have very lumpy breasts that we've known about.

[00:22:17] And it would be good to just start screening you a little bit earlier. The other screening test that comes in in your forties is your bowel cancer screening. So the national, uh, bowel cancer screening test arrives in the mail on your 45th birthday. So happy birthday. Here's a bowel cancer screening kit now that used to start at 50, but they've recently changed that to start at age 45.

[00:22:40] And the reason for that is that we know rates of bowel cancer in young people are increasing in Australia, so we know that. The rate of uptake on that test isn't fantastic, and I think it's because people feel like it might be a bit yucky. Might be a bit icky. It does involve you collecting a little tiny bit of your poo and popping it in a tube and sending it back in the post, but I promise you it's not as yucky or as icky as you think.

[00:23:03] And it's a really good test to identify traces of blood in your stool before you have any symptoms. So if that comes back positive, what happens is the GP gets you referred off to see a gastroenterologist for a colonoscopy, and then they can have a. Inside your bowel. And, and normally the most common cause is either that you've got hemorrhoids, which are not cancerous, but they can do something about, or that you've got bowel polyps, which are precursors to bowel cancer.

[00:23:29] And if they get removed nice and early, then we've, we've, uh, predicted in the bud, so to speak. And your risk of bowel cancer decreases A, because we've removed the polyps. But B, because you'll be someone that then has more intensive screening.

[00:23:42] Molly: This is so helpful. It is crazy how much we just don't know about the human body or how it works.

[00:23:48] We did a session on a podcast actually on money and menopause where we had a financial advisor to talk about the financial implications of menopause and perimenopause, and that was like the first time I'd ever even. Heard about it. Yes. Um, which was crazy 'cause I was 36 and I was like, how has no one spoken to me about this before?

[00:24:07] I know. Um, so that's, yeah. So guys, if you're listening and you wanna learn more about that, definitely go check out that episode. And I assume in your forties, in your fifties, like it doesn't matter. You keep doing those skin checks as well?

[00:24:19] Jo: Absolutely. Yep. In Australia, we've got really high rates of skin cancer, and I think, you know, our generation, Molly, we are probably going to fare better when we get into our later decades because we've been a little bit more SunSmart when we're younger.

[00:24:32] But it's still amazing how a small amount of sun exposure can damage your skin and some of that leads to skin cancer. So definitely keep going with your annual skin checks.

[00:24:41] Molly: Oh, a hundred percent. I still had many goals at my school who were like getting the baby oil out and baking in the sun.

[00:24:47] Jo: Yeah, definitely

[00:24:48] Molly: was.

[00:24:48] I can't do that because I have my, alright, anything else to add to the decade or forties before we move to the fifties? And thank you again. This was. Such helpful information.

[00:24:58] Jo: No, it's my pleasure. I do think that if in building your career, in your thirties, getting your family started, one of the things that often falls away for women is, is some sort of exercise.

[00:25:09] So we know that women, on average, most women by the time they're 21, have stopped playing any sort of team sport. Whereas men tend to keep going well into their thirties. Benefits of team sport are, are many and varied, physical, psychological, social. But I think culturally in Australia we, we are sort of used to that.

[00:25:29] Dad goes off to play cricket or touch footy, but mom stays home with the kids and, and mom, you know, you hear about used to play hockey or used to do rowing, but they're not doing it anymore. So I think one of the things going into the fifties, which we'll get to is that. Exercise and movement is really important.

[00:25:46] And the longer you leave it, the harder it is. So if in your forties, maybe the kids are a little bit older, work's a little bit more settled, might be the time to kind of reengage with some sort of exercise that you enjoy to set you up to build that really healthy routine moving into your older decades.

[00:26:03] Molly: Yeah, I love that. I'm still so inspired by my mom. She takes me to a sprint class. She's in her early sixties and she smashes me and I'm like. We love that.

[00:26:12] Jo: Yes, we love that.

[00:26:14] Molly: That's good. Get on this. So let's move on to fifties. So I guess menopause and be on. So what are like the must do screenings in your fifties?

[00:26:24] Jo: Yep. So we've talked about. Breast cancer screening starts at 50. Uh, you will get a letter in the mail saying you do for your first mammogram. There is a free breast screening program in Australia, so you can go through the free program if that's not convenient to you. There's plenty of private options as well, and in my mind, it's money well spent to get it done as soon as you can, wherever is convenient and easy.

[00:26:44] So really in your fifties it doesn't change too much. It's more of the same, but we certainly wanna be thinking about menopause and. Syndromes of menopause that go with. So we know that there's a metabolic syndrome of menopause. Lots of our perimenopausal and menopausal women come in and they say, Joe, I have always been skinny.

[00:27:03] I've always been healthy, and all of a sudden I have this weight around my belly that just will not move. I've tried all the diets. I'm at the gym. I'm doing everything I'm meant to be doing, and it just will not go away. And unfortunately, the answer that I say to them is, yep. And it sucks and it's really unfair, but your metabolism has slowed down.

[00:27:24] Your decreasing estrogen is working against you. We know that you're more predisposed to put weight on around the middle, which also means you're putting weight, unhealthy fat around your internal organs. What can we do about it? Well, you can only control the controllables, so. Certainly come in, you have a look.

[00:27:40] We check your blood pressure. If that's high, we do something about it. We do fasting cholesterol. If that's high, we do something about it. We check your sugars. If that's high, we do something about it. We can't control your age, we can't control your gender, but we can talk about diet, exercise, lifestyle modification, and some people are just fighting a fight.

[00:27:58] They're never gonna win. And unfortunately, those people do need medication to help bring those risk factors down to reduce your overall risk of things like heart attack, stroke, and blood clots.

[00:28:08] Molly: Okay. And actually just talking about heart attacks, I know the, the research, it's like there's a lot of research done for men and heart attacks, women, it's still being developed.

[00:28:19] Yes. What are those kind of, I guess, early warning signs that we might need to think about when it comes to heart disease and heart attacks?

[00:28:26] Jo: Yeah, so the sad thing about heart attacks is that they do kill an awful lot of women every year, and some of them are silent killers. So unfortunately for lots of women, the first time they know about it is when they're having their heart attack, and that at that stage it's too late.

[00:28:39] So that regular checking in with your doctor. So blood pressure, cholesterol, smoking, definitely contribute to your overall risk. We also know that your family history contributes to your overall risk Now. There are some other tests out there that maybe for a couple hundred dollars might be able to give us more of an assessment of your risk.

[00:29:01] And again, I think that that's money well spent. If that result comes back knowing that you are going to be someone that's at higher risk, then A, we can screen you more often. We can get you back to check your blood pressure more often. And B, if we need to get you off to see a cardiologist, we can do that sooner rather than later.

[00:29:17] Molly: Awesome. Fantastic. And before I just go to my last few questions, anything else we should be thinking about in our fifties?

[00:29:26] Jo: The other thing that I think is worth thinking about in your fifties is adding in a bone density screen or a DEXA scan. So the Medicare rebate for bone density screening applies from age 70 and upwards.

[00:29:37] Or if you have a diagnosis of osteoporosis, which is when your bones are, um, density is low and they're brittle. We know though that when you go through menopause and as your estrogen declines, estrogen helps protect your bones. So we certainly find that some women in their fifties do have osteopenia, which is the precursor to osteoporosis.

[00:29:55] So we know that their bones are already starting to become brittle. The cost of ad dexa scan depends on place to place, but around where I practice the local imaging centers, you'll be out of pocket about $150, uh, even without the Medicare rebate. And again, if we can find that in your fifties and do something about it, we are preventing an unfortunate fall in your sixties or seventies where you break a hip.

[00:30:20] And we know that actually the rates of getting back to your normal health after a broken hip is incredibly low in women. And for a lot of women in their seventies, a broken hip, the rate of death after that in the next 12 months is over 50%. So it's really high. Yeah. Yeah. So we want healthy bones and healthy muscles in your fifties and for $150, if you can find out that your bones are a little bit brittle and do something about it 20 years earlier, again, I think that's a good investment of your money.

[00:30:48] Molly: Absolutely. I think it's the best investment of your money.

[00:30:51] Jo: Yep.

[00:30:52] Molly: And how can, I guess, women advocate for themselves in the healthcare system to ensure that they are being taken seriously and they're not just being dismissed for, oh, it's just hormonal. It's just this, obviously like going to women. Like women focused practices like your own is obviously a great start, but maybe for women who are in more regional areas where that's not possible, what advice I guess, would you have for them?

[00:31:16] Jo: That's a great question and it's a really difficult one. So there's a few things that I think are important for you as patients when you are engaging with the healthcare system. So first and foremost, you need a really good gp and a GP that knows you and you see them regularly. I know that's easier said than done, and particularly in rural areas, that can be really difficult.

[00:31:34] But in medicine we sometimes talk about the three strike rule or the three visit rule, where if you've got a patient who comes to you with the same presentation, same symptoms, same complaint three times in a row, you've tried some things, it's not working, then you need to on refer, you need to send them to another gp, send them to a specialist because they're not getting seen and heard.

[00:31:52] The problem sometimes for women when you are, don't have a regular gp, go to the local bulk billing place where you see whoever's available is that that three strike rule, even though you're going to the same practice, you're not seeing the same person. And so it might take 10, 12, 15, a hundred visits before someone finally says, hang on a minute.

[00:32:09] You've been back over and over again about your pelvic pain. We haven't investigated this, we haven't referred you on. So I think it's really important that you find someone that you like and that you trust and that you go back to that person consistently. For our rural and. Regional women. There is a Medicare rebate number where we can do telehealth and video health, specifically for STI screening and reproductive health.

[00:32:31] So that means that at clinics like mine, uh, where we do have, we are set up for video health. We do have women from regional and rural Australia who are doing video consults with us specifically for their reproductive health. And a lot of those women, it's because they're struggling to get into a GP locally.

[00:32:47] So that's a great Medicare item number and we, we hope that the government keeps that 'cause that. Give some people some financial relief as well. I think the other thing that's really important is you know your body and you know what's normal for you, and don't be afraid to continue to fight for that.

[00:33:01] If you're finding someone that you feel like hasn't listened, you haven't been heard, you still have questions, then they're probably not the right fit for you, and you need to persevere until you find someone who does. And the final point I would make is that my GP colleagues who are in particularly in the bulk billing clinics, working really hard to try and make ends meet and pay the bills themselves, do them a favor, and do yourself a favor by booking a longer consult.

[00:33:26] So a 10 minute consult is going to get you resolution on one simple health issue. If you've got. Complex or a chronic healthcare concern. You cannot get good healthcare in 10 minutes. So yeah, make sure that you are talking to your practice about how long the appointment is at my practice. If you come for pelvic health or a Women's health general consult, it's a minimum of 30 minutes.

[00:33:47] If it's perimenopause or menopause, minimum of 45, because we think that that's the absolute minimum amount of time you need to have a really good conversation with us about your symptoms.

[00:33:56] Molly: Wow, this has been so helpful and I will also just echo what you said. You are the only one who knows your body and from someone who had a sister diagnosed in her early thirties with a blood cancer and was told it was a stress disorder for a very long time, you've gotta be your best advocate.

[00:34:15] So if something doesn't feel right, make sure you keep investigating that. Joe, thank you so. So much for coming onto the podcast and giving us that fantastic checklist. I'm so excited for you. Yeah, so welcome to here this episode. And ladies, what I would love you to do from listening to this episode is make yourself a checklist and start scheduling in these different appointments that you need to make and make sure you have.

[00:34:41] This conversation with your girlfriends as well and make sure they, like I talk to all my girlfriends about their insurances, their wills. Um, yep, I'm, I'm on. Great. I'm great fun to have around, but it's the same with our health. We need to make sure we are reminding each other as well. Joe, where can people find you if they want to learn more about you and the work you're doing?

[00:35:03] Jo: So I'm practicing at Sydney Women's Wellness, which is in Sydney in Greenwich. We have a wonderful website, so Sydney women's wellness.com au, and on our resources page, we've got lots of wonderful resources to other Australian evidence-based resources that you can have a look at. You can also find our, find us at our social media pages.

[00:35:22] So I'm at Dr. Joe Maxon and at Sydney Women's Wellness, and we're very happy to have you booked in for a consult phone, face-to-face video health, anytime.

[00:35:31] Molly: Awesome. Thank you so much, Dr. Joe.

[00:35:34] Jo: Thanks so much, Molly. It's been great to chat.

KEYWORDS

health, wealth, women's health, screenings, mental health, fertility, menopause, health checklists, women's wellness, health advocacy