Regular physician visits and medical screenings are critical for women to maintain their health. However, it can be difficult to know what tests are needed and at what ages, which doctors they should be seeing annually, and the changes women are likely to experience as they get older.
UAB Medicine experts discuss some of these issues below. They highlight changes to be aware of, questions that women should ask their doctors, and which tests are recommended in their 20s, 30s, and 40s.
Each woman’s needs are different, so it’s important to talk to your doctor about maintaining your health. However, these general guidelines can help you navigate your individual health journey and better understand and manage changes as your body matures.
Gynecologic care
Most adult women see a gynecologist regularly, so they sometimes wonder if they also need regular visits with a primary care doctor. Audra Williams, M.D., an OB/GYN physician at UAB Medicine, says that just seeing a gynecologist is enough for many women – especially if they’re healthy and in their 20s or early 30s.
“When women come for their annual screenings, we do much more than just pelvic exams,” Dr. Williams said. “We do an overall health screening, test their blood pressure and weight, dive into her family history, and identify any potential health risks. We take a full-body approach to their care and then recommend other physicians as needed to address other health concerns women may have.”
Dr. Williams says it’s important to establish a relationship with a trusted gynecologist in your 20s – not only for maintaining health but also for discussing any questions or concerns related to sexual function, family planning, fertility, and more.
“Women’s needs change from their early 20s, when they may be more focused on sexual health and prevention, to their early 30s, when family planning is often top of mind,” Dr. Williams said. “And into their 40s, when urine leakage and perimenopause are prevalent, we as OB/GYNs guide our patients through all aspects of women’s health concerns. We’re a one-stop shop in many ways.”
A gynecologist also plays a key role in detecting and preventing cancer. They conduct Pap smears for women age 21 and older to screen for cervical cancer, administer HPV vaccines, and perform routine breast exams. Even before a woman is due for a mammogram, most gynecologists develop a plan for tests and screenings tailored to the patient’s age and risk factors, then they refer her to appropriate specialists as needed.
By their mid- to late 30s, women should begin seeing a primary care physician. Although a gynecologist can test for things like high cholesterol and diabetes, most will refer their patient to a primary care doctor instead.
Heart health
Heart disease is the No.1 cause of death among women in the United States, responsible for nearly one in four female deaths. For many women, the signs or symptoms of heart disease tend to differ from those that men experience. Beyond chest pain or pressure, women are more likely to face tiredness, nausea, dizziness, and sweating. Seek medical attention if you have new or unusual symptoms.
Women with risk factors for heart disease such as hypertension, diabetes, or smoking are at greater risk for heart disease. And those who’ve had gestational diabetes or hypertension may be at higher risk for heart disease later in life.
Elizabeth Jackson, M.D., a cardiologist at UAB Medicine, recommends that women in their 20s discuss their blood pressure readings during visits with their primary care doctor or gynecologist.
“In addition to reviewing your blood pressure levels, checking for other risk factors such as elevated glucose and cholesterol levels should be done periodically, depending on a woman’s age and other risk factors,” Dr. Jackson said. “Ask your doctor how often you should have these measured. The American Heart Association also has excellent information on what these numbers mean and how often to check your levels depending on your age and other health conditions.”
Additional testing may be recommended for women with a family history of heart disease or known risk factors for it, such as smoking, high blood pressure, high cholesterol, diabetes, and being overweight. For women with autoimmune disorders or conditions such as gestational diabetes, further or more frequent testing may be advised.
“Although we outline general guidelines, we know that each woman is different, so it’s best to talk to your doctor and see what course of treatment may be right for you,” Dr. Jackson said.
To help reduce heart disease and stroke among women, the UAB Cardiovascular Institute created the Women’s Heart Health Program. Directed by an experienced team of experts, it offers a wide range of diagnostic testing and treatments and personalizes care to each individual woman.
Skin health
Skin cancer is the most common cancer in the United States, but regular body scans by a dermatologist can detect any questionable or potentially cancerous spots early. Tiffany Mayo, M.D., a dermatologist with UAB Medicine, recommends that women begin seeing a dermatologist in their early 30s, or sooner if they have a higher-than-normal risk for skin cancer.
Once the dermatologist is familiar with the patient’s skin type and medical history, he or she usually recommends how often these visits are needed going forward.
“Skin exams are important for women of all ethnic backgrounds,” Dr. Mayo said. “Skin cancers are more common in lighter skin, but they can also occur in those with African, Asian, or Hispanic backgrounds. Women should see a dermatologist for full-body skin exams, so they can better understand their individual risks.”
“At these visits, we can thoroughly evaluate the skin and discuss skin cancer risk factors specific to the individual patient, to determine how frequent she should have follow-up skin exams,” Dr. Mayo added. “For instance, some women who rarely or never get sunburned may only need to visit every 2-3 years, while women who sunburn easily – and those on certain medications that affect the immune system – may need to come at least once a year or more frequently.”
However, each body is different, so Dr. Mayo says it’s important that women understand how to identify new or abnormal spots on their skin.
Dr. Mayo says regular exams are even more important for women who regularly use tanning beds or did in the past. According to the American Academy of Dermatology, the use of tanning beds before age 20 increases the risk of melanoma, the most common form of skin cancer, by 47%. Indoor tanning also increases the risk of other types of skin cancer, including squamous cell carcinoma (58% higher risk) and basal cell carcinoma (24% higher risk).
The feet and nail beds are commonly overlooked during self-exams, so Dr. Mayo recommends paying special attention to these areas, especially for women of color. As part of regular skin exams, she also instructs her patients on what to look for.
“What we try to accomplish in our skin exams, beyond looking for cancer, is to help educate women about what looks normal and what doesn’t,” Dr. Mayo said. “If these tips help women identify spots on their own bodies – or even on the bodies of their husbands, family members, children, or friends – then that visit was worth it and can save other lives.”
Dr. Mayo recommends that women of all ages regularly wear sunscreen with an SPF of 30 or higher and reapply it every two hours or even more often if sweating or swimming. Check the expiration date on sunscreen, and replace it as needed, to ensure maximum protection. She also suggests covering your skin with clothing and hats when possible.
Oral health
Most women experience major changes in the years leading up to childbearing and during pregnancy, and many of these occur in the mouth. Hormonal changes can impact the blood supply to the gums and affect how the body responds to plaque buildup. These changes can lead to periodontal disease, which is an infection or inflammation of the gums and bone that surround and support the teeth.
For women who are pregnant or planning to become pregnant soon, a dental checkup is a necessary part of perinatal healthcare. Periodontal disease can increase the risk of pre-term or low-birth-weight deliveries.
As women enter their late 30s, they can experience higher rates of gum recession, periodontal disease, and tooth decay due to diet, inadequate dental care, increased oral dryness, or long-term exposure to harmful bacteria in the mouth. When a woman enters her 40s, there is the potential for reduced bone density in the jaw. This can lead to a faster progression of periodontal disease and even tooth loss.
Also, hormone replacement medications can affect oral bacteria and lead to inflammation. So, it’s important to see a dentist regularly, according to Mia Geisinger, DDS, chair of periodontology at the UAB School of Dentistry.
“During perimenopause and menopause, women experience changing hormone levels and may notice differences in oral symptoms as well, including dry mouth, increased inflammation, and higher rates of altered taste and sensation in the mouth,” Dr. Geisinger said. “It’s critically important to be aware of the possible changes that can occur and visit a dentist who can help women find potential treatments for oral conditions.”
Eye health
There are no eye conditions that specifically impact or cause extra concern for women during their 20s, 30s, and 40s. However, women age 20-40 should see an optometrist annually for a routine eye exam, according to Terri Call, O.D., an optometrist at UAB Eye Care.
“Routine eye exams for women during these times of life are generally sufficient, as we do a full exam of the woman’s overall eye and vision health,” Dr. Call said. “However, it is worth noting that pregnancy can change a woman’s prescription temporarily or permanently, and some women may start needing reading glasses for the first time as they approach their 40s.”
Also, Dr. Call says dry eye is a condition that becomes more common among women as they approach menopause. So, women who are experiencing new or worsening dry eye symptoms in their late 40s or 50s should consider asking their eye doctor to evaluate them for dry eye.
Finally, pregnancy can cause blurry vision due to changes to the cornea, but it’s usually temporary and often goes away after delivery. However, it also can stem from more serious conditions such as preeclampsia, idiopathic intracranial hypertension, and diabetic retinopathy in patients with pre-existing diabetes or gestational diabetes. So, it’s important to talk to your OB/GYN or primary care doctor if you have blurry vision during pregnancy.
Please visit uabmedicine.org/women to learn more about women’s health services at UAB Medicine.