With Women’s Day just around the corner, it’s only fit to dedicate some space to women’s health. That’s why, Rhea Dhanbhoora & Priyanka Singh give you the lowdown on what changes and health issues women face at various stages in their lives
Your teens are when your body undergoes the most changes. While most girls experience hormone and body issues when they are 10 or 11-years-old, most changes start around puberty. This is the age when you start your menstrual cycle, when your body starts going through important changes such as PMS and breast growth. This is a natural part of growing up, but can lead to a degree of stress.
Dr. Sadafi Rangooni, honorary consultant at Forever Young Clinic and Afterglow Clinic, tells us that teenage girls usually have more anxiety, go through peer pressure and experience depression more than boys at this age. As a teenager, your hips will get wider, you’ll experience vaginal discharge that you didn’t before and of course, your breasts will begin to swell and grow. Health issues include:
Physiological changes: At this stage, you’re going to be plagued by menstrual cramps and premenstrual syndrome, because of your first ever period. However, it’s also an important time to get checked for Polycystic Ovarian Disease (PCOD) and fibroadenoma. Problems of excessive hair growth, called hirsutism, usually warrant a doctor’s visit — and the beginning of hair removal treatments!
Medical conditions: Although problems such as insulin resistance and anemia aren’t just girl problems, most teenagers who suffer from them are female. Dental flurosis, caries and protein energy malnutrition are also common offenders.
A time of firsts
Dr. Mukesh Batra emphasises on the need to take your first pap smear when you are 18-years-old. “Remember, it is imperative for a girl to get her first pap smear done once she turns 18, or becomes sexually active. It can save lives, because 80% of women who die from cervical cancer haven’t had regular pap smears,” he says.
Dr. Manjiri Patankar-Puranik, founder of InstaSculpt and Dr. Sadafi say that girls should go for a full checkup which includes checking for vitamin deficiencies such as B12 and D. Other tests include:
Breast exam: An annual, manual exam is essential once you are 18-years-old.
Complete blood count (CBC): This test screens for anemia and measures blood components.
Immunisations: Your doctor can tell you what vaccinations you need, depending on your age.
Pap smear: As part of an annual pelvic exam.
Urinalysis: Screens for urinary tract infections and kidney disorders as per doctor’s orders.
Young Adults (20-30)
This is the best time to enjoy your youth, but it’s also an important time for your body. “When a woman enters her 20s, her estrogen and progesterone levels are at their peak, adding to fat and muscle,” says Dr. Mukesh.
Dr. Pranay says that because pregnancy occurs most commonly during this stage, you could go through an increase in body and muscle mass, breast enlargement, fat deposition, increase in waist and hip measurements. “Although few of the changes are reversible, most do not completely reverse after delivery and breast feeding,” he adds.
“The multiple roles that women assume leave her susceptible to fatigue and depression,” says Dr. Manjiri. Follow a healthy routine because what you do at this age is going to affect the changes in your body for the rest of your life.
Dr. Sadafi tells us about other issues you need to be wary of at this age:
- Autoimmune conditions such as arthritis, psoriasis and diabetes.
- Breast, cervical and ovarian cancer, which have started affecting women this age.
- Gynecological conditions such as cysts, endometriosis, gonorrhea, fibroids and PCOD.
- In your 20s and 30s, you’re most susceptible to thyroid dysfunction and osteoporosis.
- You will be at risk of episodes of depression.
Dr. Manjiri tells us about some tests that are essential for women in their 20s and 30s:
Breast exam: Annually.
Pelvic exam: Annually.
Sexually transmitted diseases: Annually.
Mammogram: A ‘baseline’ mammogram sometime between the age of 30 and 35. Those with a family history of breast cancer should have a mammogram at age 30 and then another mammogram every year or two.
Pap smear: Every other year beginning with the onset of sexual activity.
Blood work: Every five years.
Cholesterol: Every five years after the age of 35.
Breast self-exam: Every month.
Blood pressure: Blood pressure should be checked every other year after age 30.
Electrocardiogram: One baseline ECG should be done in the 30s.
Stool screening: Check for fecal occult blood every other year.
Take care of yourself
Dr. Mukesh suggests taking 1,200 mg of calcium a day after the age of 30, to prevent hip and spine fractures. Vitamin D will help your bones absorb calcium and vitamin C is good to help maintain tissue, bone and teeth as well as prevent cataract. Stress is at an all time high in this age group, with career, family life and social pressure bearing down on you. There’s a reason you need to avoid smoking, drinking and skin damaging habits because as Dr. Manjiri reminds us, this is the best time for your skin — so it’s a good idea to keep it that way!
Middle Age (40-60)
This is a phase where women have to be the epitome of multi tasking. They are a wife, mother, working woman and have to juggle all of these obligations along with the onset of perimenopause. Dr. Pranay says, “Perimenopause may occur as early as the late 30s or early 40s in some cases and last from a few months to five years. Menstrual irregularities, heavy menstruation and genital infections are common causes to visit a gynecologist.”
Besides menopause, women must also be concerned with their susceptibility to breast cancer and ovarian cancer. Dr. Pranay elaborates, “Life may begin at 40, but our bodies have started to age when we reach 50. This is not a disease, but a natural development. Whatever the reason, the fact is that after 50, parts of our bodies start to wear out.” Issues include:
Visible changes: The fat under the skin begins to decrease and oil and sweat glands are less efficient. Collagen and elastin, which keep the skin firm and plump, become less connected. As a result, your skin wrinkles and sags. Other external changes include changes in hair texture and colour, as the sebaceous glands that produce thick hair work less efficiently. Depending on your genes, you may have started to go grey or white as early as your 30s and 40s, but it will almost certainly happen in your 50s. Some women suffer hair loss during menopause.
Internal Changes: Your muscles shrink as you age, having much less mass in your 50s than in your 20s. Tendons and ligaments become less flexible, while cartilage starts to break down. Bones lose density and become more fragile, making falls more dangerous and becoming prone to osteoporosis. The loss of bone density also makes you shrink, losing almost half an inch every 10 years after the age of 40. In their 50s, many women experience menopause, when they stop menstruating and are no longer fertile. This may lead to changes in breast tissue, the bladder and the urethra. Because of the decline in estrogen, women are at greater risk of osteoporosis than men are. During this period, women may gain weight before their weight starts to level out in their 70s.
Dr. Pranay tells us about the important tests:
Mammogram: Every one or two years after 35; every year for all women over 50.
Stool screening: Check for fecal occult blood every three years; after 50, get an annual exam.
Electrocardiogram: An ECG when you’re 45-years-old to check the health of your heart.
Pap smear: Ever year, even after menopause or hysterectomy.
Bloodwork: Every five years.
Physical: Every one to three years.
Bone density baseline: Menopausal women should consider a baseline if considering or taking hormone replacement or corticosteroids, or there is a fractured vertebrae.
Eye exam: Every five years; after 50, every four years, including a glaucoma screen.
Old Age (70+)
According to Dr. Manjiri, as a woman approaches her 70s, she may lose her appetite as her metabolism slows down. So, keep taking a multivitamin and calcium supplement to combat loss of muscle strength and bone density. She adds, “Stay active. Skin begins to change as cells in the top layer become irregular. Precancerous lesions and pigment changes (liver spots) may begin to appear, with skin getting thinner and wrinkled.” This is also a time when hair starts thinning, body hair gets darker or thicker, hair may start appearing on the face and chin and sexual interest might diminish.
Apart from CBC, vitamins B12 and D and calcium, Dr. Pranay tells us what tests you need to undergo after the age of 70:
Blood Pressure: Get tested at least every two years, but once a year if you have blood pressure between 120/80 and 139/89.
Osteoporosis: Once a year.
Breast cancer: Get screened every two years.
Cholesterol test: Regularity depends on levels.
Colorectal cancer: At least once after 75.
Diabetes screening: If your blood pressure is higher than 135/80 or if you take medicine for high blood pressure.
Dr. Pranay Shah, a consultant gynecologist and endoscopist from Nova Speciality Surgery, gives us some startling statistics for teenage girls in the country:
- 45% are malnourished and anemic and in bigger cities, 5-10% are obese.
- 15% have had sex, but are not currently sexually active and 25% are sexually active, but lack information and skill for protection.
- 50% of girls in India have had a child before they’re 20 and 10% have PCOD.
“At any age, especially when you hit 20s-30s, it is necessary to check the female hormone profile which will show the PCOS -Polycystic Ovary Syndrome, which can cause excess body weight, acne and severe hair fall, and is very common these days. The tests will be available at any lab, but you can take them only after consulting your doctor. You have to take calcium, B3 and B12 which eventually contributes to good health and good looks.”
— Dr. Rashmi Shetty
“In postmenopausal life, health checks for heart disease, osteoporosis and cancer need to be done, including emotional issues, owing to loss of a loved one or bereavement. This is because women statistically outlive men.”
— Dr. Mukesh Batra, founder and CMD of Dr Batra’s
“Metabolism begins to slow down in the 30s, as lean muscle tissue in the body decreases and fat increases. Women need to start exercising now as it will become easier to put on weight. While women in their 30s are still young, they may start to see wrinkles as the rate of facial skin-cell renewal slows down.”
— Dr. Manjiri Patankar-Puranik, Founder of InstaSculpt