Inside My Yearly Physical, Hearing Loss & Dementia, and a Rant

October Midlife Roundup (2025)

Photo by Toa Heftiba on Unsplash

Fall is check-up time!

Every late September, I have my annual physical. A few weeks before my appointment, I take my blood pressure at home (but don’t look), get my blood work done (pain!) and then visit with my doctor.

Several years ago, I went concierge because of back-to-back terrible experiences, including when my blood pressure phobia set in. So, my husband and I pay a little extra to have doctors who take their time with us.

This is worth it to us.

In this roundup, I have some personal updates, including my physical (and a follow-up from last year), along a study I filed away as important for you to know about. And a bonus I added right before sending this out [rant alert!].

Let’s go!

Before the physical

In a follow-up after last year’s physical, I had an ultrasound because of some spotting. This spotting felt like a cycle. I had signs of ovulation, a little cramping, and two weeks later what seemed to be a period, but the spotting never turned into a full-blown period.

This has happened three times, and I wasn’t sure if this meant I actually wasn’t in menopause (I didn’t count the first time it happened). So, my doctor ordered an ultrasound.

I lay on the table while the technician looked at my uterus. It didn’t help that she went from chatty to super quiet.

“You see anything?” I asked, looking and seeing some spots on the screen, curious what they meant.

“Only a radiologist can give you the results.”

Even though I’m prone to health anxiety and this situation wasn’t helping, I had a polyp removed with a D&C three-ish years ago and they found no signs of hyperplasia. I figured if there was anything suspicious, we’d catch it super early.

The results came in, and they think I have a small polyp but they weren’t 100 percent sure because it was so small. My lining was 3mm, which is about right for menopause, and shows no funny business.

My doctor wanted to do further testing, but I pushed back because not only did I recently have a polyp removed, but they also spotted several polyps when I was trying to get pregnant the second time. I’m polyp prone!

She referred me to a specialist, who suggested I repeat the ultrasound in 6 months. The specialist thinks the spotting is because of the polyp, and not a cycle.

She told me ever so gently that she thinks I’m in menopause.

READ: What to Expect with Menstrual Bleeding After 40

My latest physical

I was very curious how my labs would look like this time around. Because I’m pretty much menopausal, and even if the spotting caused an increase in estrogen, I’m sure it was minimal.

Did I have inflammation? Would my blood sugar be up? I asked for a fasting insulin this time so I could calculate HOMA IR for insulin resistance (check your biomarker guide for deets). If you’re a subscriber and never got it, reply to this email and I’ll send you the downloadable link.

I also asked for more extensive thyroid hormones and a full iron panel. This isn’t my first rodeo.

As the results started piling in, nothing really changed except my LDL. I was quite surprised to see that my TSH is now below 1, as it was in my early 40s. All my iron levels were great and the highest my ferritin has been (70). Check out my results from two years ago.

HOMA IR which is calculated from blood sugar and fasting insulin, was under 1. Also, the triglyceride/HDL ratio is low—both showing no signs of insulin resistance.

My homocysteine went up a little, but it’s still below 9. And a couple of months ago I had inflammation markers checked for GI follow up (I’m in long-term remission of ulcerative colitis) and they were great.

The main hiccup is my LDL went from 100 to 123. The two times before it hovered around 90, and premenopausal was typically about 80.

This really isn’t surprising as LDL goes up with menopause. Because everything else looks good, my doctor was not concerned.

I plan to add more foods proven to lower cholesterol. Let me know if you’re interested in following along, and I’ll write about it.

I am also making an appointment to review my options for systemic hormone therapy. I’m still on vaginal estrogen. Overall, I still feel good so we’ll see.

Hearing loss and dementia risk

You’ve probably heard about the link between hearing loss and dementia. A new study published in Nature Aging examined hearing loss much earlier in life—around age 56—and followed participants for 14 to 25 years.

The researchers used two large UK-based cohort studies and found modest associations between midlife hearing impairment and later dementia risk. In these studies, 41.9% of participants in the UK Biobank and 20.5% in the Whitehall II reported hearing loss. Only the UK Biobank group had their hearing objectively tested.

“The novelty is this study provided a much longer follow-up of hearing loss than most studies we have, so we’re able to look at the outcome of dementia that far out,” said Alison R. Huang, PhD, MPH, an assistant program director of NYU Langone Health’s Optimal Aging Institute in this Good Housekeeping article.

So, if hearing loss raises dementia risk, do hearing aids lower it?

Interestingly, in the UK Biobank, after adjusting for other factors, hearing aid users actually had a higher risk of dementia (23%) compared to those without hearing loss. In Whitehall II, hearing aid use wasn’t significantly linked to dementia risk. That doesn’t mean hearing aids don’t help—more likely, people who use them have more severe hearing loss to begin with.

Other research paints a more positive picture. Observational studies show hearing aids are linked to lower dementia risk, though intervention trials are mixed. A 2023 meta-analysis in JAMA Neurology, for example, found hearing device use was associated with about a 19% lower risk of long-term cognitive decline.

Whenever I read about hearing loss, I think about why it happens with age. Sure, ongoing exposure to loud noise plays a role—but so can less obvious factors like iron deficiency or dehydration. If your hearing seems to be slipping, it’s worth getting it checked out.

And if you’re around loud environments? Protect your ears. I got these Eargasm earplugs for a family member, and they make a big difference.

Why don’t popular health experts talk about this?

I get Peter Attia’s email newsletter, and when I saw the headline: When zero doesn’t mean zero: the limits of coronary calcium in women, I read it immediately.

I thought—finally! Someone with a big platform is going to talk about this enormous gap in women’s heart health: ischemia with no obstructive coronary artery disease (INOCA), most often caused by microvascular dysfunction (which I’ve written about here). It’s far more common in women.

This is very different from the typical obstructive CAD we hear about, where plaque builds up in a large arteries and blocks it (over 50%)—a pattern more common in men.

But as I’m reading his piece, I’m stunned. Not a word about it. In an article dedicated to a woman’s health issue!

The focus was on how women have more plaque erosion, which shows up later on a coronary calcium (CAC) scan. That’s it. No mention that CAC can’t detect INOCA or coronary microvascular dysfunction (CMD).

Reminder: CAC only measures plaque in the large arteries. It tells us nothing about what’s happening in the small vessels.

A recent review even suggests INOCA may be more common than atherosclerotic CAD. And then I saw a new Substack post from Mary Claire Haver—again, no mention of it.

So what did I do? I posted about it on Instagram and tagged both of them, along with a few others. If you have a moment, check out the post and share it with friends.

Every day, women suffer and even die early because of this huge gap in healthcare. It’s time we start talking about it.

You can also visit INOCA International to read patient stories about how these women were dismissed for years. Like Lauren, who was young and healthy until her health took a turn:

Each of the 9 cardiologists she saw told her variations of the same thing – that she was “too young” to be experiencing a heart condition or to require testing, or that because she was a healthy female, it was thought she was just experiencing anxiety.

They also have a list of doctors who can help, and they know the earlier you catch it, the better people do. I believe with more research, we can also learn how to prevent or reduce the risk (I have some ideas I’ll be talking about in my next behind-the-scenes post).

But first, we need to build awareness!!

That’s enough ranting for today. I’d love to hear what you think and how you’re doing in the comments!