When I look in the mirror, I see my motherthe cheekbones (good), the nascent lip wrinkles (not so good). But we have more than just facial structure in common. In fact, my PMS symptoms resemble the ones she experienced in her 30s, and my first pregnancy (Im expecting my own daughter) is almost a carbon copy of what my mom went through when she had me 35 years ago. So, I have to wonder: As I age, can I expect to inherit her hot flashes, too?
Experts say its wise to know both your parents health histories, but ask your mom the right questions and you may be able to avoid a struggle to get pregnant or bothersome menopause symptoms later on. “Knowing your mothers gynecological history can really arm you with what you need to know to take proactive steps in the future,” says Tracy Gaudet, MD, executive director of Duke Integrative Medicine at Duke University and author of Consciously Female. Here, questions to help you start talking.
When did you enter perimenopause and/or menopause?
Margaret Moxley, 46, of Nashville, Tennessee, expects to enter menopause any minute now. After all, she and her mom started their periods at the same age, and they both had their kids on a similar schedulethree, all between 30 and 36. Since her mother entered full menopause at 46, the odds of Moxley doing so around that time are good, says JoAnn Pinkerton, MD, a professor of obstetrics and gynecology at the University of Virginia and president-elect for the North American Menopause Society.
How knowing helps: If your mom suffered killer menopausal symptoms, dont panic about following her into hot flash hell. Her struggle may suggest an increased risk for you, but “it in no way sentences you to her experience,” Dr. Gaudet points out. To lessen your risk, make lifestyle changes in your 30s and 40s to keep your nervous system in balance: Gradually cut back on caffeine, build regular exercise and stress-reduction techniques into your routine, and add more Hormone therapy is another option to discuss with your doctor. Recent studies suggest that low doses are effective and safe for short-term use in many women, particularly when started in early menopause.
A word of caution: If your mom hit menopause in her early 40s (the average age is 52), you might want to start a family sooner rather than later. Dr. Pinkerton says you can also look into freezing eggsa technology thats advancing rapidlythough your insurance probably wont cover it. Check with the American Society for Reproductive Medicine (www.asrm.org) for more info.
Did you have trouble getting pregnant?
“Fertility is like menopause,” Dr. Gaudet says. If your mom had a hard time conceiving, it doesnt predict that you will, but your risks may be higher. Problems with egg production or endometriosis (two typical causes of female infertility) tend to run in families, says Robert Greene, MD, an infertility specialist and author of Perfect Hormone Balance for Fertility. Nearly 20% of women with premature ovarian failure have a family history of the disorder, and the risk of endometriosis doubles in women with relatives whove had it, he says.
How knowing helps: If your mother had trouble and you know you want kids, its not wise to postpone trying. Consider being tested for any fertility problems early on, Dr. Greene says, rather than waiting until youve tried to conceive for a while and been unsuccessful. (Check with your insurance company about coverage for such tests.)
Did you have preeclampsia?
Preeclampsia is a pregnancy-induced condition thats marked by high blood pressure, excess protein in the urine, severe headaches, and sudden weight gain that can lead to preterm birth and may require bed rest or induced labor near the end of a pregnancy. Women whose mothers had it are often thought to be at higher risk during their own pregnancies. But other factors may be more significant than your moms experience, Dr. Greene says. They include being overweight or older than 35, carrying multiples, having preexisting high blood pressure, or simply being pregnant for the first time. Of course, if you have any of these risk factors to go along with a mom who had preeclampsia, that can nudge the risk even higher.
How knowing helps: Tell your obstetrician if your mom had preeclampsia; she may want to monitor you extra closely. Keep your weight gain in the safe range (25 to 35 pounds if youre not over- or underweight starting out), and go easy on salty and sugary foods.
Do we have a family history of any disease?
Family history can predict many health risks beyond gyno concerns, including heart disease, diabetes, some cancers, osteoporosis, depression, and stroke. You want to know both of your parents histories, “but the links to these diseases are often stronger on the maternal side for a daughter,” Dr. Pinkerton says.
Having a mother, sister, or daughter with breast cancer doubles a woman's risk. And the younger a relative is when she develops ovarian cancer, the higher your risk. About 10% to 15% of ovarian cancers result from an inherited tendency to develop the disease. “You should find out if theres a history of either cancer on the maternal side of your familyyour mom, her mother, their sisters,” Dr. Gaudet says.
How knowing helps: Your moms history may prompt your doc to refer you to a genetic counselor, who can discuss a blood test that screens for genetic mutations. For many other diseases, a healthy lifestyle and simple preventive measures (such as watching your sugar intake if diabetes is a threat) can lower your risk, no matter the family connection. If your mom suffers from low bone mass, or osteopenia, thats useful info, Dr. Pinkerton says.
“Youll want to build bone density in your 30s by eating enough calcium and doing weight-bearing exercises like lifting weights or practicing yoga,” she explains. And in your mid-40s, a bone-density test should go on your list of issues to discuss with your doctor.