A recent report from Harvard Medical School says middle-aged and older women need to worry about particular health concerns - osteoporosis, breast cancer, ovarian cancer and microvascular disease, a type of heart disease more common in women.  

The report, titled "A Guide to Women's Health Fifty and Forward," gives specific examples of the small changes women can make to create significant health improvement. Things like replacing animal fats with vegetable oils, which can cut the risk of heart attack almost in half.

Four lifestyle changes - stopping smoking, becoming more active, reducing blood pressure and controlling diabetes - greatly reduce the chances of a woman landing in a nursing home.

Dr. Celeste Robb-Nicholson, the report's medical editor, says "one thing I'm learning from my patients is that every woman is unique, not only in her genetic endowment but in her life experiences as well. And each woman ages differently. As a result, your health concerns aren't likely to be the same as they were 30 years ago, nor are they likely to be identical to those of your friends."

Among the most interesting sections in the report is one labeled"managing bothersome problems."

These include persistent menopausal symptoms. And while estrogen was prescribed for decades for these problems, by the late 1990s studies were showing the hormone therapy might actually increase the risk of heart attacks.

Non-hormonal approaches to menopausal symptoms the study suggests include:

- Dressing in layers to easily shed clothes and alleviate hot flashes.

- Sleeping in a cool room to avoid sleep disturbances from hot flashes.

- Using lubricants and moisturizers to relieve dryness and vaginal itching.

- Use prescription antidepressants to relieve depression and hot flashes.

- Regular exercise, such as brisk walking, has been shown to improve memory and help sleep problems in women ages 50 to 63.

The Harvard report also pays usually overlooked midlife health concerns, including wrinkles and hair loss.

As Dr. Robb-Nicholson notes, the report won't tell you how to get the best treatments for serious conditions, but it will help you determine the conditions for which you are at greatest risk and help you avoid them.

The report also includes understanding such health risks as Alzheimer's and stroke.