This article was written by Peggy Edwards, co-author of the recently released book "The Healthy Boomer: A No-Nonsense Midlife Health Guide for Women and Men." Peggy is a principal with the Alder Group, an Ottawa-based consulting firm dedicated to the promotion of health and innovation. She is a well-known health promotion writer, consultant and facilitator.
This year, there are some 10 million baby boomers (people born between 1946 and 1964) in Canada. Suddenly, the generation whose motto was "never trust anyone over 30" is asking questions about hormones, hair loss, heart disease and what to do with the second part of their life! And not surprisingly, health promotion practitioners are seeing an increased need, both professionally and personally, to provide information, advice and guidance on midlife health.
My two co-authors-family physician Miroslava Lhotsky and psychologist Judy Turner-and myself wrote "The Healthy Boomer" in response to requests from midlife women whom my partners were seeing in their Toronto-based practices. These women felt confused and frustrated by the expanding and often contradictory information on menopause and other midlife health issues. They were also concerned about the changes and stresses their partners and male friends were experiencing. They told us that the men in their lives were changing too, but that they were having trouble talking about it.
After searching for available resources, we realized there was as yet no one comprehensive source that addressed both men's and women's concerns, that was written in lay language and would encourage communication about the midlife journey.
We decided to write "a small handbook." It grew into a 450-page fully-referenced book which one reviewer called "The Dr. Spock of Midlife." It grew because of our commitment to health as not just physical, but mental, emotional, social and spiritual as well. It grew as we conducted focus groups, workshops, and interviews with individuals in midlife.
We quickly realized that once the medical questions about hormone replacement therapy and prostate cancer were answered, men and women in midlife were deeply concerned about issues such as complementary therapies and alternative medicines, relationships, sex and impotence, and why they can't remember where they put their keys!
It took us four years to write "The Healthy Boomer." In the process we personally experienced many of the challenges of midlife, including adopting a baby, watching young people leave home, becoming a grandparent, losing relatives and friends from breast cancer and AIDS, and becoming caregivers to parents who were ill.
As a physician, psychologist and health promotion specialist schooled in epidemiology and physical education, we made a unique team. Sari Simkins, a Registered Dietitian served as our primary consultant on nutrition, and several other experts in public health, medicine and psychology provided us with advice on various chapters. We were well guided by the men and women in midlife whom we interviewed.
In one brief article, it is impossible to discuss all of the topics in "The Healthy Boomer." Instead, I will provide a general overview of midlife health issues, as well as a specific focus on selected topics.
B. THE MIDLIFE JOURNEY
Our research with men and women in the middle years suggests that midlife has less to do with your chronological age than it does with your experience of the midlife transition. Sometimes, an early menopause spurs women into midlife at age thirty-eight or forty. Some men postpone the journey until their late fifties. And while most of us experience some common upheavals in the middle years, major events, such as the loss of a parent, may occur earlier, when you are in your thirties or forties. So, to a large extent, "midlife" is self-defined. Poet Ogden Nash says it this way: "You know you are middle-aged when it is Saturday night, you're home alone, the phone rings, an you hope it isn't for you."
It is hard to deny that things are changing in the middle years-new aches in our bodies, changes in our sexuality, children leaving home, parents getting older, and a nagging sense of limited time left in life. All of these things suggest that the period from approximately age forty-five to sixty-five is a unique stage of adult development with a discrete set of issues and experiences.
We see the journey of midlife consisting of three phases:
* the beginning is initiated by an experience of loss, and focuses on letting go of the known, predictable past;
* the middle period of turmoil and uncertainty is when you question your purpose in life and re-assess your priorities. You may feel like a trapeze artist, caught in the moment when you have let go of one bar and not yet grasped the next one;
* the regeneration is an emergence out of the "dark night of the soul" of the middle period into a time of renewed energy.
Many boomers on the midlife journey look to anti-aging theories and remedies in an effort to delay or reverse the aging process. Our research shows that there is no magic fountain of youth. Aging is inevitable and we need to accept and welcome both the first and second stages of adulthood. At the same time, healthy lifestyles, social support, a safe environment and other factors can delay or prevent many of the declines and diseases associated with growing older.
The physical and psychological changes of menopause are an integral part of the midlife passage. Interestingly, 80% of the men we interviewed said they believed in a "male menopause." This is backed up by an increasing number of medical studies on andropause that have shown how men experience many of the same symptoms that women do in the perimenopause and menopause.
By remaining open to growth and wisdom, each of us has the opportunity to experience the renewal and regeneration that is part of the midlife journey. The journey is a spiral. We do not return to the place where we started. Instead, we find ourselves inescapably altered, at the frontier of a new time in our lives.
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C. HOW TO DIE YOUNG... BUT AS LATE AS POSSIBLE
The second part of "The Healthy Boomer" covers critical aspects of physical, social and mental well-being in midlife: the change process, active living, healthy eating, drugs, relationships, sex, impotence, stress, memory loss, appearance, depression, anxiety and insomnia. Here is an excerpt on the effects of aging on sex.
Despite the media hype about sex as a prerogative of the young, sex can get better in midlife. Part of this is due to emotional changes. Happily, we found a subtle shift in midlife sexuality away from "raw sex" to enhanced feelings of intimacy and love. The physical effects of aging on the three phases of sexual response can also be an advantage.
Effects of Aging on Sex: Men and Women
* Sexual passion or desire is controlled by testosterone. If levels drop too low, a man loses his interest in sex. Hormone therapy can help in the rare occasions when testosterone levels are below normal.
* Testosterone levels also affect sex drive in women. Hormone treatment must be used with caution because of side effects.
* Erection is delayed and the penis becomes less rigid with age.
* In young men, either physical or psychological stimulation (fantasy) can produce an erection; older men require both to attain and maintain an erection.
* At menopause when the ovaries stop producing estrogen, the walls of the vagina are less lubricated and elastic. As with older men, arousal is delayed.
* HRT, regular intercourse, use of water-soluble lubricants, and estrogen cream or an estrogen ring can slow this process
* Most men ejaculate normally until a very advanced age. While the interval between a first and second ejaculation is a few minutes at age 17, it can take 48 hours by age 80.
* Men have more control over the timing of their ejaculations as they get older.
* Women may find the intensity of their contractions at orgasm decrease with age.
* Women can experience multiple, rapid, repeated orgasms throughout life.
The changes that come with aging can actually lead to better sex. Because it takes men longer to get an erection and to ejaculate, and because they need both direct and indirect stimulation, foreplay is longer and more enjoyable for both partners. This is a particular bonus for women who take longer to reach orgasm than men at any age.
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D. AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE
This section provides prevention advice on health and disease issues related to midlife: healthy bones, prostate health, breast health and heart health. It also suggests ways to be an empowered consumer when it comes to dealing with the health care system, hormone replacement therapy and complementary and alternative medicine. Here is an excerpt from the chapter entitled "Partners in Health Care."
Who's in Charge Here Anyway?
In the last two decades there has been a major shift in the practice of medicine. As educated consumers have demanded more control and input into their care, the medical profession has responded with what it calls patient-centred care. This approach encourages physicians to see patients as partners in their own care. It encourages patients to ask questions and share the responsibility for medical decisions affecting them. It also acknowledges the emotional and psychological aspects of illness.
Here are some tips on how to develop a partnership with your family physician and other health care providers:
* Remember, your input is vital to your physician's ability to treat you effectively and respectfully.
* Educate yourself about your own health concerns. Visit the library. Surf the net, looking for reliable sites, such as those sponsored by universities, government health departments, and well-established organizations, such as the Cancer Society, the Heart and Stroke Foundation and the Arthritis Society.
* Share what you learn with your health care provider.
* Consider joining a support group. People share their stories and solutions and provide support that only others with similar problems can give. These groups most often meet face to face, although increasingly they meet on-line as well.
* Take prescribed medications as directed. Report any side-effects to your physician and discuss alternatives. The modern cornucopia of pharmaceutical offers many variations on the same drug. You and your physician may try several different ones before you find the one that is best for you.
* Tell your physician and alternative practitioners whether you are using over-the-counter medications, vitamins, herbs, or other complementary and alternative medicines. These may react with prescription drugs.
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E. LOOKING AHEAD
In previous generations, religious faith was a major support for people entering the midlife transition. But many baby boomers-perhaps more than previous generations-rejected organized religion during their adolescence and young adulthood. Now, as they face the challenges of midlife, the desire and need to experience greater meaning in life begin to take precedence over their striving for day-to-day material success. Evidence of this spiritual quest fills bookstore shelves, newsstands, and prime-time television slots.
The quest for meaning and purpose is central to who we are. In midlife, this search is intensified by our struggle to face mortality, and to understand and accept the inevitable losses that occur.
The women and men we interviewed found spiritual well-being in a variety of sources-a return to established faiths or the adoption of new ones, communing with nature, exploring poetry and the words of the great teachers, enjoying music and art, finding peace in meditation, prayer and mind-body activities, reaching out to support and help others, taking time to be in the here and now, and creating meaningful rituals in their personal and family lives.
Often, the midlife passage feels like a journey through the rising and falling waves of a turbulent sea. Sometimes, we feel like refusing to board the ship. When we do, we are sure that we will lose control and be washed overboard. But by staying informed and learning to nurture our body, minds and souls, each of us can grab the wheel, enjoy the voyage, and sail on to the next productive stage of life. Welcome aboard!
"The Healthy Boomer" is available from the Canadian Public Health Association [email: firstname.lastname@example.org] and all major bookstores in Canada.