With women often taking on the role of Chief Medical Officer for their children, partners, pets and even ageing parents, their own health checks can easily fall by the wayside. Not only are regular health checks important for crucial early detection of diseases such as cancer, diabetes, osteoporosis and cardiovascular conditions, they are essential in preventative care as well as maintaining overall wellbeing.
Dr Sarah Farrell, director of Sydney Women’s Wellness, stresses the importance of proactively managing health by prioritising health checks. While family history and overall health might change the onset and interval of certain health checks, it’s important to get routine checks, regardless of how healthy you think you are.
“It’s far easier to prevent illness than to reverse it.” says Farrell. “If we wait for symptoms, you’re often late. Brain, heart and bone changes can be silent, so health checks help you get ahead of them.”
So apart from the obvious health checks particular to women and regular mental health and skin checks, what other health checks do we need, and when?
Dr Farrell
Dr Farrell breaks down the most important health checks for women from their 30s all the way through to their 60s.
The time to get lifestyle foundations right
“For metabolic health, your 30s aren’t about finding problems,” says Farrell. “It’s about knowing your baseline and your risk. Getting a baseline is important as you can’t manage what you don’t measure.”
Dr Farrell recommends blood pressure, waist circumference and blood tests for lipids and glucose if there are risk factors. “If any of these measurements show someone is high risk, we can then refocus on prevention and monitoring,” Dr Farrell explains.
The Cervical Screening Test (which has replaced the Pap test), should be performed every five years, starting at age 25, until age 74.
If you are sexually active with new partners or have a partner change, STI checks should be conducted every three months.
Fertility awareness also matters, even if children are a ‘future plan.’ If you are ready to start a family, a preconception check is ideally done around six months before trying to conceive. Dr Farrell emphasises this because immunisation coverage has slipped and syphilis has risen sharply, with NSW Health reporting syphilis in women has increased by more than 500% over the past decade.
A decadse of transition and active prevention
Continue cervical screening every five years, as well as yearly blood pressure, waist circumference, lipids and glucose. “Your 40s are the time to get more serious about metabolic health – cholesterol, glucose, blood pressure,” says Dr Farrell. “If they start to creep up, we need to reassess lifestyle and nip unhelpful habits in the bud.”
From age 40, Dr Farrell advises women to start mammograms, free through BreastScreen Australia (although notes you aren’t formally invited until 50), and repeat the test every two years. Breast density is a risk factor for breast cancer, she says, so finding out your breast density through a mammogram in your 40s can be helpful in deciding which screening tests will be most beneficial.
Bowel cancer screening, free through the National Bowel Cancer Screening Program, begins at 45 (although again you aren’t formally invited until 50), and is repeated every two years.
With 40s being the decade most women enter perimenopause, women need to be aware of changes to their menstrual cycles, mental health, sleep, stress response and energy levels – all potential symptoms of perimenopause. While lifestyle changes and menopausal hormone therapy (MHT) can be beneficial in reducing severity of symptoms, the effects of these hormonal fluctuations are far reaching.
Dr Farrell believes a woman’s hormonal risk to be an often neglected area in women’s health. “Oestrogen is anti-inflammatory and supports cardiovascular health by regulating blood vessel function and metabolism,” says Dr Farrell. “As levels decline, cholesterol, blood pressure and blood sugar can start to shift in an unfavourable direction, contributing to a sharp rise in cardiovascular risk in the midlife.
“While heart disease becomes more common in the 50s and 60s, many of the metabolic changes that drive risk begin in the 40s, during the menopause transition.”
The decade to get serious about health and lifestyle
In addition to continuing cervical, breast and bowel screening, Dr Farrell places a sharper focus on cardiovascular risk, as well as bone health (especially in light of how the hormones affected in menopause can impact these areas of health). “We can’t feel what’s happening in our bones,” she says. “Osteopenia, the stage before osteoporosis, has no symptoms, but is also the window where we can prevent progression.”
Dr Farrell encourages patients to undergo absolute CVD (cardiovascular disease) and AusD risk assessments to give women an understanding of their risk for heart attack, cardiovascular disease and diabetes. Depending on risk, Dr Farrell does advise further investigation, risk management or treatment.
Setting yourself up for how you will live the rest of your life
Continue all screenings from previous decades: bowel, breast and cervical; yearly or twice yearly (if higher risk) blood pressure, lipids and glucose; and monitoring of bone health.
Dr Farrell also recommends assessing falls risk by checking balance and reaction time, using simple tests such as walking heel-to-toe along a line, standing on one leg, and advises balance work on an unstable surface like a wobble board. “What I tell women in their 60s is: ‘If you build a strong core now, you’re far more likely to steady yourself when you stumble. You can’t fracture bones if you don’t fall in the first place.’”
No matter what decade of life you are in, Dr Farrell believes in focusing on healthspan, not just lifespan. “Living longer only matters if you’re living well while you’re doing it. This starts with consistent screening, but it also means paying attention in between by noticing changes outside those time frames and getting them checked early.
“Each decade brings different priorities, but the underlying message is the same,” Dr Farrell states. “Health checks promote long term wellness by staying ahead of risk, screening for silent changes and making small course-corrections before problems become symptoms.”
Comments provided in this article are generic in nature and do not replace medical advice from a health professional. See your GP for a proper consultation.
