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Your Guide to Good Health—Women’s reproductive and sexual health through the 20s to 40s and 50s

Sound advice, preventative screening tests, and tips to live your healthiest life in every decade straight from the doctor’s office to your screen.

By Maryann Savina Xavier
25 May 2021

With every passing decade of our life, our body adapts—it may nurture life, recover from an illness or achieve athletic milestones. It demands little in return—a healthy diet, plenty of rest with consistent exercise, and regular health checks. We spoke to Dr Bana Rupa, Obstetrician and Gynecologist, Apollo Health City Jubilee Hills, Hyderabad and Dr Ranjana Sharma Senior Obstetrician and Gynecologist, Indraprastha Apollo Hospitals, New Delhi to create this guide to healthy living for women in their 20s,30s, 40s and 50s.

In your 20s

The roaring 20s are all about pushing your limits and setting a healthy base for your life. While you hardly notice the late nights and skipped meals, develop good habits now for a healthy life later. Increase your intake of greens, exercise at least for 30 minutes every day, and stick to a consistent bedtime to help keep your menstrual cycle regular and hormonal headaches at bay. Don’t forget to hydrate.


What to watch for

Self-breast exam: Raise your arm and bend your elbow behind your head. Using your fingers, apply firm pressure and in a circular motion to feel the breast. If you notice any lumps, changes to the skin on the breasts or discharge, inform the doctor. They may perform a clinical exam and suggest further examination if needed. The self-breast exam can be done every month and an individual can perform this test while standing before a mirror or while lying down.

Contraception: Practice safe sex and always use protection. This reduces the chances of contracting sexually transmitted infections, and of course an unwanted pregnancy. Speak to your doctor about the right contraceptive for you. Be aware of frequent use of the morning-after pill as it can disrupt your menstrual cycle.

PCOS: Report any changes in your menstrual cycle to your doctor. Polycystic ovary syndrome is a hormone-related condition that causes irregular or prolonged periods and increased levels of androgens—male hormones—that cause facial hair, hair fall, and weight gain.

Preventive Screening: The American Cancer Society recommends cervical cancer screening with an HPV test alone every 5 years for everyone with a cervix from age 25 until age 65. People can opt for the HPV/Pap cotest every 5 years or a Pap test every 3 years. Pap smear is done to identify the presence of pre-cancer or cancer in the cervix. As part of the process, cells in the cervix are scraped and then examined for any abnormalities.

Human Papillomavirus (HPV) testing: Persistent HPV infection is the reason for cervical cancer in almost all cases. HPV testing is recommended to identify at-risk women for cancer cervix.

Immunizations: A tetanus-diphtheria booster is recommended for women after the age of 19 years and should be taken every 10 years. The Human Papillomavirus Vaccine (HPV) protects women against cervical cancer. All HPV vaccines increase your resistance to HPV types-16 and 18, which pose the highest risk of cervical cancer. The Centre for Disease Control recommends HPV vaccine for routine vaccination preferably at age 11 or 12 years but can be given up to the age 26 years. The vaccination can be started at age 9 and can be given up to the age 45 years after discussing with a physician.





In your 30s

You’ll probably start to notice odd aches and pains. Fertility may be on your mind. This is a good time to explore meditative practices to cope with your responsibilities. If you’ve picked up a ‘bad habit’ like smoking, consider quitting. Bone mass starts dropping in this decade, so speak to your doctor about supplementing calcium and folic acid. Check your blood sugar levels and blood pressure every year. Planning for your future includes making important health-related decisions. This includes health or medical insurance and any other financial planning.

Blood Pressure: Hypertension screening is done to identify high levels of blood pressure (above 130/85). High blood pressure levels can lead to other health complications like myocardial infarction or stroke. Check with your doctor about how often you should get screened based on your health conditions.

Immunization: Consult with your doctor to see if you need to take any immunization shots for cervical cancer.

Preventive Screening: Screening for PCOS may include a physical examination including checking your blood pressure, BMI, waist size and other visible signs such as hair growth, acne or discolored skin. Your doctor may also perform a pelvic ultrasound.

Birth Control: According to an article Birth Control over 30 on PubMed, low-estrogen or no-estrogen oral contraceptive pills are considered safe for healthy women over the age of 30. These pills may also help prevent ovarian and endometrial cancer. Speak to your doctor to know what preventive measures are best for you.

In your 40s and 50s

Consider reducing your sugar intake to cut the risk of the whole range of life-threatening illnesses like chronic diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and cancer. A Harvard University study provides evidence that reducing red meat intake while eating other protein foods or more whole grains and vegetables may reduce the risk of heart disease.

Premenopause and menopause: Screening tests for premenopausal women include Estradiol-E2 Serum, Progesterone Serum, Follicle Stimulating Hormone and Prolactin Serum. Talk to your doctor to know more. Here are some premenopause symptoms you need to watch out for:

  • Changes in sexual function
  • Changing cholesterol levels
  • Hot flashes
  • Irregular periods
  • Sleep problems
  • Mood changes
  • Vaginal and bladder problems
  • Decrease in bone density.

Breast Cancer Screening: This is done to identify any risk of breast cancer. This kind of screening may include a self-done examination by the individual, a clinical breast exam, breast ultrasound, and mammogram or breast magnetic resonance imaging (MRI) by a health professional.
A clinical exam is done by a doctor to personally check for lumps or any other breast changes in a patient. You can approach a doctor if you notice any irregularities in the shape or size of your breasts.

A mammogram is done by taking a special X-ray of the breast. This is an effective way to identify breast cancer early, when there are still chances of complete treatment. Mammography is recommended from the age of 45 to the age of 75 years, every two years. The frequency depends on the age and the presence of risk factors.

A breast MRI involves imaging with the help of magnets and radio waves. Sometimes, an MRI may be recommended alongside a mammogram to identify cancer in women who are at high risk. According to the CDC, an individual is at high risk of developing breast cancer if they are overweight, obese or gain weight after their menopause and the nature of their reproductive history. It’s important to know that MRI is free of radiation.

Colon cancer screening: Colon-cancer screening is done to detect any traces of cancerous cells in the large intestine. Women should test for colon cancer starting from 50 years. Screening for colon cancer includes:

  • Guaiac-based fecal occult blood test (can be done from home) every one year
  • Computed tomographic colonoscopy must be done every five years
  • Colonoscopy must be done every 10 years
  • Double-contrast barium enema must be done every five years
  • Flexible sigmoidoscopy should be done every five years








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