Essential Women’s Health Checklist

Written by Kasey M. Fuqua

How Women Can Stay On Top of Their Health at Any Age

Throughout their lives, women face different health challenges than men. From reproductive health issues in their younger years to osteoporosis as they age, women need their own set of screenings and preventive services to stay healthy their whole lives.

While in childhood, boys and girls receive the same vaccines and well-child checks, but starting in the teen years, their care needs begin to change.

Age 13-21 — First Trip to the OB/GYN

It may come as a surprise to some parents, but the American College of Obstetrics and Gynecology recommends an initial gynecologist appointment between 13 and 15. A teen’s first trip to the OB/GYN can be nerve-wracking, but adolescent gynecologists such as Dr. Mariel A. Focseneanu at Children’s Hospital of the King’s Daughters in Norfolk, Va., make it easier on teens, keeping their information confidential and helping guide them through the process.

By their first gynecology appointment, most girls will have started their periods and gone through puberty, which may leave them with a lot of questions. Problems with periods like severe cramps can be signs of gynecological problems, like endometriosis, that respond best to early treatment. And if a girl has not started her period by age 15, that’s another good reason to see a gynecologist.

“Even if there is nothing that they are concerned about, as they enter the teen years, they are going to have a lot of questions about their development and periods and birth control,” Focseneanu says. “It is important to have a relationship with a doctor, so when issues arise, they feel comfortable.”

If girls have not received the HPV vaccine yet, it’s also a great time for them to get vaccinated. Children and teens vaccinated before age 15 will only need two shots instead of three.

At age 21, it’s time for a woman’s first Pap smear to check for cervical cancer. If the screening is normal, you will not need another screening for three years.

Age 22-45 — Preventive Health

During these adult years, women still need to keep an eye on their health with annual visits to a primary care physician. Even at these early ages, it’s possible for problems like type 2 diabetes, high blood pressure and high cholesterol to start affecting long-term health.

The United States Preventive Services Task Force (USPSTF) recommends that women receive:

  • Blood pressure screenings every two years
  • Diabetes screening after age 40 if you are overweight or obese
  • Depression screenings if you show possible symptoms
  • Cholesterol screenings every four to six years between ages 20 and 45 if you are at high risk for heart disease

In addition, doctors recommend a flu shot every year, especially if you are pregnant or planning to become pregnant. Women should also make sure they perform regular breast self-exams.

Age 40 — First Mammogram

At age 40, most women will need their first mammogram, with repeat screening mammograms every two years following. However, if you have a family history of breast cancer, you may need to start your mammogram screenings earlier. If a first-degree relative — mother or sister — had breast cancer in their 30s, a good rule of thumb is to get your first mammogram 10 years prior to the age of their diagnosis. So if your mom was diagnosed at 38, you should start getting mammograms at 28. Your physician can help you weigh the risks and benefits of earlier mammograms so you can choose the best time for your health.

Age 45 — First Colonoscopy

In 2018, the American Cancer Society (ACS) changed their colonoscopy guidelines — moving the first test up by five years — after analyzing data that showed new cases of colorectal cancer occurring at an increasing rate among younger adults.

The ACS believes early screenings will result in more lives saved. After your first colonoscopy, you may not need to have another for 10 years. Since you don’t need a colonoscopy after age 75, it’s possible you’ll only need three of these tests in your lifetime.

Age 50 — Menopause

The dreaded “change” happens, on average, at age 51 — but that doesn’t mean you won’t start experiencing menopausal symptoms earlier as your estrogen levels decline. Hot flashes, trouble sleeping, reduced frequency of periods and vaginal dryness are all early signs of menopause.

Besides these symptoms, menopause also means big changes to your  overall health. After menopause, you have an increased risk for heart attacks, strokes and osteoporosis. It’s more important than ever that you see your physician annually for a physical and screenings.

To help fight the symptoms of menopause, you may choose to take hormone replacement therapy. This therapy involves taking estrogen and, in some women, progestin to help reduce symptoms. This therapy can also reduce your risk for bone loss, though it does not improve heart health.

Hormone therapy does come with risks, such as small increased risks of breast or uterine cancer. You may be able to fight some symptoms of menopause with other treatments, such as lubrication for vaginal dryness. Your physician can help you develop a plan for menopause that fits your health needs and goals.

Age 60 — Vaccines and Hepatitis C Screening

At age 60, it’s time for a few more vaccines to protect you as you age. You may need to receive:

  • A shingles vaccine
  • A pneumonia vaccine (age 65)
  • A Tdap (tetanus, diphtheria and pertussis) booster every 10 years

You may also need other vaccines if you did not receive the vaccines when you were younger or if you participate in risky activities like illicit drug use.

For people born between 1945 and 1965, the USPSTF also recommends a one-time blood test for hepatitis C. People born in this time may have been exposed to hepatitis C through blood transfusions (before blood could be screened for hepatitis C) or other means since hepatitis C transmission was highest in the 1960s.

Age 65 — First DEXA Scan

As you age, your bones become less dense, putting you at risk for fragility fractures. These fractures are a leading cause of death, disability and loss of independence in seniors. Women are more likely to develop osteoporosis (weakened bones) than men, with half of all women experiencing an osteoporosis-related fracture in their lifetime.

Dual-energy x-ray absorptiometry (DEXA) is a noninvasive imaging test to check the density of your bones. You’ll need the test every two years to help you manage your bone health.

Women Beyond 65

After age 65, a woman’s need for screenings and preventive services will only increase. By having a trusted primary care physician, you can ensure you receive the services and care that are right for you based on your health, family history and lifestyle.

The Other Docs

Besides health services, there are essential legal documents women should make sure they have. These will minimize conflicts or confusion should you become seriously ill or die.

A Will

This spells out how you’d like property and assets distributed.

A Durable Power of Attorney

Giving someone your power of attorney allows you to designate that person to make financial, legal and tax decisions on your behalf if you lose your decision-making capacity.

An Advanced Health Care Directive

This includes a “living will” that spells out your wishes regarding end-of-life medical treatment along with a health care power of attorney.

About the author

Kasey M. Fuqua

Kasey Fuqua has been writing for hospitals and healthcare publications for over five years. Her writing often inspires her to explore new habits at home, from baking healthier to trying different workout routines. She’s a firm believer in lifting heavy weights, enjoying the food you eat and getting eight hours of sleep.

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