On Women

Though hormone replacement therapy works well to alleviate menopausal symptoms, that relief comes at a price in the form of a slightly elevated risk of breast cancer. Well, now the price just got a bit steeper. A study out today in the Archives of Internal Medicine shows that HRT boosts the likelihood of having an abnormal mammogram or a breast biopsy.

Let's look at the numbers: In the study, some 35 percent of HRT users had an abnormal mammogram compared with 23 percent of those taking placebos, and 10 percent had biopsies based on their mammograms compared with 6 percent of those on placebos. Adding insult to injury, more breast cancers were diagnosed in the hormone takers even though mammograms were also more likely to miss tumors in this group. (The researchers used data from the Women's Health Initiative trial, which randomly assigned more than 16,000 women to get either HRT or a placebo.) The effects last for at least a year after women go off hormones.

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Last night while attending the Washington Press Club's annual dinner for members of Congress and the journalists who cover them, I resigned myself to the fact that, being a health writer, I probably wouldn't know anyone there besides my office colleagues. After making a beeline for the bathroom, I was surprised and delighted to meet Abigail Trafford, a health columnist for the Washington Post who told me she used to work for U.S. News. She was standing next to Miss America—the crown was a dead giveaway—and the three of us exchanged pleasantries. While struck by the statuesque, oh-so-thin, blond beauty queen, I found my gaze kept returning to Trafford with her silver coiffed locks and quiet self-assuredness. "You know," the 67-year-old confided to me as we headed to our separate tables, "love improves with age because women are better at it."

I called her today to elaborate. The new book she's writing, As Time Goes By, focuses on love in the over-50 set, attempting to dispel the notion that seniors are too old and crotchety for romance. Rather, she calls it the "high noon" for passion. She's been spending her days interviewing dozens of older folks, both attached and unattached, including those who've remarried each other after getting divorced. "The separation gave them time to find their own space, take care of themselves, and really change the nature of their relationship," she says. One couple who got back together originally split up because the husband was much older than his wife and was too tempted to be her mentor; after spending time on her own, the wife was able to become more self-sufficient and financially independent. When they reunited, they felt more like equals.

Other couples who stay married over time find themselves feeling a sense of urgency once the kids leave home. "They ask themselves, 'Who is going to be with me in this next phase?'" says Trafford. "It's not enough that you don't fight; you need to have areas of engagement and common interests." Those who don't often split up, but those who do find that, like fine wine, their marriage has become richer with time. Most women in their 50s, 60s, and beyond are more confident in themselves and don't rely as much on their partners' love for self-assurance. They're also more aware of their own mortality, which may help them cherish the time they have left. "One couple, both retired, told me that they just decided to be more polite to each other," she adds. "Who wants to live out their years in a sulk?"

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As writer Amy Bloom puts it, "Love at first sight is easy to understand; it's when two people have been looking at each other for a lifetime that it becomes a miracle." A new finding from the University of Michigan appears to confirm the challenges of sustaining romance: While we manage to improve our relationships with our parents, kids, and friends as we age, we're more likely to find our spouses ever more irritating and demanding. What's more, other research has shown that marriages go downhill after having children. Now they tell me? After I had three kids?

Fortunately, for every problem, there's a self-help book. And The Secrets of Happily Married Women: How to Get More Out of Your Relationship by Doing Less, out last month, might be particularly helpful because it's written by a guy—Scott Haltzman, a marriage counselor and assistant professor of psychiatry at Brown University—who wants to help us get into the heads of the men we love. Scanning down the chapter titles, some of the advice is fairly obvious: Chapter 1: Know Your Husband. Chapter 2: Nurture His Needs—and Yours. Chapter 5: Have Lots of Sex.

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