14 Jul Embracing Age

A deep dive into the emotional, physical, and psychological aspects of aging

Every morning, Bracha Goetz wakes up in her Baltimore home, walks to the mirror, and smiles. While the 65-year-old children’s book author sees one thing, she feels something else entirely.

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“I think, ‘Who is that old lady in the mirror?’” she laughs. “In truth, I feel like a very young person. I believe we are spiritual beings housed in bodies. Our bodies might be aging, but our souls aren’t, and my soul feels as young and as vibrant as ever.”

The disconnection Goetz feels is common among many women as they age. Yet, of late, there is a movement to embrace signs of aging, and women are speaking up about it. For example, in 2016, Martha Truslow Smith started the Instagram account @grombre to celebrate women allowing their hair to turn gray. Since its launch, the account has taken off and, at press time, had more than 223,000 followers.

For Dr. Ellen Albertson, a 58-year-old wellness coach based in Burlington, Vermont, approaching midlife has come with an enormously positive life change. For most of her adult life, Albertson struggled with workaholism, negative body image, and a brutal inner critic. It wasn’t until she was in her late 40s that she happened upon the work of Dr. Kristin Neff, an expert on the concept of self-compassion and the author of Self-Compassion: The Proven Power of Being Kind to Yourself.

“As women, we’ve been taught that our self-worth is based on our appearance,” Albertson says. “I decided to do my PhD dissertation on this topic of self-compassion and realized just how powerful it can be for all women, including those who are approaching midlife.”

Albertson now works as a coach for women under the moniker “The Midlife Whisperer” and largely teaches women to incorporate self-compassion into every aspect of their lives. Some of these practices center on speaking to oneself as if to a close friend. If a woman is suffering, instead of internally berating herself, she should build up herself with positive affirmations.

“I will work with women on better ways to take care of themselves in a host of categories, including body, mind, spirit, heart, and relationships,” she says. “When they experience inner-critic suffering, which is actually the internalized voice of early caregivers, they can then pull out a list of things to make them feel better. These actions can include things like five minutes of deep breathing, listening to music, doing some yoga. And pretty soon, women start to notice themselves offering self-compassion when they are stressed. This can improve every aspect of their well-being.”
But what does self-compassion and Goetz’s spiritual connection to her soul over her looks have to do with aging?
Quite a bit.

It turns out that a positive mindset can lower stress levels, and a 2017 American Psychological Association study showed that self-compassion increased self-esteem and body image in women. Decreased stress levels have been shown in many studies to lengthen life expectancy. And positive thoughts about oneself can in turn inspire healthier life choices, which impact all aspects of aging.
Rachel Lankester, who is 54 years old, knows this firsthand. The London-based founder of the Magnificent Midlife Movement, whose mission is to help women change how they perceive themselves as they age, was diagnosed with early menopause at 41 years old. It wasn’t until she got her nutrition in order, eating regularly to keep blood sugar levels up, that her body got back on a healthy rhythm of menstruation. Since then, she’s become dedicated to learning and teaching about healthy lifestyle changes that will help women as they age.
“Stress management is massive, and that means emotional stress but also nutritional stress if you aren’t eating well,” she says. “Technically, the only symptom of menopause is the end of one’s period. Yet so many women experience horrible symptoms. I see those symptoms as the canary in the coal mine if you will—the signal that something needs to change, lifestyle-wise.”

Goetz was expecting discomfort—hot flashes, headaches, restless legs, night sweats, brain fog, and many more unpleasant physical sensations—during menopause, especially because her mother and oldest sister had experienced most of them. But when Goetz started going through the process, she waited for symptoms to manifest, and they never did.
“I eat healthfully and do joyful exercise like yoga and dancing every day,” she says. “When I visited the chiropractor a few years ago, they told me that my spine was like that of a 19 year old. I wasn’t too surprised because I move so much.”
In addition to nutrition, exercise, stress management, and positive attitudes, here are two more health concerns around aging.

Menopause and hormone replacement therapy
Dr. Soma Mandal was in her medical residency more than 20 years ago when the study linking hormone replacement therapy, or HRT, to breast cancer, was published. Now an internist and women’s health specialist at Summit Medical Group in Berkeley Heights, New Jersey, she remembers an order to immediately end prescribing hormones to women experiencing menopausal symptoms. But what the medical community has learned since the release of that study is that the safety of HRT “depends on the person,” she says, adding that those with a history of cancer are at greater risk.

Multiple follow-up studies have been conducted since then, and today quite a bit of skepticism is given to the original study.
“The study from 20 years ago used synthetic estrogen made from horse urine and synthetic progesterone,” says Dr. Tara Scott, chief medical officer and founder of Revitalize Medical Group in Akron, Ohio. “Synthetic versions are not the same as our bodies. Hormones work in our bodies like a lock and a key. As a metaphor, a valet key won’t do as well in your car as your normal key.”
These days, HRT is used on a case-by-case basis. One of the by-products of menopause is a drop in estrogen, which can increase many health concerns, include heart disease. Recent studies have found that estrogen therapy has “a favorable effect in decreasing heart disease risk,” Scott says, adding that heart disease is the number one killer of women.

She also notes that the original study surveyed mostly older women using horse estrogen, which highlighted the increased risks of breast cancer and blood clots. “But since then, we’ve done other studies and find that the way you take HRT matters,” Scott says. “We’ve found, for example, that taking it through the skin, by way of a cream or a patch, doesn’t increase the propensity for blood clots.”
In the early 2000s, a follow-up study on HRT recommended physicians cap HRT prescriptions at five years, just in case the risks proved true over time.

“But guidelines from the North American Menopause Society no longer say anything about five years,” she says. “Instead, they say that between the ages of 50 and 60, the benefits outweigh the risks to taking HRT in the absence of any reason not to, like a predisposition to cancer.”

Osteoporosis
Also high on the list of concerns of women as they age is osteoporosis, the condition where bones become brittle over time due to loss of tissue. Our bone density is strongest in our late teens and early 20s, but goes down in the years after, and especially in the three years following the onset of menopause, says Scott. She adds that most women start to get insurance coverage for bone density tests around the age of 65, but some women can gain coverage in their mid-50s.

The biggest issue with osteoporosis is that bones can break and fracture more easily as they get weaker. “And once you break your hip, if you aren’t mobile, you may not be able to take as deep a breath, which will increase your risk of a blood clot in the lungs, and that can kill you,” Scott explains. “The death rate after a hip fracture is usually around two years, which is higher than that of breast cancer.”
Thankfully, women can do many things to guard against the onset of osteoporosis. According to Johns Hopkins Medicine, women under 50 years old should take 1,000 mg of calcium daily, and those over 50 should take 1,200 mg per day. These nutrients can come in the form of foods like yogurt, greens, beans, and fat-free milk. Additionally, women under 70 should be taking 600 IU of vitamin D, and those over 70 should be taking 800 IU. An end to smoking and cutting back on caffeine and alcohol can also help, as can participating in weight-bearing exercises.

“This doesn’t have to be strength training with weights, but anything that puts pressure on your bones and muscles is great, like walking, yoga, and dancing,” says Mandal. “Try to do this every other day or at least three times per week.”
Finally, watching what you eat is vitally important for all aspects of aging.
“You are—100 percent—what you eat,” Scott says. “We just aren’t taught this, but, truly, food is medicine. Try to eat food in its native form regardless of what you like to eat. Stay away from processed foods. My brother died at age 38 of a heart attack, and I see that as a preventable death. It is what made me go into functional medicine. I recommend looking at the labels of everything and making sure you can pronounce it all. That is a great place to start.” DW

By BY KATIE MORELL

Katie Morell is a writer based in Bend, Oregon. Read more of her work at katiemorell.com.