Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 8/10/2022
Thanks to our hormones, the unique setup of our reproductive systems and the overall feminine mystique surrounding the female body, women’s health presents its own array of nuance and context that needs to be understood and addressed accordingly.
We’ve probably heard about the dangers of heart disease and know that we need a pap smear every three years, but did you know that women begin losing bone mass as early as their thirties and should still be getting STI checks into their fifties?
With everything there is to keep track of when it comes to women’s health, here’s a decade-to-decade checklist of health concerns to keep an eye on, preventative actions to take and conversations you should have with your doctor.
As we get older, our health becomes more than just getting better rest, exercising more regularly and drinking more water; it means keeping a watchful eye over parts of our bodies in ways we haven’t before. It means taking a more thoughtful approach to our healthcare schedules — which may include new tests and screenings to help ensure we’re aging gracefully.
Remember, ladies: getting older means getting better.
Your twenties are generally regarded as a time when you can feel unencumbered by health concerns, but abandoning that notion and focusing on preventative care during this decade is the key to achieving long-term health and longevity.
Along with annual physicals, finding a healthcare provider that provides gynecological care is important for this age group, as it’s when women should begin scheduling routine pap smears.
This procedure, done in conjunction with a pelvic exam, involves collecting cells from your cervix and is performed to detect precancerous or cancerous lesions of the cervix.
You should have your first pap smear (without an HPV test) at age 21, and then every three years after that until you reach age thirty. At 30 and older, you can continue having pap smears alone every three years or you can have co-testing (the preferred method), which consists of a pap smear and HPV test, every five years.
It is important to screen for other STDs in your twenties. The American College of Obstetricians and Gynecologists (ACOG) recommends that women be tested for chlamydia and gonorrhea annually for women who are 24 years and younger and are sexually active, 25 years and older for women who have risk factors (e.g., multiple partners, a new sexual partner or recent diagnosis with another sexually transmitted infection).
Unfortunately for some women, their twenties is a time when they may receive an endometriosis diagnosis, after suffering from symptoms for several years prior.
Endometriosis is a painful condition that affects one in 10 women and occurs when the tissues that normally line the inner walls of a woman’s uterus instead grow on the outside.
While there have been strides in expediting diagnoses, many women still experience years of pain and misdiagnosis, which can harm their reproductive ability. Understanding symptoms and approaching your doctor is extremely important in the effort to live as pain-free as possible while suffering from this condition.
While you may not be able to prevent things like endometriosis, you can take other steps to ensure a healthy transition to your thirties and middle age.
This is the time to begin thinking about skin care and remembering that sunscreen is your friend.
Along with incorporating a daily SPF-infused moisturizer, avoid unnecessary sun exposure — especially tanning beds, which expose you to harmful UV rays that speed up the aging process while damaging skin cells.
Additionally, it’s important to keep yourself up to date on recommended self health checks, like home breast exams.
According to the American Cancer Society (ACS), self-breast exams, long lauded as life saving, have shown no correlation to any significant decreases in breast cancer deaths.
While the ACS encourages familiarity with the size, shape and overall appearance of your breasts, it’s more important to stay on top of mammograms — but for the majority of women, those don’t start until your forties. Having said that, the National Comprehensive Cancer Network recommends women receive a breast exam by a healthcare professional every one to three years from age 25 to thirty-nine.
Things begin to change in our thirties. Many women have been done with school for several years and there’s a general feeling of stability that seems to come for many entering their third decade. Basically, our thirties are pretty cool.
Regardless of how our quality of life changes in our thirties, our bodies begin going through some pretty significant changes, especially when it comes to fertility.
If you’ve noticed that many of your friends have waited until their thirties to begin having children, you’re not alone.
According to the Center for Disease Control (CDC), the average age of women’s first birth rate has risen over the last four decades, with particular increase detected after age thirty-five.
While the decision of when to have a baby is a highly personal one that is often heavily influenced by socio-economic and familial factors, it’s important for women to communicate with their doctors if they plan on holding off on having a baby until their mid- to late-thirties.
A woman’s reproductive ability begins to gradually decrease around age 32, with a more significant drop in ability around age 37.
Whether or not you’re planning to conceive, you should begin dedicating extra focus to preventative care in your thirties.
During this decade, it’s not uncommon for your metabolism to start slowing down, making it harder to lose fat or maintain weight on the same diet that was enjoyed during your twenties.
Not only that, but this is also the same set of years when women begin losing bone and muscle mass, which can lead to osteoporosis. Finding a strength training and cardio routine to maintain a healthy weight and bone density is key.
For women at high risk for breast cancer, their thirties is a time that they may want to consider introducing chemoprophylaxis medications to their health routines. These medications reduce the risk of invasive estrogen-receptor-positive breast cancer by nearly 50 percent in high-risk menopausal women. As there are certain criteria and considerations involved in introducing your body to these medications, make sure to discuss your options with your doctor so you can make a plan together.
Love it or hate it, this is the decade of the mammogram (for most women — some with a higher chance of breast cancer may need to get them earlier).
A mammogram is a specialized low-dose x-ray of the breast. According to the ACS, all women between ages 45 and 54 should get one every year, and extend their appointments to every two years once they reach the age of fifty-five.
Keep in mind that frequency is a decision that should be made after consultation with your doctor, as it takes into consideration family history, personal concerns and other risk factors. Other academic medical societies, like ACOG, suggest that mammograms can start as early as age forty.
Of course, detecting anything unusual with the appearance, size or shape of your breasts means you should schedule an appointment with your doctor.
Along with extra screenings for your breast health, your forties are a time of transition from your more fertile twenties and thirties. Though not quite at your menopausal years, some women in this age bracket begin experience perimenopause due to declining estrogen levels.
Even if you’ve finished having children or previously decided not to conceive, don’t let your guard down when it comes to your birth control. Contraception should definitely be used until you know that you have gone through menopause (one year without a period.)
Your forties may be a time when you consider transitioning to a new method of birth control, especially if your doctor has deemed you to be at higher risk for future cardiovascular issues.
If you fall into that category, you may want to consider an IUD. They come available as either a hormone-free or a low-dose hormone alternative to, say, the pill, and they're also long-lasting, with the copper (non-hormonal) IUD only needing a replacement every ten years.
Some women also begin experiencing hair thinning in their forties. This is often related to hormonal changes, but you should check in with your healthcare provider to ensure there isn’t another culprit.
An often unwanted symptom of the aging process, there are treatments and products available to retain your hair’s lustrous appearance which, in conjunction with an SPF-friendly skincare routine, can help reduce the overall appearance of aging.
Of course, all women are different, but the majority of them will bid their monthly periods farewell during their fifties, likely with some mixed emotions. Menopause is the outcome of your ovaries discontinuing their production of estrogen and progesterone, and is considered official when you’ve gone twelve full months without getting your period.
While menopause has essentially become synonymous with hot flashes, it’s unfortunately also accompanied by a number of unwanted physical symptoms that can include disrupted sleep, vaginal dryness, hair thinning, mood fluctuations, loss of focus and memory changes.
While these symptoms may leave a feeling of dread in the pits of many women’s stomachs, the option of taking menopausal hormone therapy (MHT) is available.
Menopause isn’t all bad, though. For many women, the removal of the stress of an unplanned or unwanted pregnancy can feel liberating, but loss of fertility has no effect on whether or not someone can contract a sexually transmitted infection (STI).
However, sex in your fifties also comes with potential drawbacks. For instance, you may start experiencing the symptoms of vaginal atrophy.
Due to estrogen loss that lessens the amount of blood flow to the vagina, women may begin to experience dryness, irritation and painful intercourse, symptoms that will likely grow worse without treatment.
Luckily, there are a number of solutions, including over-the-counter vaginal moisturizers and lubricants and low-dose hormone treatments.
Oh, and just because you’re getting older doesn’t mean menopausal and postmenopausal women are off the hook from STI screenings. Make sure you’re getting checked, ladies!
There are several other screenings women in their fifties should begin scheduling, especially colorectal cancer screenings.
While the thought of a colorectal screening may make you squirm, they’re extremely effective in identifying colon cancer. In fact, according to the ACS, it’s estimated that more than half of all colon cancer cases are preventable with regular screenings, which according to ACOG, should begin at age forty-five. So, please, make the appointment!
You might want to start slowing down in your sixties, but don’t let your relaxed pace turn into a sputter and stall.
At this age, women are at a greater risk for osteoporosis, so you should prioritize physical activity in your schedule, along with scheduling a bone density test around age sixty-five. An additional benefit of extra movement is warding off obesity, which not only places strain on your heart and joints, but is also linked to several types of cancer.
One of the most pressing health concerns older women face is heart disease.
Heart disease is the number one killer of women and is attributed to one in three deaths among women every year. That’s more than all combined cancer deaths.
Exercise and a healthy diet are essential tools in battling these statistics, but so is communication with your doctor, symptoms familiarity and learning how to live your healthiest life post-diagnosis.
Make sure you’re still scheduling pelvic exams at this age, as they help doctors make a diagnosis and assist with treatment options.
A pelvic exam will also help your doctor detect if you have pelvic floor muscle dysfunction. This is when your pelvic muscles begin to weaken, which can lead to incontinence and pelvic floor prolapse.
Luckily, there are effective treatments available, so don’t shy away from discussing symptoms with your doctor.
As we get older, our bodies start speaking to us in different ways, and the language we use to communicate back to them becomes more complex — and there’s nothing wrong with that. While our hormones and reproductive organs alone can contribute to and be affected by a series of health problems, we are also at an increased risk for heart disease, specific cancers and declining estrogen can simply make older age feel unpleasant.
Preventative care and remaining in touch with the signals your body is sending is the crucial step in maintaining a lifetime of health, so make sure to check every year and adapt to the changing needs of your body.