How to Be Healthy at Every Age
This article originally appeared in the August 2016 issue of ELLE.
20s
You look amazing, thanks to your radiant skin, lustrous hair, and sparkly white teeth. This can also be a supremely self-conscious decade; make sure to appreciate your beauty!
It's time to get your first cervical cancer screening. CDC guidelines recommend that women ages 21 to 65 have a Pap smear every three years.
Get the HPV vaccine if you haven't yet. Human papillomavirus can lead to cervical cancer. The three-dose vaccine is recommended for women 26 and under.
Know your family history. Now's the time to find out who among your parents, aunts and uncles, and grandparents had cancer, heart and cardiovascular problems, fertility and pregnancy issues, or other serious conditions.
If that history includes breast cancer, consider getting the BRCA1 and BRCA2 tests by age 25. This will show if you have a genetic predisposition for breast and ovarian cancer.
Take heart health seriously. Get tested for total cholesterol, HDL (good) cholesterol, blood pressure, blood sugar, and body mass index (BMI). High blood pressure in your twenties may lead to gestational diabetes in your thirties, which may lead to heart disease in your fifties.
Go to that friend-of-a-friend's birthday party. A study published in Psychology and Aging showed that those who'd had an active social network in their twenties felt less lonely or depressed in their fifties than those who'd kept their circles small. "By having a wide variety of social interactions when you're still establishing your identity, you're developing interpersonal tools you'll take with you throughout life," says study coauthor Cheryl L. Carmichael, PhD.
30s
Your body may not feel or look so different from 10 years ago, but in good ways, you feel older. Many women hit a lot of milestones this decade-marriage; career achievements; children; coming into their own, confidence wise-which can be exciting…and stressful.
It's time: Assess your fertility (if you want kids). If you've been trying to get pregnant for a year, ask your gynecologist to test your ovarian function, hormone levels, and other relevant factors. (And have a would-be father get a fertility test.) If you're considering freezing your eggs, doing so before age 35 increases your chances of a positive outcome.
Be well heeled. High heels shorten your calf muscles, which can mess with your gait and cause pain even when just walking. Flats can lead to back pain. Flip-flops are aptly named, as they can cause both flips and flops. Vary your heel height; always buy well-made shoes, and never wear shoes that don't fit. A too-small shoe can wreck just about everything.
Fight depression now. Major depressive disorder is most likely to deepen its shadow during the childbearing years. "The more episodes of depression you have, the more likely you are to have them again," says Ruta Nonacs, MD, PhD.
Go for social quality. The same study that recorded the benefits of a wide social network in your twenties also found that it's the quality of relationships in your thirties that is most beneficial for well-being in your fifties.
40s
In the United States, the average age that women enter perimenopause is 47-but the average age of the last menstrual cycle is around 51 or 52. "Perimenopause is the wake-up call of the entire life cycle," writes Christiane Northrup, MD, in the 2010 edition of the classic health guide Women's Bodies, Women's Wisdom. "If we've been pressing the snooze button on any parts of our lives that need attention, the years surrounding menopause will bring them to our attention.
It's time: You're allowed to consider limited hormone-replacement therapy to help with menopause symptoms. Insomnia, hot flashes, reduced sex drive…. As the Women's Health Initiative hormone-therapy study confirmed, long-term use of combination HRT (with estrogen and progestin) can slightly increase risk of breast cancer. But, says Anne Moore, MD, of New York's Weill Cornell Breast Center, "one to two years is fine if there's no family history of breast cancer."
Continue to use birth control if you don't want to get pregnant.
Just because your fertility drops in this decade doesn't mean it's impossible to get pregnant. Data collected from 150,000 women at UK abortion clinics showed that those under 30 were more likely to use contraception than their older counterparts.
Don't bother: Getting mammograms. This is rapidly becoming the standard for women who aren't high-risk: The U.S. Preventive Services Task Force says to hold off until 50, to minimize the risk of false positives.
50s
With life expectancy arcing up over 80 years, American women can expect to spend more than three decades in postmenopause. That's a long time to feel bad about your neck. But research from the Stanford Center on Longevity has found that, with age, we tend to be more emotionally balanced, better at solving interpersonal conflicts, and less likely to feel negative emotions than our younger selves.
It's time: get a colonoscopy. General guidelines call for an initial test at age 50, with follow-up tests every 10 years until age 75. If abnormalities like polyps are detected, or if you have a family history of colon cancer, you'll likely get screened more often.
Eat calcium. Estrogen loss can decrease bone density, leading to osteoporosis and fractures, so the daily calcium requirement for women over 50 jumps from 1,000 mg to 1,200 mg a day. Supplements have been linked to kidney stones, so a calcium-rich diet-dairy, but also broccoli, leafy greens, sardines-is the way to go.
Okay, now get a mammogram. The USPSTF recommends one every other year starting at 50. (But according to the NIH, if you had your first period before age 12 or if you hit menopause after 55, you're at increased risk for breast cancer and should discuss screening frequency with a doctor.)
Battle the bulge. As your metabolism slows with age and lower estrogen levels tamp down fat-burning, it's easier to gain weight and harder to lose fat-especially around the abdomen. This "visceral fat" is a risk factor for heart disease, high blood pressure, and diabetes because of its inflammation-causing proximity to the liver. Central obesity (i.e., an unhealthy amount of abdominal fat) is defined as a waist-to-hip ratio of >.85. So if your hips are 39 inches, your waist should be no more than 33 inches for a healthy ratio.
Don't assume that getting a bone mineral density screening is necessary. Unless you have a strong family history of osteoporosis, have premature ovarian failure, went through menopause before age 40, or have been taking certain medications for asthma or breast cancer that can cause calcium and other mineral deficiencies in your bones, 65 is the age to start getting this test.
Don't assume that lifting weights is the only exercise to maintain bone health. The wisdom of this is being challenged. In one 2005 study of adult female athletes, published in the Journal of Bone and Mineral Research, those who did high-impact sports, like volleyball or squash, had denser bones than did competitive body builders. Not into squash or volleyball? Try jumping rope!
