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National Women’s Health Week in May is a time to increase awareness of women’s health issues and encourage more women to seek routine medical care.
Changes in hormone levels throughout life introduce different health care needs for women.
Swedish gynecology nurse practitioner Elizabeth Chase, ARNP, discusses what kinds of changes women can expect and the various needs they may face during the phases of life.
When it comes to women’s health, there are plenty of questions about the bodily changes women can expect over a lifetime. From teenage years to menopause, the details of women’s health have often seemed mysterious — largely because these topics aren’t discussed.
“There’s so much that women aren’t taught about their bodies and things that people don’t talk about because they’re deemed socially unacceptable. Even mothers won’t talk with their daughters about problems,” says Elizabeth Chase, ARNP, a gynecology nurse practitioner with Swedish Women’s Wellness and Specialty GYN Services. “Consequently, it’s very important for gynecologists and women’s health providers to be very open with our patients.”
To improve women’s long-term health and quality of life, people need to start talking. National Women’s Health Week is a prime opportunity to increase understanding of the phases of a woman’s life and the changes they’ll experience.
Each stage is unique, Chase says. Knowing what to expect can prepare you for better health throughout your lifetime.
Early reproductive/highly fertile years
Even though it may seem early, you should start paying attention to your health as early as age 11 or 12, Chase says. Around this time, you’ll get your first period. Every woman’s period is different, so you need to know what’s normal.
For most girls, their menarche (the first period) shows up around ages 12 or 13, and each cycle is around 28 to 32 days. If yours is irregular — coming more often than 21 days or less often than 45 days — talk with your doctor. You should also seek help if your period is very heavy or painful, she says.
Around this same time, doctors recommend the human papillomavirus (HPV) vaccine (for boys as well). Getting vaccinated before you’re sexually active can prevent cervical cancer. When you’re 21, be sure to schedule your first Pap smear with your gynecologist or women’s health provider for your first cervical cancer screening.
Topics of interest that may come up during the early reproductive years, from your early 20s to mid-30s, Chase says, can be fertility and family planning.
“At this point, many women are planning on starting families and wondering if they need fertility testing,” she says. “It’s around this time that I encourage my patients to have a plan or a timeline for when they intend on potential pregnancies.”
It’s a good time to start talking to family members about any risks and complications that they went through during their reproductive years.
If you want children, women’s health providers often recommend trying to do so before age 35, Chase says. While many women have healthy pregnancies at this age and older, being pregnant after age 35 increases your risk for certain complications, including premature birth and potential genetic birth defects. Being pregnant at this age requires more routine monitoring throughout your pregnancy and clear communication with your health care providers.
Don’t worry if you don’t get pregnant right away, Chase says. It’s a misconception that it’s easy to conceive. For some healthy women, it can take up to a year. You can increase your chances if you understand your menstrual cycle. Women who have cycles that last between 28 and 32 days typically ovulate (are most fertile) around day 14. You can use ovulation tracker apps on your phone which are quite helpful and fun.
You can consider seeing a fertility specialist if you haven’t gotten pregnant within a year or within six months if you’re over age 35.
Perimenopause typically begins in your 40s and can last five to 10 years before you transition into menopause. With huge swings in hormones, it can feel like a rollercoaster for a lot of women, Chase says.
“Perimenopause can come with a slew of symptoms. With the huge fluctuations in estrogen, progesterone and/or testosterone, you can experience huge bursts of energy followed by big lows, and it can be coupled with huge swings in emotion or even lack of emotion,” she says. “It’s almost like repeating your teenage years.”
That includes other problems, too. You can also experience hair or acne on your chin or face, heavy menstrual bleeding, periods that get closer together and then even skip for several months.
Birth control pills or intrauterine devices (IUDs) are some options that help control bleeding and help regulate your hormones until you reach menopause, she says.
“These options give patients a constant and even dose of hormones. It’s like we’re tricking the brain into thinking that it doesn’t have to do much work so that we don’t see those huge swings in emotion or those menstrual irregularities,” she says. “It can help stabilize women until they get into the natural transition of menopause.”
Once you haven’t had a period for 12 months, you’ve officially entered menopause. This typically occurs in your late 40s to early 50s. Your levels of estrogen and progesterone drop, and your ovaries stop releasing eggs. These hormonal shifts can cause some significant and unpleasant side effects, Chase says.
“Most women know what the symptoms of menopause are, and they believe they’re doomed to experience them once they hit 50,” she says. “That’s not the case. A significant number of women don’t have any of these symptoms and of those who do, the severity truly ranges and depends on the person.”
If you do experience symptoms, they can include:
- Hot flashes
- Brain fog or memory lapses
- Decreased sex drive
- Vaginal dryness and pain with intercourse
- Difficulty sleeping
- Mood swings and irritability
- Night sweats
- Weight gain
It’s important to talk with your health care provider about your symptoms and how they affect your quality of life. Medications and hormonal and alternative therapies, including lifestyle changes, supplements and acupuncture, can help minimize their impact.
After menopause, you’ll be in post-menopause for the rest of your life. It can be easy to forget about your annual medical visits, but it’s important to keep those appointments, Chase says.
“You always need to come in for a yearly check-up,” she says. “Your health needs change, but you must maintain the regular pattern.”
The good news is, if you’ve always had normal Pap smears, you won’t need the screening anymore once you reach age 65. But you still need a gynecology exam to check for some other problems, such as vulvar, uterine or ovarian cancers, as well as mammograms to screen for breast cancer.
Although the pandemic has been difficult for everyone, Chase says, it’s been particularly challenging for women.
“Women naturally tend to take care of everyone else before themselves, so most women put themselves on the back burner when their family members got sick,” she says. “Fortunately, we’re seeing that trend reverse.”
Increasingly, women who overlooked routine medical appointments are again scheduling mammograms and pelvic exams. That’s encouraging because it improves early detection rates.
The pandemic has also created more emotional and mental health obstacles, such as anxiety, depression and burnout, for some women.
“These problems are even more difficult when you’re dealing with changing hormones,” Chase says. “Women had family members getting sick, children not being able to go to school, isolation from friends, and they were trying to parent during it all. It was a lot to deal with during a time when there was a shortage of mental health providers.”
Take care of yourself
Keeping up with your doctor appointments is a big part of maintaining your long-term health, Chase says. However, there are things you can do daily to boost your well-being.
- Exercise: Try to get at least 30 minutes of exercise daily. Something as simple as a daily walk can boost your endorphins — the “happy hormones.”
- Connect with others: Reach out to a friend or family member a few times a week to talk and share your feelings.
- Set a tangible goal: Determine a goal for yourself, such as walking daily or doing something social once a month. Hold yourself accountable by recording how much you accomplished at the end of each month.
Find a doctor
Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.
Join our Patient and Family Advisory Council.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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