Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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A woman's health needs continue to evolve from her teen years through her golden years. Being active, eating well, and getting your recommended health screenings are the foundation for good health at any age.


The years before and after menopause, called perimenopause and postmenopause, bring a range of physical and emotional changes for women. Making healthy choices in midlife can benefit your well-being for years to come. This includes:

  • Healthy eating 
  • Activity and exercise
  • Health screenings
  • Medical care, if needed, for possible health challenges

Health Screenings

As you complete menopause (your final menstrual period), your risks increase for these serious health conditions:

  • Breast cancer
  • Heart disease
  • Osteoporosis 

Though healthy lifestyle choices can help prevent these conditions, it’s also important to get specific screening tests. By catching these conditions early, we can treat them most effectively. 

Talk with your doctor if you have a family history of any of these conditions, or know that you have risk factors. 

Women who are generally healthy can use these basic screening guidelines.

Mammograms every 1 to 2 years for women ages 50 to 74., to help detect breast cancer. It’s the most common cancer in women.

Blood pressure. Get tested every 1 to 2 years. The results help you and your doctor take care of your heart and general health.

Blood cholesterol. Get tested every 5 years, beginning at age 40. Test results help you and your doctor take care of your cardiovascular system

Bone mineral density (BMD) test (if recommended by your doctor). The results help detect whether you have osteoporosis (bone loss). Also talk with your doctor about preventing bone loss and avoiding fractures.

Colorectal screening. Women ages 50 to 74 need regular colorectal screening. Ask your doctor about the right test for you and how often to get tested.

Also ask your doctor about other screening tests you may need during midlife.

Healthy Eating

Healthy eating and exercise are important for your well-being. 

As women get older, often their body fat increases and metabolic rate (burning calories) decreases. Eating healthy foods can help you avoid midlife weight gain.

It also reduces your risks for:

  • Heart disease and stroke
  • High blood pressure and diabetes
  • Breast and colorectal cancers
  • Bone loss (osteoporosis)

If you’ve overweight, losing as little as 8 to 10 pounds can significantly improve these conditions. And before and during menopause, losing 10 or more pounds can help reduce hot flashes.

Healthy eating in midlife includes:

  • Vegetables and fruits. Aim for 5 to 9 servings daily.
  • Whole grains. 
  • Seafood. Eat fish, shellfish, and other seafoods 2 to 3 times a week.
  • Healthy fats, such as olive oil, avocados, and nuts, in small amounts. Avoid foods high in saturated (animal) fat.
  • Foods rich in calcium and vitamin D. 
  • Limited salt and sodium. 
  • Soy foods (tofu or soymilk, for example). Soy contains phytoestrogens that help reduce menopause symptoms.

Avoid alcoholic drinks, or limit to 1 a day. Drink plenty of water daily.

When you want to eat healthier, it’s best to make small changes over time. For example, add a piece of fruit or vegetable daily to a meal or have as a snack.

Additional References:

Activity and Exercise

Midlife may be the most important time in your life to be active. In addition to reducing your risk for diseases and managing weight, physical activity can improve:

  • Arthritis pain
  • Immune system function
  • Self-confidence 
  • Energy and ability to relax
  • Bone and muscle strength
  • Sleep
  • Mood
Make time for exercise

Aim for 30 to 60 minutes of activity on most days. Try these tips.

  • Schedule exercise on your calendar and stick to it.
  • Exercise at or near home. Try online or video workout programs.
  • Meet a friend for a walk instead of lunch. 
  • Walk or bike instead of driving to do errands.
  • Fit in mini-workouts during the day. Lift weights in the morning. Walk after work.
  • Plan longer workouts, such as hikes or longer bike rides, on weekends.
Keep it fun

Mix up your activities to strengthen different areas of your body and avoid boredom. Try:

  • Walking in beautiful places or on different routes, such as local hiking trails.
  • Something new. How about dance, tennis, yoga, or biking?
  • Listening to music or audiobooks while exercising.

Emotional and Mental Health

Midlife can be a wake-up call to a healthier, more reflective life. It may also bring challenges, such as:

  • Difficulty sleeping
  • Difficulty with concentration or forgetfulness
  • Tiredness
  • Worsening premenstrual syndrome (PMS) 
  • Mood swings or irritability
  • Anxiety or depression
Know when to get professional help

Although you can often take care of your own emotional and mental health, sometimes you may need help. Get professional help if you’ve had any of these symptoms for 2 weeks or longer:

  • Ongoing feelings of sadness
  • Loss of interest in your usual activities, including interest in sex
  • Ongoing tiredness or trouble concentrating
  • Strong feelings of guilt, worthlessness, or helplessness
  • Trouble sleeping or restlessness
  • Change in weight
  • Suicidal thoughts or plans

Sexual and Relationship Health

Your body’s hormone production slowly decreases before and during menopause. After menopause it drops off steeply. This change and other physical shifts can affect your sexuality, lovemaking, and intimate relationship.

Your own responses will be unique. Solutions are available for challenges you and your partner may face.

Possible reasons for less interest in sex include:

  • Vaginal dryness that leads to painful sex. Dryness can result from decreasing levels of the hormone estrogen.
  • Emotional changes, stress, or depression.
  • Menopause symptoms, such as hot flashes, irritability, or sleeplessness.
  • Your partner's changing sexual abilities.
  • Serious illness or surgery, or medication side effects.
  • Lack of time with your partner, or lack of a partner.
  • Boredom with your sex life.

Make dates to spend time with your partner. This can increase your communication and closeness. Share movies or other activities you both enjoy. Feeling close helps you adjust to changing lovemaking rhythms and capacities. You may find you have more energy to have sex in the morning or afternoon, rather than at night.

Try these tips, based on your unique needs.

  • Increase foreplay, to allow your arousal and lubrication time to increase.
  • Use vaginal lubricants during sex. Silicon-based products usually work best.
  • Do Kegel exercises to strengthen pelvic floor muscles and blood flow.
  • Keep sexually active, with your partner or on your own. This keeps your vaginal muscle flexible and decreases discomfort during sex.

Consider estrogen. Vaginal estrogen creams, rings, or tablets can increase lubrication and comfort during sex.

Self-Care and Complementary Therapies

Healthy eating and regular activity and exercise are your foundations for midlife health. When you decide to make positive lifestyle changes, we recommend making these your first priorities.

You may also want to try self-care and complementary therapies to manage menopausal symptoms and further improve your well-being. Here are some options.

Mind-body methods

You can do some these on your own. For others, you’ll need the support of a clinician or certified teacher. Ask your local Kaiser Permanente Health Education Center about classes and other resources.

Prayer, meditation, and relaxation methods. These can be practiced in many different forms to help reduce stress and anxiety and increase happiness. 

Humor can reduce stress-related chemicals in the body and boost your immune system.Watch a funny movie and let yourself laugh.

Music can influence body, mind, and emotions. Put on your favorite music. Relax and enjoy.

Acupuncture, clinical hypnosis, and Mindfulness-Based Stress Reduction are promising methods for relieving sleep and mood problems and other menopause symptoms.

Aromatherapy is the therapeutic use of oils and extracts from plants, such as lavender, to promote relaxation.

Massage therapy uses healing touch to relieve pain, stimulate circulation, release tension, and reduce stress.

Visualization and guided imagery involves focusing on mental images or imagining yourself in a peaceful place, to promote relaxation. 

Yoga helps keep you strong and flexible and may improve your responses to stress.

Supplements, herbs, and other over-the-counter products

Kaiser Permanente pharmacies carry herbal products and supplements that research studies have found to be effective. 

Before you use herbs, supplements, and related products, we recommend:

  • Checking recent information from reliable sources about each product.
  • Getting advice from a knowledgeable practitioner.

Your Care with Me

To help you be your healthiest in midlife, I encourage you to take advantage of the resources we offer for women before, during, and after menopause. Mammograms and routine Ob/Gyn appointments are important to your health in midlife, and they may be booked online or by calling the Appointment and Advice line.

In addition to our online resources, our Health Education center offers:

  • Classes on healthy lifestyle, weight management, and tobacco cessation, all of which may relieve your menopause symptoms and improve your overall health.
  • Copies of our Kaiser Permanente Menopause Guidebook for Women, a comprehensive reference to help you manage your symptoms and decide on treatment options.

Contacting Me

You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.

For nonurgent questions or concerns, you can: 

  • Email me using this site. 
  • Book an appointment online to see me in person.

For immediate concerns, or you prefer to use the telephone:

  • Call our 24/7 Appointment and Advice line at 1-866-454-8855. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to a specialist

My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.

If you are due for preventive screenings or tests

As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.

Convenient Resources for You

As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions and schedule appointments.
  • View your past visits and test results.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at our medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Classes and Coaching

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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