Wellness & Education

Wellness & Education

Women’s Preventative Health Care: Adolescence to Menopause and Beyond

This month is National Women’s Health Month. It is an excellent time to review and discuss preventive healthcare during four key stages in a woman’s life.

Adolescence: Ages 13 to 18

Young women in this age group may see a gynecologist for the first time. The content of the visit will vary depending on a young woman’s needs, her health history and risk factors. The visit includes a health screening interview, general physical examination, screening and counseling. If a young woman is not sexually active, an internal pelvic exam is generally not part of the physical examination. Topics covered include personal health, nutrition and sexuality, with emphasis on the prevention of pregnancy, sexually transmitted disease (STD) and the human papilloma virus (HPV) vaccine.

Peak Reproductive Years: Ages 19 to 39

Preventative Health Care for WomenDuring this time, many women begin a long-term relationship with an OB/GYN physician, midwife or other women’s health care provider that can last most of their lives. A broad range of needs are met, including reproductive, medical, surgical, psychosocial and preventative health. Visits are annual and record height, weight, body mass index (BMI) and blood pressure. An examination of the neck, breasts, skin, abdomen and pelvic examination is performed. At age 21, a Pap smear of the cervix is performed during the pelvic exam and may be repeated annually, or less frequently depending on the results. Testing for sexually transmitted disease (STD) is appropriate. Counseling on contraception, fertility and family planning occurs. Prepregnancy counseling and genetic counseling are appropriate.

Prevention and Detection of Disease: Ages 40 to 60

Preventative care is very important during this period, which emphasizes the routine detection and prevention of disease. Several disease screening recommendations change during this time, so continuing to see your healthcare provider annually is important. Annual visits include a general and pelvic examination, discussion of medications taken and personal and family history of medical conditions. If a medical or gynecologic problem is identified, intervention can take the form of additional monitoring, treatment, referral or surgery.

Disease screening recommendations that begin during this time include:

  • Age 40: annual mammography to screen for breast cancer. 
  • Age 45: Screening for diabetes (fasting glucose test) and risk factors for heart disease (lipid panel). 
  • Age 50: Referral for colonoscopy (colorectal cancer screening) 
  • Menopause: Bone mineral density testing (screening for osteoporosis) starts at menopause (depending on risk factors).

Menopause is defined as when monthly periods have ceased for one year. The average age of menopause is 52. Problems and symptoms related to peri-menopause, the transition to menopause, may occur for several years prior to this. Annual, or more frequent, appointments during this time will include discussion of a woman’s symptoms and the impact they have on her life. This can include a discussion of the benefits and risks of hormone replacement therapy.

Postmenopausal Preventative Health: Ages 65 and Older

The post-menopausal years are a time of medical and social life changes. A detailed review of a woman’s health history, medical conditions and medications remains an important part of the annual exam. Height, weight, BMI and blood pressure are recorded. The physical examination includes a breast and pelvic exam, though the Pap smear to screen for cervical disease may be discontinued. Issues discussed typically relate to the menopause, pelvic relaxation and urinary or bowel problems.

Screening mammography continues after menopause. Bone mineral density testing is usually done every two years, although a woman’s provider may recommend another interval depending on her bone health. Annual influenza vaccine is recommended, and other vaccines are discussed.

The annual exam is important to a woman’s preventative health throughout her life. It is important to remember that screening recommendations mentioned here are guidelines for healthy women with average risk factors; your healthcare provider may recommend beginning to screen for certain diseases earlier or more or less frequently depending on your personal and family health history. Contact a Women’s Healthcare Associates office to schedule your annual exam with one of our physicians, nurse midwives or nurse practitioners >

Anthony Taitano, MD, Gynecologist - Portland, OregonDr. Anthony Taitano, MD, is a board-certified OB/GYN physician at the Peterkort office of Northwest Gynecology Center. He serves the gynecological needs of women from adolescence through menopause and beyond, focusing on women’s wellness and disease prevention, including annual gynecologic exams. He diagnoses and treats gynecological conditions and performs gynecologic procedures and surgery. Dr. Taitano’s clinical interests include evaluating and treating infertility, family planning and helping women with symptoms of menopause.