A Lifetime of Better Health
A GUIDE FOR WOMEN OF ALL AGES
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Your Teen Years
A TIME OF CHANGE
As girls develop, hormones play a critical role. These years include major physical and life changes, which bring joy and excitement as well as mental health challenges and the need to learn about and protect sexual health.
YOUR PERIOD NOW
Most girls start menstruating between the ages of 10 and 16 (the median age is 12 to 13 years old). Early on, menstrual cycles can be irregular but typically become regular within four years. In a 2024 study in the Journal of Pediatric and Adolescent Gynecology, 51% of adolescents had irregular periods. Talk to a healthcare provider if your period:
• Occurs more frequently than every 21 days or less frequently than every 45 days
• Lasts for more than seven days
• Requires frequent pad or tampon changes (soaking more than one every 1 to 2 hours)
• Causes severe pain
✽HEALTHY HABITS Q&A
How can I avoid toxic shock syndrome (TSS)?
TSS is associated with tampon use. Each year, an estimated one to three of every 100,000 women are diagnosed with this potentially life-threatening illness. Symptoms include fever, low blood pressure and a sunburn-like rash. To avoid TSS:
• Use pads at night.
• Change tampons frequently (at least every 4 to 8 hours).
• Choose the lowestabsorbency tampons possible to handle your flow.
• Wash hands carefully before inserting or removing tampons.
Why should I get the HPV vaccine?
21-45 DAYS
The range of menstrual cycle lengths (time between period start dates) considered normal for girls and women younger than age 20
For your convenience, we have broken this health information into decades. However, please note that some issues and topics overlap and are more/less prevalent for individual women at different ages.
The HPV vaccine saves lives. Thanks to it and the Pap smear, cervical cancer is no longer a common cause of cancer death for women. The HPV vaccine is recommended for girls (and boys) 11 or 12 years of age but can be given as early as age 9. Although it’s preferable to receive the vaccine before you become sexually active, it’s recommended for everyone through age 26 years.
HANDLE ACNE LIKE A PRO
Fluctuating hormone levels around menstruation can trigger acne. See our prevention tips below. If they don’t improve your acne, talk to your healthcare provider about medical treatment options.
1. Wash your face in the morning and after exercise. Using a gentle acne face wash, applied with your fingertips, can clear the sebum and dead cells that build up on the skin’s surface overnight and clog pores.
2. Always use a clean face towel—not your shower towel.
3. Use noncomedogenic makeup and sunscreen products, which have been formulated not to block skin pores.
4. Shampoo regularly—oily hair can cause forehead acne.
5. Keep your hands off your face. Dirt and oils from your hands can cause acne flare-ups. Popping “zits” can make them take longer to clear up and increases the risk of scarring.
6. Stay out of the sun—tanning can make acne worse.
7. Wash your face with an acne cleanser again before bed to clear your pores of makeup and other impurities that have collected during the day.
85% of women get blemishes in the week before their period starts.
MIND MATTERS
Talk to a primary care or mentalhealth provider if you have any of these symptoms most of the day, almost every day for more than two weeks:
• Lack of interest in activities you used to enjoy
• Eating and/or sleeping more or less than usual
• Feeling tired, even after sleeping well
• Difficulty concentrating or making decisions
• Feeling sad, irritable, worthless or hopeless
• Experiencing aches, pains or stomach problems
• Excessive fear or worry that is difficult to control
17% of Americans age 12-17 reported experiencing symptoms of depression in a CDC survey conducted in 2021-2022.
DOUBLED DEPRESSION RISK
Vaping nicotine can intensify symptoms of depression and anxiety and increase stress levels. A study of nearly 30,000 e-cigarette users found that current users have double the odds of being diagnosed with depression compared with those who have never vaped.
THE TRUTH ABOUT VAPING
E-cigarettes are the most common way U.S. teens use tobacco. Like smoking, vaping brings into the body unhealthy chemicals that injure the lungs. E-cigarettes also contain nicotine—often at higher concentrations than regular cigarettes—so they’re equally (or more) addictive. The Centers for Disease Control sums it up simply: “There are no safe tobacco products, including e-cigarettes.”
Your 20s HITTING YOUR STRIDE
In your 20s, you step into new independence. Working, going to college, making new friends and dating bring both fun and new challenges. You’re responsible for your own health, keeping up with preventive care and making important decisions.
WHAT IS PCOS?
An estimated 7% to 15% of women have polycystic ovary syndrome (PCOS), which is typically diagnosed in adolescence. Symptoms vary, but often include irregular periods and signs of an excess of androgens (the hormones that trigger male physical characteristics), such as excess hair growth, severe acne and, sometimes, male-pattern baldness.
BIRTH CONTROL CHOICES
Birth control makes it possible to plan to have children when you’re emotionally and financially ready. There are many options, including:
• Intrauterine contraception (IUD)
• Hormonal methods, which can be given as a shot (every three months), implanted under the skin, taken as a pill, or administered via a skin patch or ring inserted into the vagina
• Barrier methods (diaphragm, sponge, condom)
• Fertility awareness (avoiding sex when you are fertile)
If birth control fails or you have unprotected sex, there are emergency methods that can be used to prevent pregnancy. These include the copper IUD and emergency contraceptive pills. Either method must be administered within five days of unprotected intercourse.
HEALTHY HABITS Q&A
How can I prevent a urinary tract infection?
Urinary tract infections are caused by bacteria that enter the urinary tract through the urethra. To help prevent UTIs:
• Drink lots of water (1.4 liters/ day) to help flush bacteria.
• Empty your bladder when you feel the urge to go.
• After using the toilet, wipe from front to back.
• Don’t use douches, sprays or powders in the genital area.
• Shower before sex, urinate soon after, and ask your partner to wear a condom.
• Avoid spermicidal jelly, which kills good bacteria in the vaginal area.
• Avoid taking long baths.
• Choose cotton underwear that isn’t tight.
• Consume probiotic foods.
What is vaginitis?
Vaginitis is an inflammation of the vagina, typically caused by bacteria or an infection. It can cause discharge, itching and pain. Yeast infections are a type of vaginitis. To help prevent vaginitis:
• Avoid harsh soaps and douches.
• Wear breathable cotton underwear and change out of wet clothes quickly.
• Consume probiotic foods.
How can I lower my risk of sexually transmitted infections (STIs)?
• Use condoms every time you have sex.
• Limit your number of sex partners.
• Be in a mutually monogamous relationship with a partner who does not have an STI.
THERE’S AN EXERCISE FOR THAT!
The increased strain of supporting a growing baby and hormonal changes can weaken pelvic floor muscles, which support the bladder and bowel. Help prevent future incontinence by doing Kegel exercises to strengthen pelvic floor muscles.
BECOMING A MOTHER
While pregnancy and childbirth are among life’s most joyous times, they may come with significant challenges. Having regular prenatal visits helps prevent common complications that can lead to health problems for babies and moms. Issues that can’t be prevented can be best managed when caught early. The most common pregnancy complications after 20 weeks’ gestation are:
FERTILITY CHALLENGES
The inability to conceive is often psychologically painful. Fortunately, medical treatment can help, either by solving the physical issue that’s preventing pregnancy or by offering alternatives like IVF. If you’re younger than 35, consider seeking medical help after one year of trying to conceive, or if you’re 35 or older, after six months.
• HYPERTENSION. High blood pressure can reduce blood flow to your baby, slowing growth and increasing your risk of preeclampsia and preterm labor.
• GESTATIONAL DIABETES. This type of diabetes occurs during pregnancy and usually resolves after delivery. Managing blood sugar closely will help to avoid problems, including preeclampsia and large-birth-weight babies.
• PREECLAMPSIA. This serious medical condition develops in the second half of pregnancy. Primary symptoms: high blood pressure and high levels of protein in the urine.
• INFECTION. Infections, including STIs, can create complications for both mother and baby. Medical care throughout pregnancy can prevent infections from reaching the fetus and causing complications.
• PRETERM LABOR. Labor that begins before 37 weeks of pregnancy increases a baby’s risk of complications.
MORE THAN THE BABY BLUES
13% of women report depressive symptoms during the postpartum period.
The combination of adjusting to being a mother and hormonal changes after childbirth can cause women to experience symptoms of depression (see page 3). Usually, postpartum depression (PPD) starts one to three weeks following birth. If you think you might have PPD, talk to your healthcare provider or a mental health professional. Seeking help is one of the most important things you can do for yourself and your family.
Your 30s REPRODUCTIVE HEALTH
Each decade of a woman’s life is marked by transformation. Here’s what to know in your 30s, when sexual and reproductive health are top of mind for many women.
YOUR PERIOD NOW
While most women have regular menstrual cycles, some experience less-predictable periods. Pregnancy disrupts the menstrual cycle, but periods also can be impacted by hormonal fluctuations and disorders such as polycystic ovary syndrome, endometriosis, uterine fibroids and pelvic inflammatory disease. Medications, including birth control pills, hormonal injections and antidepressants, can cause irregular periods, as can lifestyle factors like excessive exercise, stress, smoking and extreme weight loss or gain. See your healthcare provider if:
• You haven’t had your period for three to six months and are not pregnant
• You bleed between periods or after sex
• The number of days between your periods keeps changing
• Your periods are closer together or further apart than usual
FEMALE CANCERS & FAMILY CLUES
In some women, breast, cervical or ovarian cancer can be linked to genetics. If you have a personal or family history of cancer, your doctor
might recommend genetic testing. The recommendation depends on many factors, including the age at which your family member was diagnosed; how closely related you are; the type of cancer and how extensive it was; and how many people in the family have had cancer.
ISSUES TO WATCH FOR
For women in their 30s, several medical conditions of the reproductive tract can develop. Talk to your healthcare provider if you experience any of these symptoms:
• Endometriosis—pain in the abdomen, lower back or pelvis; very heavy periods; infertility
• Uterine fibroids—heavy or painful periods; bleeding between periods; feeling full in the lower abdomen; urinating often; pain during sex; lower back pain; infertility
14-25%
Approximate percentage of women of childbearing age who have irregular periods
• Pelvic inflammatory disease—pain or cramping in the lower abdomen; unusual vaginal bleeding or discharge that might have an unpleasant odor; pain during intercourse; fever; chills; painful, frequent or difficult urination
WHAT TO KNOW NOW
Diabetes: After age 45, the risk of developing type 2 diabetes increases for women. Risk factors include being overweight, having a parent or sibling with type 2 diabetes, being physically inactive and having had diabetes while pregnant or given birth to a baby weighing more than 9 pounds. The good news? Diabetes can be prevented and, in some cases, reversed through diet and exercise.
Breast Cancer: With advances in breast cancer research and treatment, doctors are often able to reduce the amount and intensity of treatment while maintaining equally good cancer outcomes. Many earlystage breast cancer patients can have less-invasive surgery than in years past. Genetic testing on tumors often can help doctors determine which type of treatment will be most effective.
Urinary Health: Urinary incontinence becomes more common in women after age 50. Treatment options include behavioral therapies, targeted exercises, diet modifications, medications and surgery. Help is available, so don’t be shy about talking to your healthcare provider about this common problem.
Must-Have Vaccines: Each year, about 47,000 Americans die of flu or pneumonia. An annual flu vaccination is recommended for everyone older than 6 months.
Pneumococcal vaccine is recommended for people age 50 or older, but is needed only twice, one year apart.
Your 40s & 50s
FORTIFYING YOUR BODY
Taking care of yourself in your 40s and 50s can help build a solid foundation for aging well. Keep up with recommended health screenings and vaccines, exercise and commit to a healthy diet.
HORMONAL HEALTH
The transition to menopause, called perimenopause, begins between the ages of 40 and 45 with irregular menstrual cycles and ends one year after a woman’s last menstrual period. During perimenopause, changing hormone levels can cause hot flashes, vaginal and sexual changes, altered mood, and sleep and menstrual irregularities. Symptoms vary greatly from woman to woman. Talk to your healthcare provider about treatment options and lifestyle changes that can help ease symptoms.
BUILD YOUR BONES
After age 35, bone strength begins to decline. Osteopenia is a condition characterized by lower-thannormal bone mineral density. The estrogen loss that women experience as they age increases their risk. Some medications and certain medical conditions also can increase bone loss. While osteopenia increases the likelihood that osteoporosis might develop, lifestyle changes can help retain bone density.
The average age at which women in the U.S. reach menopause
30% of postmenopausal women in the U.S. have osteoporosis.
Your 60s & Beyond STAYING VIGOROUS
At age 60 and above, make sure to set aside time for maintaining health and preventing common diseases that come with age.
JOINT EFFORT
As joints wear down over time, osteoarthritis becomes a common issue. Don’t just grin and bear the pain—talk to an orthopedic doctor or your primary care provider. Physical therapy, pain medication and lifestyle changes can greatly reduce symptoms. In some cases, joint replacement might be recommended. These steps can support joint health and reduce arthritis pain:
Focus on flexibility. Yoga and flexibility exercises improve a joint’s ability to move through its full range of motion, reducing joint stiffness and improving function.
Keep moving. Aerobic exercise increases bone strength, makes moving easier and reduces joint pain.
Get stronger. Strengthening the muscles around joints eases the burden on those joints and reduces pain.
Eat healthy. An anti-inflammatory diet can help reduce inflammation associated with arthritis.
WHAT TO KNOW NOW
Heart Health: A woman’s risk of cardiovascular disease increases as estrogen levels decline. Slower metabolism and reduced activity levels can lead to weight gain, which also increases risk, as does the development of high blood pressure and diabetes. The most common heart-attack symptom is chest pain. But women are more likely to report other, less obvious warning signs, including severe fatigue, shortness of breath or nausea.
Cognitive Function: Some women begin noticing age-related changes in memory or cognitive abilities. Dementia and Alzheimer’s disease risk increases. Stay sharp by reading, doing puzzles and playing games, maintaining an active social life, and addressing any hearing problems.
Vision Changes: Beginning at age 65, have an eye exam every year to protect your eyesight from common conditions like cataracts and macular degeneration.
Stroke Risk: High blood pressure, obesity and diabetes increase stroke risk. When stroke is suspected, FAST treatment is critical. Use the acronym BE FAST to remember symptoms to watch for:
B = Balance loss
E = Eyesight changes
F = Face drooping
A = Arm weakness
S = Speech difficulty
T = Time to call 911
Maintaining good health is a lifelong journey. Share this decade-by-decade guide with the ladies in your life as a blueprint for wellness and healthy living.