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Sonia Faces 40: Breaking down all the health info you need to celebrate your prime years

Let's begin with a head to toe examination.

DALLAS — It is time for your health check! 

And this week, we have a special series of health checks in honor of a big birthday our Sonia Azad has coming up: she's turning 40 on Friday. As part of the lead up to the day, she will be asking medical experts their advice for what health details you need to focus, whether you're staring down the big 4-0, just celebrated the milestone, or beyond. 

It'll all culminate in a celebratory "Bar Crawl" - but healthy, of course!

So, what are those big health topics you need to keep top-of-mind? Let's begin with a head to toe examination.


Dr. James Pinckney II, M.D. from Diamond Physicians says while aging feels like it happens overnight, it's actually a gradual process, and the things we do today will affect how we feel tomorrow. 

"Our metabolism slows down, we don't produce as much of certain hormones, we don't have the same energy levels," he explained. 

He encouraged everyone facing 40 to know their numbers:

  • Blood pressure
  • Cholesterol
  • Baseline heart rate
  • His doctors even do a "neck to pelvis" scan that takes a look at  organs and assesses a patient's future risk for heart disease by looking at the plaque in their arteries 

Pinckney said taking that deep dive now can prevent bigger problems later.

"Cardiovascular disease is the number one killer in this country and has been for the last 20 years, and it's really something you have to focus on in your youth," he explained.

Also important for prevention: eye and dental health.

As we get older, our vision changes and sometimes that can get in the way of day-to-day life, like driving at night, reading menus in dark restaurants - or simply checking your text messages.

"What happens is, the internal structure of the eye, which are really flexible all of our life, that structure loses its flexibility," explained Dr. Anisah Shahizadeh with EyeQ Vision.

While Shahizadeh said there's not much that can be done to prevent this natural process, heavy computer use is contributing to more vision problems for people, across the board. A yearly dilated eye exam with your eye doctor is key to detecting any issues early, so they can be treated.

Checking  for diabetes, high blood pressure, sleep apnea - all these things really do affect our visual health, as well. 

As for dental health, it might be something we usually neglect until there's something wrong, like pain, cavities, or gum disease. In fact, half the population over age 30 experiences gum disease, and 95% of people end up with at least one cavity in their lifetime.

Dr. Michael Fooshee, DDS at Apex Dental Partners said as we age, "more and more people end up on medications, which leads to dry mouth. That actually leads to a lot of issues with cavities in patients."

His advice:

  • Consider fluoride. He said it decreases the risk of future cavities by 75%.
  • Correct your bite. Fooshee said consider braces or Invisalign if your teeth have shifted out of alignment. Moving teeth back into place actually reduces the risk of gum disease because when your teeth are in alignment, you can clean them better.
  • Be careful of crunching on ice or hard foods. That can cause fractures over time.
  • Avoid highly acidic foods. They can lead to increased risk of cavities.
  • Get regular check ups. They are critical, and should be done every six months.


Definitely, as that 40th birthday is coming months and immediate years afterward- there's a significant change in a woman's fertility. 

By now, you know that a woman's age is the most powerful predictor of whether or not she'll be able to get pregnant. 

There are options, of course, egg freezing, in vitro fertilization and adoption, but to understand what really happens to our fertility as we age, here's a closer look. 

As babies, every little girl is born with a "set" egg supply. 

By her first menstrual cycle, she's got a half-million eggs left. Sounds like a lot -- but fast forward 40 years and not only is our supply lower...

"We're more likely to have eggs that make chromosomal mistakes... That can cause miscarriage," said Dr. Kathy Doody.

She's a fertility specialist at the center for assisted reproduction in Bedford. 

"We can be successful at age 40, 41 - but that window of opportunity is changing. And so we want to be very proactive," Doody said.

Ways to be proactive are egg freezing or IVF. 

"If you're thinking ahead I think it's most ideal to freeze eggs in your late 20s, early 30s," Doody said.

I froze my eggs -- 5 years ago-- at care fertility. Now, 12 viable eggs are on reserve should I need them, when the time is right.

Doody says if you're 40 or above and are having trouble getting pregnant, then IVF -- or in vitro fertilization -- is the best option for a successful pregnancy. 

"The guidance really is - for women at age 40-  they should seek a fertility evaluation after just 3 months of trying to conceive," Doody said. "Embryos can be tested to see if they are chromosomally correct."

By the way, those embryos and eggs are frozen in time and good for use indefinitely.

For some women with minimal egg supply, there's a process called "effortless" IVF-- using an invocell device. It's considered an easier, more natural alternative to traditional in vitro fertilization.  

"We have definitely done invocell or effortless IVF and been successful with women in their early 40s," Doody said.

Bottom line? For women in their late 20s and early 30s who prioritize birthing biological children:

"Be proactive. Don't wait until you're 43 and say gosh I wish I had started the process sooner," Doody said.

Vitamin D levels are linked to fertility and pregnancy outcomes-- so be sure you're at healthy levels. 

Skin Health

Age may be just a number, but let's be honest - part of feeling young is looking good. That includes your largest organ: your skin!

Three of the most common complaints from people over 40: Wrinkles, acne and thinning hair.

There's no specific guidelines saying that when you turn 40, you need to get your skin checked. But Dr. Corinne Erickson, a board-certified dermatologist said this age is "really a great time when you're 40 to say, 'alright, looking ahead 10 years, what do I want my skin to look like? What do I want to feel like at 50?'"

Erickson, who just turned 40 last year, said it's never too late to start taking care of your skin.

"Some damage has been done, but a lot of damage hasn't been done, so you still have an opportunity to protect what you have right now," she encouraged.

Some ways to do that? Start with sunscreen.

"Starting to wear sunscreen every day can make a big difference," she explained. "The magical number is 30. So, you want an SPF of 30. But feel free to go higher."

Erickson recommends zinc- and titanium-based sunscreens. She recommended looking at the labels and trying to stick to less than two ingredients.

Noticing differences in your skin tone - and texture? The good news: you're not crazy.

Collagen break-down, over time, reduces elasticity, and we end up with wrinkles and fine lines. As for discoloration, those dark spots, freckles and redness appear for two reasons: genetics and photo-aging.

Photo-aging, Erickson said, are the changes that UV exposure induces on the skin. She said you can reverse some photo aging with either products or procedures - or a combination of the two. Anything that helps stimulate collagen or promotes more skin cell turnover.

That could include topical antioxidants like vitamin C, or even over-the-counter retinols, or retin-A. Erickson said it's important to seek guidance from a dermatologist because those are not for everyone.

One more thing to talk about when it comes to skin: hormones.

If you're wondering why you're waking up with less hair on your head and more of it in undesired places, blame it on androgens, a group of hormones that become more apparent in your 40s. They're the hormones responsible for female adult acne, and a lot of other fun stuff - for men and women.

"Androgen hormones can cause shrinking, decreased density of hair follicles on our scalp and promote hair growth in women where we prefer not to be growing hair," Erickson explained.

When it comes to thinning hair, Erickson said PRP, or platelet rich plasma, injections can help, if you can afford it. But there are also oral medications, topical formulas targeting hormone-induced skin changes and other procedures. But again, whether you're trying to grow hair - or get rid of it - the method is unique to you and requires a conversation with your dermatologist.

"There's not a one-size-fits all solution for unwanted hair removal, especially because there are different types of unwanted hair, and it depends on the type of hair, the color of hair, texture of hair as well as the skin type."

According to the American Academy of Dermatology, more than one million people are living with melanoma, and one person dies of the disease every hour.

So, something simple you can do today: make an appointment for a full body skin check.

Breast Cancer

One in eight women will get breast cancer in her lifetime. 

For "average risk" women, the recommendation is to start yearly mammograms at age 40. But for high-risk women, you may qualify for screening earlier than 40 if you have a family history (particularly a parent, sibling or child) of breast cancer or if you have a "known genetic mutation" for developing it. 

Why 40? Studies show one-sixth of all breast cancers in women happen younger than age 50. 

"You're in the developmental stages of breast cancer below 40 or below 50, and you don't even know it," explained Dr. Sean Raj, the medical director of Baylor Scott and White's High-risk Breast Program.  

That's right - cancer is a slow process usually. 

"The reason we do screening mammography is to be able to find cancers when they're smallest and most treatable," he explained.

At Baylor, every woman who comes in for a screening mammogram gets a risk assessment - at no cost. 

I got a 3-D mammogram. It involved taking four pictures at different angles, with staff guiding me thru when to breathe, and when not to. 

You feel a little pressure, but the whole thing is over in minutes. Then, the results. Typically there's a waiting period, but for the purposes of our story, Dr. Raj offered me immediate feedback: nothing concerning on the initial pictures. But, he pulled up my screening images from 2017 for comparison. Because of my family history, I decided then to start screening earlier than guidelines suggest. 

There was one area that Dr. Raj wanted to look at more carefully, so they took one more picture in order to look more closely at some subtle changes he noticed between 2017 and now. 

After examining the layers of dense breast tissue, he gave me the all-clear. 

"There you go. You got a clean bill of breast health. Congratulations," he said. "That's what we're going for here."

Along with stressing the importance of prevention, there are some myths about breast cancer that Dr. Raj busted" 

1. That it's painful. He said pain is usually not associated with breast cancer. If you are feeling pain, that's likely either hormonal, or the result of a poor fitting bra. 

2. That women with smaller breasts can't get be diagnosed with breast cancer. That's false. Breast cancer doesn't discriminate. 

3. That men can't get breast cancer. Also false! While men don't need screening mammograms at 40, they can get breast cancer. So, for men and women, if you notice any changes - a lump, rash, discoloration, focal pain or bleeding - definitely talk to your doctor for further examination. 

RELATED: Take it from a survivor: Breast cancer is a 'guy thing' too