Media contact: Anna Jones
UAB experts discuss changes women should be aware of as their bodies mature and what exams they should receive during different time periods.Regular physician visits and medical screenings are critical to maintaining one’s health. However, women are often unsure about what tests they need and at what age, which doctors they should be seeing annually, and what physiological changes they may experience at certain ages.
To clear up confusion, experts at the University of Alabama at Birmingham shared changes women should be aware of as their bodies mature, questions they should ask their doctors, and when they should receive specific medical exams during their 20s, 30s and 40s — timely with Women’s Health Month.
While each woman’s needs are different, having open conversations with physicians will help them navigate their individual health journeys, enabling them to anticipate changes they may experience in the coming years and how they can optimize their health care to best suit their needs.
Gynecological Care
As a gynecologist tends to be the primary and constant physician that most adult women see on a yearly basis, many wonder if it is OK to view that appointment and relationship as one for primary care as well. Audra Williams, M.D., assistant professor in UAB’s Department of Obstetrics and Gynecology, explains that, yes — particularly in your 20s and early 30s — seeing just your gynecologist if you are a normal, healthy adult is sufficient.
“When women come for their annual screenings, we do much more than just pelvic exams — we do an overall health screening, test their blood pressure and weight, dive into a woman’s family history, and identify any health risks they may have or be predisposed to,” Williams said. “We take a full body approach to their care and then recommend other physicians as needed to address other health concerns women may have.”
Williams explains that establishing a relationship with a gynecologist in your 20s not only is important for maintaining health but gives you a trusted physician with whom you can discuss any questions or concerns relating to sexual function, family planning, fertility, breast awareness and more.
“As 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 top-of-mind — even to their 40s, when urine leakage and perimenopause are prevalent — we as OB/GYNs guide our patients through all aspects of related concerns specific to women’s health,” Williams said. “We’re a one-stop shop in many ways.”
A gynecologist also serves as a key component in cancer detection and prevention. Whether by conducting a Pap smear for women 21 or older for cervical cancer, administering HPV shots, or doing routine breast exams to check for abnormalities before a woman may be due for a mammogram, gynecologists will develop a plan for tests and screenings tailored to the patient’s age and risk factors and refer them to appropriate specialists as needed.
Williams adds that, by their mid- to late 30s, women should see a primary care physician as well. While a gynecologist can test for things like cholesterol and diabetes, they may refer a patient to a primary care physician for further routine testing.
Heart Health
Heart disease is the No.1 cause of death among women in the United States, translating to nearly one in every four female fatalities. For many women, the signs or symptoms of heart disease differ from men’s symptoms of heart disease. Women experience chest pain or pressure; but they are also more likely to have other symptoms, including fatigue, nausea, dizziness or sweating. Any new or unusual symptoms should prompt medical attention. Women with risk factors for heart disease such as hypertension, diabetes or smoking are at greater risk for heart disease. Additionally, women who have had gestational diabetes or hypertension may be at higher risk for heart disease later in life.
Elizabeth Jackson, M.D., a professor in the UAB Division of Cardiovascular Disease, recommends that women in their 20s review their blood pressure numbers at their visits with their primary care doctor or gynecologist.
“In addition to reviewing your blood pressure levels, checks for other risk factors such as elevated glucose or cholesterol levels should be done periodically, depending on a woman’s age and other risk factors,” 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 these measures depending on your age and other conditions.”
Jackson notes that additional testing may be recommended for those who have a family history of heart disease or known risk factors for heart disease, such as smoking, high blood pressure, elevated cholesterol, diabetes or obesity. For women with autoimmune disorders or conditions such as gestational diabetes, additional testing or more frequent testing may be recommended.
“Although we outline general guidelines, we know that each woman is different, so it is best to talk to your doctor and see what course of treatment may be best for you,” Jackson said.
In an effort to curb heart disease and stroke in women, the UAB Cardiovascular Institute created the Women’s Heart Health Program. Directed by an experienced team of UAB experts, including hypertension specialists and interventional cardiologists, the program has full access to the UAB Cardiovascular Institute’s extensive diagnostic and therapeutic services. UAB health care providers manage the health of women with all types of heart disease, while addressing the distinct concerns of women.
Dermatology
Skin cancer is the most common cancer in the United States, but regular body scans by your dermatologist can assist in early detection of any questionable and potentially cancerous spots.
Tiffany Mayo, M.D., an associate professor in the UAB Department of Dermatology, recommends that women begin seeking yearly visits with their dermatologist in their early 30s to ensure that there are no abnormalities, or sooner if at increased risk for skin cancer. Once a dermatologist gets an understanding of that patient’s skin type and medical history, they can then determine the frequency of visits moving forward.
“Skin exams are important for women of all ethnic backgrounds,” Mayo said. “Skin cancers are more common in lighter skin; but they can also occur in those with African, Asian and 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 for the individual patient to determine how frequent follow-up skin exams should occur,” Mayo said. “For instance, some women who rarely or never sunburn may need visits once every two to three years, while women who sunburn easily and those on certain medications affecting the immune system may need to come at least once a year or more frequently.”
Each body is different, and Mayo says it is important that women understand how to identify lesions that may not look normal or have recently appeared.
She stresses that regular exams are even more critical for women who currently are or may have been regular tanning bed users in the past. Tanning bed use increases the risk of melanoma by 47 percent, squamous cell carcinoma by 58 percent, and basal cell carcinoma by 24 percent, according to the American Academy of Dermatology Association. She also stresses that the feet and nail beds are commonly forgotten during self-exams, and this can be a location of melanoma, particularly in skin of color.
In regular body scans, education is top-of-mind.
“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,” Mayo said. “If these tips help women identify lesions on their own bodies or even those of their husbands, family members, children, or friends, that regular visit was worth it and can save other lives.”
Mayo recommends that women of all ages regularly wear sunscreen with an SPF of 30 or higher and reapply every two hours or even more frequently if sweating or swimming. Whether you are out for a walk with a friend, lying on the beach or watching your child play sports, sunscreen and appropriate layers like hats or long-sleeved shirts should always be top-of-mind in protecting your skin. She also reminds patients to check expiration dates for sunscreens as well — they should be replaced regularly to ensure optimum protection.
Oral Health
In years leading up to childbearing and during pregnancy, there are tremendous physiological changes that occur, and many appear in a woman’s mouth. Hormonal changes can impact the blood supply to the gums and modify how the body responds to plaque buildup. These changes can lead to gingivitis and periodontal disease — which is infection and inflammation of the gums and bone that surround and support the teeth.
As women enter their late 30s, they can experience higher rates of gum recession, periodontal diseases, and tooth decay due to diet, regularity of dental care, increased oral dryness, or long-term exposure to pathogenic oral microbes. When a woman enters her 40s, there is potential for a decrease in bone density in the jaw which can lead to faster periodontal disease progression and—ultimately—tooth loss, a new territory in oral health care for many women.
“During perimenopause and menopause, women experience changing hormone levels and may notice differences in oral symptoms as well, including dry mouth (xerostomia), increased gingival inflammation, and higher rates of altered taste and sensation in the mouth,” said Mia Geisinger, DDS, professor in the UAB School of Dentistry. “Being aware of the possible changes that can occur and visiting a dentist who can help women find potential treatments for oral conditions is critically important.”
Eye Health
While there are no eye conditions that specifically impact or cause extra concern for women during their 20s, 30s and 40s, Terri Call, O.D., an optometrist at UAB Eye Care and associate professor in UAB School of Optometry, suggests that women ages 20 to 40 see their optometrist for routine eye exams on an annual basis.
“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,” Call said. “However, it is worth noting that pregnancy can change a woman’s prescription temporarily or permanently, and some women may experience the need for reading glasses for the first time as they approach their 40s.”
Call explains that dry-eye disease tends to become more prevalent in women as they approach menopause, so if a woman is experiencing new or worsening dry-eye symptoms as she enters her late 40s and 50s, she may wish to request an extra dry-eye evaluation from her eye doctor.