Women’s Health at Different Life Stages

In your 30s, preventive care is key. If you don’t already have a good relationship with a primary care physician — whether they are an internal medicine doctor, family physician or OB-GYN — now is the time to establish one. 

“Prevention is better than cure and is the heart of what we do in primary care,” says Dana Mourad, MD, an internal medicine physician at Scripps Clinic Carmel Valley. “Between the ages of 20 and 40, a lot of our focus is on investing in our health and trying to prevent disease as much as possible.” 

Diet and exercise are important at any age, but during your 30s, building healthy habits for a lifetime really comes into play. Quality sleep, stress management and strong social connections are also important components of good health. 

Make sure you’re up to date on recommended immunizations and preventive screenings, including an annual skin cancer check for any unusual spots. Pap tests for cervical cancer are recommended every three years unless you have had an abnormal result or risk factors. 

Another common concern in a woman’s 30s is family planning. Whether you’re hoping to start a family, prevent pregnancy or have questions, your doctor can help you focus on your health. Pregnancy after age 35 is considered high-risk, so it’s especially important to understand the risk factors and any special care you might need. 

If your primary care doctor does not provide gynecologic care, schedule an annual visit with an OB-GYN also.

“Even if you aren’t planning to get pregnant, the female anatomy is complex,” says Dina Fainman, MD, an OB-GYN at Scripps Clinic Encinitas. “We have expertise in a variety of women’s unique health issues.” 

In addition to Pap tests and skin checks, you’ll likely have your first annual mammogram to screen for breast cancer at 40 and your first colonoscopy for colon cancer screening at 45, if you are at average risk. Your doctor also may recommend cholesterol screening. 

If you’ve put off starting a family until now, talk to your doctor about the challenges associated with pregnancy later in life. 

“Women should recognize that fertility declines quite significantly after 40. Not only is it more difficult to become pregnant, but the risk of complications also rises,” says Dr. Fainman. “Still, I absolutely talk to these patients about contraception, because it is possible to become pregnant at this age.” 

Another concern is perimenopause, a transitional period before menopause when women experience hormonal changes. 

“The big talk that I have with my patients in their 40s is menopause awareness, because perimenopause starts one to five years before the official menopause transition,” says Dr. Mourad. 

“Menstrual changes, hot flashes, night sweats, sleep problems, vaginal dryness — these are all symptoms women may experience as part of the transition to menopause, and there are ways to help them navigate these changes and make them easier.”

The average age for menopause — defined as 12 months without a menstrual period — is 52, but it can vary widely. Estrogen levels drop significantly after menopause, and this decline is associated with changes to weight, hair and skin, as well as vaginal symptoms and more. 

“There is a misconception that weight gain in the 50s is related to menopause, but studies have shown this is not true,” says Dr. Mourad. “Midlife weight gain is related more to aging and lifestyle, whereas changes in body composition and fat distribution, such as more fat around the abdomen, are indicative of menopause.” 

Production of collagen, which gives skin its elasticity, drops by about 30% in the first five years post-menopause and continues to fall over the next 20 years. Part of this is due to the decline in estrogen, but genetics, sun exposure, diet and the environment all play a role. 

“Genitourinary symptoms, including pain with sexual intercourse and more frequent urinary tract infections, affect one in every two women post-menopause,” says Dr. Fainman. “Often women don’t recognize how significant their symptoms are until they talk to me about it.” 

Estrogen also can affect bone density, so your doctor may recommend a bone density scan at age 65 (or sooner if you have a family history of osteoporosis). Vaccinations and preventive exams remain important into your 60s and 70s. You’ll continue to have Pap tests as recommended until age 65; mammograms and colonoscopies usually end around age 75. 

“Regardless of your age, if you have concerns about your health, don’t hesitate to talk to your doctor about them,” says Dr. Mourad. “We have a lot of options and, together, we can find ways to manage them.” 

Immunizations, cancer screenings and preventive care can help ward off disease or detect it early. Your recommended preventive care depends on various factors including your age, medical history and lifestyle. Be honest with your doctor about your diet, exercise, alcohol or substance use and family medical history — these all help determine what is best for you. 

Again, being transparent with your doctor about your lifestyle is vital to optimal health. Downplaying your alcohol intake or glossing over feelings of depression or anxiety ultimately make it more difficult to get the appropriate care. Your doctor is there to help you, not judge you. 

No one wants to think about potential health problems, but it is important to understand if you have an increased risk of any diseases and what to do about it. Heart disease, for example, is the leading cause of death among women; risk factors include age, high blood pressure, high cholesterol, smoking and early menopause. 

Grocery and drug stores have entire aisles devoted to supplements for joint health, sleep, mood, weight loss, skin care — you name it. Ask your doctor if there are supplements you should be taking, such as calcium and vitamin D, to help prevent bone loss. 

Pain, weird skin spots, digestive issues, hair loss, painful sex — if something is “off” or you’re concerned about it, speak up early in the appointment, even if it seems minor. Where your health is concerned, there are no stupid questions!