Most healthy women can expect to live beyond 80 years. To promote good health we recommend a well-balanced diet, regular exercise and age-appropriate routine screening tests.
Not smoking and limiting alcohol consumption is beneficial for all ages.
Teenagers should visit a gynecologist when it seems they may be deciding to become sexually active, preferably before. If the teen is not yet contemplating sexual activity, an appropriate first visit would be during her junior or senior year in high school.
Other reasons for a teen visit would be an evaluation of gynecological problems, such as menstrual irregularities, severe menstrual pain, or vaginal irritations.
The first visit may or may not include a complete physical exam depending on the reason for the visit. Informational brochures and handouts are provided that are age-appropriate such as birth control options, menstruation, how to prevent sexually transmitted infections, and your first visit.
20s and 30s
Recommended annual visits include:
- Breast exam, breast self-exam instruction
- Pap smear screens for cancer of the cervix every 2 years in 20s, every 3 years in 30s
- Bimanual exam that evaluates uterus and ovaries
- Review of contraceptive needs and prevention of sexually transmitted diseases (STDs)
- Addressing any problems and answering your questions
- Encouraging healthy diet and exercise
- Discouraging smoking
- Counseling usage of alcohol in moderation
40s and 50s
In addition to the annual evaluation and issues:
- Annual rectal exams
- Annual mammogram referrals
- Counseling for osteoporosis prevention and bone density testing (DEXA scan), if indicated
- Referral for the first colonoscopy at age 50
- Remind patients to see their primary care providers for routine health care and screening for cholesterol, glucose, thyroid and EKGs, etc.
- Discuss possible perimenopausal or age-related changes to expect such as menstrual cycle changes, hot flashes, mood swings, breast tenderness
- Long term contraceptive needs and continued sexually transmitted disease (STD) prevention
Menopausal Years Onward
The prefix "peri" means "around" in Latin. Perimenopause encompasses the period around menopause when reduced estrogen levels may result in menopause-related symptoms. One full year after the last menses, women are considered to be in menopause. The transition into menopause can be troublesome for some women secondary to hot flashes, night sweats, vaginal dryness, insomnia, and mood disturbances. The goal is to promote health by monitoring wellness screenings and optimize well being by considering all available therapies including conventional HRT, alternative therapies, as well as bioidentical hormones. This can be accomplished by individualizing care, taking into account the woman's risk/benefit profile, her treatment goals and symptoms that may affect the quality of life. Menopause is an optimal time to encourage health and make informed decisions about lifestyle changes that may reduce chronic diseases and help reduce menopause-related symptoms.
In addition to the annual evaluation and issues, we recommend:
- Calcium intake 600 mg twice daily and exercise to decrease bone loss
- Repeat bone density scans (DEXA), approximately every other year if bone loss is present
- Colonoscopy, approximately every five years
- Follow up with primary care for medical screening
- Addressing issues such as vaginal dryness, urinary frequency or incontinence and sexual function problems
- Hormone Replacement Therapy (HRT), if indicated