Empowering Women: Conversations with Dr. Tina Sindwani
To kick off our women's health series, we had the privilege of speaking with Tina Sindwani, MD, a board-certified Internal Medicine physician with over 20 years of clinical experience. Dr. Sindwani oversees a private concierge medicine practice, contributes as a distinguished member of the Voluntary Faculty at NYU, and serves as Chief Medical Officer at the Madison Square Garden Company.
Can you provide an overview of the key health issues that specifically affect women?
Women suffer from many of the same medical conditions as men including cancer and heart disease. These are the leading killers in both men and women. Some conditions are more common in women, such as autoimmune disease, osteoporosis (postmenopausal), and anemia (premenopausal). Women are also more affected by monthly cyclical hormonal fluctuations unlike men, which can affect mood, sleep, weight, and energy level, until they reach menopause, which is also a uniquely female condition. Mood disorders are more common in women, but it is unclear if women are more likely to report or seek care for mood disorders.
What are the most significant developments in women's health care over the past few years?
More open dialogue about menopause and the symptoms around perimenopause has emerged in the past few years. This is helpful because women can feel less isolated when this big change occurs. HRT has come back into favor as an accepted treatment for menopausal symptoms as the materials/methods/inferences of the Women’s Health Initiative are being refuted. This has been a huge relief for many peri-menopausal women. In addition, I would say that strength training has become more of a focus for women instead of just the cardio that women of the 80s and 90s used to do. Women have been more interested in exploring gut health and more open about discussing mental health in the context of social media and other public forums. I think that self-care has become more of a focus for women in the last few years. Many women are in a caregiver role much of their lives and it is so important for them to be able to take time to nurture and fulfill themselves.
Why is heart health a crucial topic for women, and what are the specific risk factors?
Women do not always exhibit the typical symptoms of angina, such as chest pain/pressure radiating to the left arm with shortness of breath and sweating. Women tend to have more silent or atypical symptoms of heart disease. Before menopause, women have lower heart risk than men overall, but following menopause the risk rises to the level that women and men have nearly equal risk. The risk factors are the same for men and women with respect to heart disease, and these include smoking, family history, age, diabetes, high blood pressure, and high cholesterol. There are other biomarkers that predispose as well such as lipoprotein and CRP.
What recommendations do you have for women to proactively manage their health and well-being?
Women should get pap smears every three years from age 21-19. Women aged 30 and up should get pap smears every five years if HPV negative and more frequently if HPV positive to screen for cervical cancer. Women over 40 should consider getting a mammogram, and women over 50 should get an annual mammogram to screen for breast cancer. Women who are post-menopausal with a family history of osteoporosis or whoever smoked should get a bone density test for baseline. After age 65 they should get periodic bone density screenings based on the baseline evaluation. Women, just like men, should use sunscreen daily to prevent skin cancer, keep up to date on colon cancer screening, get an annual physical which should include blood pressure, weight, cholesterol, and blood sugar evaluations, exercise for 30 minutes at least 5 days a week, avoid smoking, limit alcohol to one drink per day or less, sleep at least 7 hours, and follow a Mediterranean style diet.
Women’s health involves various aspects, including mind and body. A skilled healthcare advisor can bring together and collaborate with an array of experts across all disciplines to create a holistic plan to mitigate risk and help you thrive in all stages of life.
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