[12 MIN READ]
In this article:
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Women’s health issues change and evolve throughout their different life stages – from puberty to post-menopause – requiring regular screenings, family planning and healthy lifestyle choices to manage their health effectively.
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Women often ignore the early warning signs of illness and delay getting care until the issue has progressed and worsened.
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A women’s health expert at Providence outlines the many ways women’s health issues change throughout their lives and discusses the importance of regular health maintenance and screenings.
A comprehensive guide to women’s health
Women’s health issues change and evolve as they age, so it stands to reason that their health concerns also change over time.
We talked to Melanie Santos, M.D., FACOG, FPMRS, about common health issues women face and how those issues change and evolve with every life stage. While Dr. Santos is a urogynecologist who specializes in treating women with incontinence and other pelvic floor disorders, she is very well acquainted with many of the different health issues women encounter throughout their lives. Here’s what she shared.
How health concerns evolve from adolescence to post-menopause
“Puberty is a time of major physical and emotional changes, signaling the body’s ability to reproduce. During this stage, it’s important to learn about the menstrual cycle, hygiene practices and what to expect as your body changes,” says Dr. Santos.
Reproductive years are another life stage that affects a woman’s health. As she enters adulthood, understanding and managing reproductive health becomes crucial.
According to Dr. Santos, this includes:
- Regular health screenings – Stay current on Pap tests, breast exams and screenings for sexually transmitted infections (STIs).
- Contraception and family planning – Educate yourself about different birth control methods and plan your family in a way that’s right for you.
- Healthy lifestyle – Maintain a balanced diet, get regular exercise, quit smoking, manage stress and avoid alcohol and other drugs.
“Perimenopause, the transition period into menopause, can start years before menopause. Symptoms such as irregular periods, mood changes and hot flashes can begin during this time,” says Dr. Santos.
Menopause typically occurs between ages 45 and 58. However, it can happen earlier or later and be considered “normal,” says Dr. Santos. A woman has reached menopause when she has not had a period for 12 months in a row. Post-menopause, women are at a higher risk for certain health conditions, including osteoporosis, diabetes, heart disease and mental health issues.
Breast health and cancer awareness
Breast health is an essential component of women’s overall health. According to the American Cancer Society, breast cancer is one of the most common cancers in women, coming in second after skin cancer. It accounts for one in three new female cancer diagnoses every year.
“The central concern with breast health is breast cancer, which is influenced by genetic factors, lifestyle choices and hormonal imbalances,” says Dr. Santos. “Regular screenings and self-exams are crucial for early detection.”
How your breasts change over time
As a woman ages, her breasts lose fat, tissue and mammary glands. The area around the nipple, called the areola, becomes smaller and may turn in slightly. Breast lumps become more common around menopause. Although they tend to be noncancerous cysts, according to the National Institutes of Health (NIH), all lumps should be examined further to ensure they’re not cancerous.
Mammograms and early detection
Breast cancer screenings can detect breast cancer in its earliest stages when it’s most treatable. Breast self-exams and clinical breast exams can often reveal a lump or change, but they should not be the only cancer screening tool you use, according to the NIH.
A mammogram is an X-ray of the breasts used to evaluate symptoms and detect breast cancer. It is the most common type of breast cancer screening. Screening recommendations vary depending on the organization. Generally, a mammogram is recommended for all women once they reach 40 and should be repeated every year. Women with a family history of breast cancer should talk to their doctor about screenings and other preventative steps.
Reproductive health and hormonal changes
“Reproductive health faces threats from conditions like polycystic ovary syndrome (PCOS), endometriosis, and cervical cancer, which can impact fertility and overall well-being. Regular gynecological check-ups, safe sexual practices and vaccinations (such as the HPV vaccine) are essential for prevention and early intervention,” says Dr. Santos.
Menstruation, pregnancy and menopause
For women, specific sex hormones like estrogen, progesterone and even testosterone have significant roles during each stage of a woman’s life. These shape physical attributes and influence mood, metabolism and the entire reproductive system.
According to Dr. Santos, puberty typically kicks off between ages 9 to 11 for girls. This stage is primarily propelled by a surge in hormones. Estrogen prompts the development of secondary sexual characteristics such as breast development, the widening of hips and the start of menstruation. At the same time, other hormones, like growth hormone, also spike, leading to rapid growth and maturation.
During their reproductive years, women’s bodies undergo a cyclic hormonal pattern that regulates their menstrual cycle each month. The rise and fall of estrogen and progesterone not only determine the uterine lining’s preparation and shedding, but they can also influence mood, skin health and energy levels. During pregnancy, hormones increase to ensure the body sustains the fetus and is prepared for childbirth.
As women approach their late 40s to early 50s, they will inevitably reach menopause, marked by the cessation of the menstrual cycle. This transition is accompanied by a drop in estrogen levels, leading to various symptoms like hot flashes, sleep disturbances and changes in bone density. Post-menopause, the sustained low hormone levels also play a role in longer-term health considerations, including cardiovascular health and osteoporosis.
When is hysterectomy the right choice?
“A hysterectomy is typically considered the right choice when other treatments have failed or are not suitable, and the condition significantly impacts a person’s quality of life,” says Dr. Santos.
Some common reasons a hysterectomy may be recommended include:
- Uterine fibroids – When fibroids cause heavy bleeding, pain or pressure that does not respond to medication or less invasive treatments.
- Endometriosis – If severe, endometriosis causes chronic pain.
- Adenomyosis – When the uterine lining grows into the muscle of the uterus, leading to severe pain and heavy bleeding.
- Cancer – If a person has uterine, ovarian or cervical cancer, a hysterectomy may be necessary for treatment.
- Severe pelvic inflammatory disease (PID) – If the infection causes long-term damage and other treatments do not work.
- Uterine prolapse – When the uterus descends into the vaginal canal, causing discomfort or urinary issues, and conservative treatments are insufficient.
- Abnormal uterine bleeding – If bleeding is persistent, severe and not manageable with medications or other procedures.
Urinary and vaginal health
Women often overlook their urinary and vaginal health, according to Dr. Santos. “Women wait an average of eight years to address urinary incontinence. They put everything else first, and by the time they seek help, the problem has often worsened,” she explains. “That’s why early intervention is so important.”
How to support pelvic floor health
The pelvic floor is a group of muscles that hold a woman’s pelvic organs in place. The pelvic organs include the bladder, urethra, rectum and intestines. A woman’s pelvic organs also include the vagina, cervix and uterus.
As women age, their pelvic floor may become weak, causing pain, difficulty urinating, leaking stool and problems emptying their bladder completely. Pelvic floor disorder specialists can help develop a treatment plan tailored to their patient’s unique needs.
Overlooked women’s health issues: Common conditions women hesitate to discuss and why they matter
Many women tend to ignore certain health issues due to embarrassment, fear or societal stigma. But pretending something doesn’t exist doesn’t make it true. Ignoring potential health issues is never a good idea, and it can have catastrophic consequences for your health. Dr. Santos explains how.
Pelvic pain and menstrual issues
“Many women believe severe cramps, irregular periods or heavy bleeding are normal. But they could indicate endometriosis, fibroids or polycystic ovary syndrome (PCOS). If left untreated, any of these conditions can lead to infertility, chronic pain or other complications,” says Dr. Santos.
Urinary incontinence
“Women ignore urinary incontinence issues out of embarrassment or the assumption that it’s just part of aging or childbirth,” explains Dr. Santos. “If left untreated, urinary incontinence can worsen over time, leading to recurrent infections, other pelvic issues and mental health issues.”
Breast changes
“Women ignore changes in their breasts out of fear of a cancer diagnosis or a belief the lumps are normal. This can lead to delayed detection of breast cancer or benign conditions like cysts that could become painful if left untreated,” says Dr. Santos.
Gastrointestinal issues
“Women often don’t like talking about bloating, constipation or blood in their stool,” says Dr. Santos. “They may feel embarrassment about discussing digestion or bowel movements, but they could be a symptom of irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) or even colorectal cancer. It’s important to get them checked out.”
Mental health issues
“Fear of stigma, appearing weak or being judged as an incapable woman causes many women to ignore mental health issues such as anxiety, depression or postpartum issues,” says Dr. Santos. “Not addressing the problem has consequences. It can lead to worsening mental health, self-harm, strained relationships, and even physical symptoms like headaches and fatigue.”
Heart disease symptoms
“Women often dismiss symptoms like chest pain, fatigue and shortness of breath as stress or anxiety and assume heart disease is a men’s issue. In reality, heart disease is the leading cause of death in women. Ignoring symptoms can lead to life-threatening heart attacks or strokes,” says Dr. Santos.
The link between emotional and physical well-being
Stress, anxiety and chronic emotional distress can weaken the immune system, making women more susceptible to illnesses. High levels of stress contribute to hormonal imbalances, potentially affecting menstrual cycles, fertility and even menopause symptoms.
“Positive emotional well-being improves heart health by reducing the risk of hypertension and cardiovascular diseases,” says Dr. Santos.
Relationships matter
According to Dr. Santos, supportive relationships with partners, friends and family promote emotional stability and help women cope with challenges, reducing the risk of depression and anxiety. Unhealthy relationships, including emotional or physical abuse, can lead to chronic stress, low self-esteem and increased risks of conditions like heart disease, high blood pressure and even gastrointestinal disorders.
“Social connections contribute to longer life expectancy and better cognitive function as women age,” she explains.
Mental health affects physical health
Depression and anxiety are linked to chronic conditions such as diabetes, obesity and autoimmune disorders.
Research shows poor mental health can lead to unhealthy behaviors like overeating, substance abuse or neglecting medical care, worsening overall health. Women with good mental health are more likely to engage in self-care, exercise and healthy eating, leading to better physical outcomes.
“A woman’s emotional, relational and mental well-being are deeply connected to her physical health. Prioritizing mental health, fostering healthy relationships and managing stress can lead to a longer, healthier life,” says Dr. Santos.
Women’s heart health and stroke prevention
Heart disease is the leading cause of death among women. It is often overlooked and ignored due to its atypical symptoms compared to men. Risks include high blood pressure, high cholesterol, diabetes, smoking and lack of physical activity. Maintaining a heart-healthy diet and regular exercise can reduce these risks.
Why heart disease affects women differently
“Heart disease is a massive issue for women,” says Dr. Santos. “Women’s heart health is especially concerning because heart attacks often present differently in women than in men. While men typically experience chest pain, women might feel nauseous or fatigued – things that can easily be dismissed."
“Raising awareness and empowering women to speak up is key,” she adds.
Prioritizing preventative care and healthy living: Essential health screenings every woman needs
According to the United States Preventive Services Task Force, these are the screenings women need at every age to achieve their best health.
Women in their 20s & 30s
Women in their 20s and 30s should get these screenings once a year:
- Primary care visit
- Clinical breast exam
- Blood pressure screening
Women ages 21–29 should be screened for cervical cancer every three years. For women ages 21–25, the benefit of a Pap test is much less because the risk of cervical cancer is extremely low. However, for women who have not had the HPV vaccine, screening can be considered. Women ages 30–65 should be screened every three years for cervical cancer alone, every five years for HPV alone or every five years if co-testing for both.
“The decision depends on a woman's history of abnormal Pap tests and HPV and her HPV vaccine status. If you are unsure, please discuss it with your OB-GYN,” says Dr. Santos.
Additional screenings during this stage may include:
- Sexually transmitted infection (STI) screening – All sexually active women younger than 25 should be tested for gonorrhea and chlamydia every year. Women 25 and older who have new or multiple sex partners or a sex partner who has an STI should also be tested for gonorrhea and chlamydia every year.
- Family planning – This is done during an OB-GYN visit; it brings attention to contraception, reproductive health and reproductive planning, all of which are important for women interested in starting a family.
- Genetic testing – If there is a strong family history of cancer, including breast, ovarian cancer, cervical cancer or colon cancer, genetic testing might be recommended.
Women in their 40s & 50s
Women in their 40s and 50s should have a primary care visit that includes blood tests and lipid screening once a year.
The following tests are also recommended:
- Pap test and pelvic exam – The USPSTF advises women to screen every three years for cervical cancer, every five years for HPV or every five years when combining both tests.
- Screens for breast cancer – Once a year, starting at age 45. Women ages 40–44 can start annual mammograms if they wish. Women 55 and older can switch to every two years if they choose.
- Colonoscopy – The American Cancer Society recommends starting screening at age 45 or earlier if you have a family history of colon cancer. For those without a history of colon cancer, it’s generally recommended to get a colonoscopy every 10 years after the initial screening.
- Lung cancer screening – The USPSTF recommends adults 55 and older should be screened if they have smoked for 30 years and currently smoke or if they’ve quit within the last 15 years.
Women in their 60s & older
For women in their 60s and older, these tests are often recommended annually:
- Routine blood tests and lipid screening
- Skin cancer screening
- Cardiology screening, especially if you are African American, have had preeclampsia or high blood pressure while pregnant or have a family history of heart disease
“Women 65 and older with normal bone mass should have a bone mineral density (BMD) test every 15 years. More frequent testing is recommended for women with certain risk factors for osteoporosis, such as smoking, alcoholism, history of hip fracture in a parent or rheumatoid arthritis,” says Dr. Santos.
Based on the best available guidelines, the Pap test is not routinely recommended after age 65.
Taking charge of your health
Women can take several steps to improve their health, but according to Dr. Santos, the top three strategies are:
- Prioritize preventive care – Regular check-ups, screenings such as mammograms, Pap smears, bone density tests and vaccinations help detect and prevent serious health conditions early. Managing chronic conditions like diabetes, hypertension or thyroid disorders is also crucial.
- Maintain a balanced diet and exercise routine – A nutrient-rich diet with plenty of fruits, vegetables, lean proteins and healthy fats supports overall health. Regular physical activity, including strength training, cardio and flexibility exercises, helps maintain weight, reduce disease risk and boost mental well-being.
- Manage stress and get quality sleep – Chronic stress can negatively impact heart health, immune function and mental well-being. Engaging in relaxation techniques such as meditation and deep breathing or hobbies you enjoy and ensuring seven to nine hours of sleep per night supports overall health and hormonal balance.
“Thankfully, women’s health is gaining more visibility. We’re seeing more discussions about menopause and other aspects of women’s lives. Celebrities and influencers are using their platforms to normalize these conversations and push for better care,” says Dr. Santos. “Raising awareness and empowering women to speak up is key. If your provider isn’t listening, find someone who will.”
Contributing caregiver
Melanie Santos, M.D., FACOG, FPMRS, is the medical director of pelvic health for St. Jude Medical Center in Fullerton, California. She specializes in many of the health issues women face throughout their lives.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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