A brief overview of female health at different stages of life, by Dr Sharena Sheikh
Female GPs see a lot of patients at all ages, and we are in a privileged position to empathise and improve their quality of life. Here, we look into the common conditions that may affect them at different times in their lives.
Adolescence and young females
Consultations with young females usually begin at the time of “menarche” (the start of their periods), where issues with painful and/or heavy periods can be managed with painkillers, or even hormones (in the form of the “pill”) to regulate the cycles. Although cycles can be infrequent at this stage, an absence of periods altogether can be an early indicator of weight issues/eating disorders.
As girls get older, they may need the pill for contraception rather than cycle control. Raising awareness about breast self-examination and good sexual health is important during contraception consultations. Abnormal vaginal discharge and/or pelvic pain may indicate infection. The cervical screening programme usually starts around this time (aged 20-25) and women are taught to be aware of bleeding that is post-coital (after sex) or at unusual times in their cycle.
Period problems can continue into twenties and thirties, sometimes associated with fertility issues. Endometriosis is a diagnosis to bear in mind as the pain can be debilitating and severely affect quality of life. Polycystic ovarian syndrome can be a cause of irregular periods and difficultly conceiving.
Many females do become pregnant at this age, experiencing a change in their bodies, both physically and mentally. Motherhood can be a very anxious time and a huge adjustment, particularly for women who conceive later in life, having established successful careers. Juggling caring responsibilities with work leaves little time for self-care and often results in poor eating and sleeping patterns- this can impact physical and mental health.
The next stage (early 40s) we see is “perimenopause”, an ill-defined stage in terms of duration, covering symptoms that indicate the levels of reproductive hormones are falling, although not enough to stop the periods completely.
Females may experience increased anxiety, joint pains, brain fog and problems concentrating. Their cycles can change in frequency/duration/heaviness and a visit to the GP is recommended to investigate these symptoms.
When cycles do eventually stop, we term this “menopause”. Many will have been experiencing hot flushes, mood swings and loss of libido well before this, but the absence of cycles leads them to come in to talk about possibly starting HRT. Around this time, the National Breast Screening programme starts and well-woman checks can pick up early signs of cardiovascular disease (high blood pressure/raised cholesterol) or diabetes. Good advice regarding diet and exercise is emphasised, especially weight-bearing exercises, that can preserve the health of bones, preventing osteoporosis. Any vaginal bleeding after menopause needs to be urgently assessed as this could be a sign of womb cancer.
At this time, good mental health support is important as females may feel lonely with children having left home or losing a spouse. For some, it can be a liberating time of life, having no responsibilities and a renewed sense of freedom. It can also be an enjoyable time with grandchildren and an opportunity to pass on experience and wisdom. Keeping active and mentally challenged is key to preventing cognitive decline and maintaining independence.
Take care of yourself
Our dedicated specialists are on hand to consult and reassure members with health conditions, at any stage of life. Find out more about the services we offer.