Women Taking Charge of Their Health

AN AGE-BY-AGE LOOK AT WOMEN’S HEALTH PRIORITIES

By Jenn Diamond

Life is a marathon, not a sprint. A woman’s current health is the result of a lifetime of decisions about overall diet, physical activity, sexual practices and even personal hygiene. It’s no secret that prevention is the key to longevity. As women, there are a number of specific health concerns we need to be aware of that affect us in our 20s, 30s, 40s, 50s and beyond.

Before delving into age-specific health issues, it’s important to understand that there are a few things all women should all be doing no matter where we fall on the life spectrum.

MAINTAIN A HEALTHY WEIGHT
Being overweight increases your risk for heart disease, diabetes, and high blood pressure. Your doctor can tell you what you should weigh for your height. You can get to your healthy weight and stay there by eating right and being physically active.

QUIT SMOKING
Eliminating bad habits such as smoking and tobacco use can literally add decades to your life. More than 430,000 Americans die each year from smoking, according to the U.S. Preventive Services Task Force. Smoking causes illnesses such as cancer, heart and lung disease, stroke, and problems with pregnancy. The U. S. Public Health Service has a number of publications and resources to help you quit smoking. To get free copies, call the AHRQ Publications Clearinghouse at 1-800-358-9295 or email ahrqpubs@ahrq.gov.

PREVENT SKIN CANCER
Skin cancer is often preventable. Though you’ll find the best results if you begin preventative measures as a child, it’s never too late to slather on the sunscreen. The effects of sun damage in your teens and twenties are not likely to be known for decades.

Now that you’re aware of what you should already be doing, here’s an age-by-age guide to preventative health for women based on the recommendations of the U.S. Preventive Services Task Force Pocket Guide of Good Health for Adults (and Banner Health?), one of the largest, nonprofit health care systems in the country.

YOUR 20S
You’re on your own for the first time. Common health concerns for women in their twenties include stress, acne, fitness, urinary tract infections and reproductive health (particularly, what birth control to use and pregnancy issues).

At this age, women need to begin a number of routine preventative measures. All of these will continue throughout our lifetimes, only to be augmented by additional tests and screenings as we age:

• Monthly self breast exam;
• Blood pressure test every two years; more often if your doctor identifies a need;
• Annual dental exam and twice yearly teeth and gum cleanings;
• Baseline cholesterol screening, including the high-density lipoprotein (or “good”) cholesterol, low-density lipoprotein (or “bad”) cholesterol and triglycerides. Repeat every five years, or more frequently if you have elevated cholesterol;
• Skin examination by a health-care provider every three years; more often if your family has a history of skin cancer ;
• Baseline eye exam

While all women should get an annual well-exam, the exam may differ slightly depending on your age, family history and sexual activity. The tests include a regular Pap smear test to detect cervical cancer (a liquid PAP test every other year), clinical breast and pelvis exam and checking for cancer of the thyroid, oral cavity, lymph nodes, ovaries and skin.

During this exam, your doctor will probably ask you about your history of dietary intake, physical activity, tobacco, alcohol/drug use and sexual practices.

Sexually transmitted diseases, such as Chlamydia, HIV infection, herpes, syphilis, gonorrhea, and hepatitis B, are passed easily from one person to another during sex and may cause serious health problems. HIV causes AIDS. Hepatitis B can cause liver damage, including liver cancer. Many STDs can even harm a pregnancy and the health of the baby. Some, such as Chlamydia, can lead to infertility.

If you are at increased risk for sexually transmitted diseases, talk to your doctor about whether you should be tested. This is especially important because some diseases, such as Chlamydia, may have no symptoms. Serious health problems may develop before you realize you have a disease.

You can greatly lower your risk for sexually transmitted diseases by using a male latex condom every time you have sex. If you are allergic to latex, use a polyurethane (soft plastic) or synthetic condom.

YOUR 30S
In your 30s, your skin worries include wrinkles, skin cancer and stretch marks and scarring. Additionally, at this stage your metabolism begins to slow and hormones
fluctuate, causing things like increased PMS or irregular periods.

In addition to the routine exams and screenings you should begin in your 20s, now is the time for a regular or liquid Pap test every two to three years OR a Pap test with HPV DNA test every three years if your Pap testing history has been normal

All women who are or have been sexually active are at risk for cancer of the cervix unless their uterus has been removed. Experts indicate that the death rate from cancer of the cervix can be reduced if the cancer is found and treated early. A Pap test is used to find cervical cancer. A baseline thyroid test is also added to the list,
followed by repeat screenings every five years.

YOUR 40S
Infertility, weight gain, high-risk pregnancy, irregular periods, and hot flashes are common symptoms in your 40s. This is also the stage when heart disease and cancer become of greater concern.

Tests you will need in addition to the above include a mammogram, a fasting blood-sugar test to check for diabetes and a fecal-occult blood test to check for colon and rectal cancer.

Breast cancer is the most common cancer among women in the United States. From age 40, your risk for breast cancer increases. If you have a sister or mother who has had breast cancer, your risk is even higher. A mammogram every one to two years beginning at age 40 can help find this disease early when it is easier to treat.

Colorectal cancer is second only to lung cancer as a cause of death from cancer.

If you’ve reached menopause, your doctor will also likely order a baseline bone-mineral-density test to determine your risk for osteoporosis.

FACTS ABOUT MENOPAUSE
The time when your menstrual cycle stops for good is called menopause. Most women reach menopause in their late 40s or early 50s.

During the years leading up to menopause, levels of two female hormones, estrogen and progesterone, begin to change. These changes signal that your body is getting ready to stop menstruating. This time leading up to menopause is called perimenopause.

Most women begin perimenopause between ages 35 and 50. Perimenopause usually lasts around five to seven years. You can still get pregnant during this time, so you may want to use some method of birth control.

For many women, the shifting levels of hormones during perimenopause cause physical and emotional changes. Some of these changes may be uncomfortable, but there are many ways to relieve the discomfort.

The changes could include skipped periods, irregular bleeding, hot flashes, mood swings, sleep problems and painful intercourse from vaginal dryness.

50S AND BEYOND
After menopause women are at higher risk for some diseases, such as osteoporosis (bone thinning) and heart disease. Osteoporosis is more common in women than in men. After women have gone through menopause, their bodies make less estrogen (a hormone that helps protect their bones). Their bones then become more prone to breaking.

Half of all women past menopause will break a bone during their lives. A bone density test can help determine whether your bones are prone to breaking. Women who are 65 or older should be tested regularly. You should begin to be tested for osteoporosis at age 60 if you are at increased risk for fractures, for example, if you weigh less than 155 pounds.

You can reduce your risk for osteoporosis by doing weight-bearing exercises, such as walking, climbing stairs, jogging, yoga, and lifting weights, getting 1,000 to 1,300 milligrams of calcium every day, not smoking, and by taking medicines that can help prevent osteoporosis.

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