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Cynthia Nixon on Love, Sex, and Women's Health

The Sex and the City star talks about playing Miranda, her battle with breast cancer, her fabulous 40s, and her next role.

Five Rules for Fit and Fabulous 40s continued...

Check up. Choose an internist or primary care doctor, and get a regular physical exam every two years before age 40 and every year after that. Too many women consign their care to their gynecologists until their first serious illness.

Get busy. Sex is a life-giving force that is important at all ages. It does not disappear when you hit 40. Your partners should be carefully chosen, and you should always have protected sex unless they are fully known. Also, don't assume that because you're over 40 you can't get pregnant. Finally, masturbation is normal and a healthy addition to your sex life.

Speak up. Let your doctor know if you're not going to take the medication or get the exam she recommends. We can't drag our patients to tests, but we'd like to suggest a list and be aware of what they're willing to do.

Keep it real. Do not choose a cosmetic procedure unless you're well aware of the risks and benefits of that surgery. And remember: People respond to charm more than appearance.

Work out. Regular exercise is shown to reduce the risk for heart attack, improve cardiovascular conditioning, relieve tension, keep weight down, and promote bone health by guarding against thinning of the bone, or osteoporosis. Core strength is important for balance. Many people fall because of weakness, and their walking is stiff and awkward. Exercise doesn't have to be boring; one of my patients does salsa dancing.

Cynthia's Battle With Breast Cancer

Although breast cancer is behind her, Nixon speaks publicly about it from time to time. She is frustrated by the controversial new mammogram guidelines released in November by the U.S. Preventive Services Task Force (USPSTF), which recommended routine screening mammograms for average-risk women to start at 50.

"It's just so horrible to me, because the main thing I have to tell these women is to get your mammograms and don't delay," says Nixon, who has received regular screenings since she was 35, because her mother had recurrent breast cancer.

Nixon's cancer was discovered on a mammogram when she was 40, but she says it was so small that doctors wouldn't have looked at it twice if they hadn't been able to compare it with images from the previous five years. Plus, the cancer was too small to feel in a breast exam.

"I don't want to be an alarmist and say we need to get mammograms at 22, but get them at 40, and get them every year," she says, "and earlier if you have breast cancer in your family." That's what the American Cancer Society officially recommends: a routine annual screening mammogram starting at age 40 for healthy women at average risk.

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