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Gynecologic Care Decade by Decade

By Christopher A. Naraine, MD

Gynecologic care is essential for women’s overall health and wellbeing, and whether you’re 25 or 65, it is important to receive regular gynecologic care and check-ups at every stage of life.

Regular visits to the gynecologist can help detect and address any potential health issues early on and can also help ensure women receive preventative care, such as screenings for cancer and sexually transmitted infections (STIs.)

Care for Teens

The American College of Obstetricians and Gynecologists (ACOG) recommends that young women have their first gynecologic visit between the ages of 13 and 15.

In most cases, young women will not need a pelvic exam on their first visit unless they are experiencing problems such as pain or abnormal bleeding.

During the first visit, the doctor will likely perform a general physical exam, discuss specific health concerns, and recommend a vaccine for the human papillomavirus (HPV), which is the most common sexually transmitted infection (STI) in the United States and can lead to cervical cancer later in life.

As young women become sexually active, their gynecologist can talk with them about protecting against STIs and discuss options for birth control.

Additionally, young women should see a gynecologist if:

  • Their period does not start by age 15 or if they started their period, but then it stops for more than three months.
  • They have heavy bleeding that soaks through a pad or tampon every one or two hours.
  • Their period lasts for more than seven days.
  • They have a period that comes more often than every 21 days or less than every 45 days.

In Your 20s

Gynecologic care for women in their 20s typically focuses on birth control and screening for cervical cancer.

With so many options available for birth control — from condoms to hormonal patches and rings to emergency contraception — women should have a conversation with their gynecologist to identify an approach that meets their specific needs.

Annual pelvic exams and routine Pap tests should also begin when a woman is in her 20s. Healthy women between the ages of 21 and 29 should have a Pap test every three years to look for changes in the cervix that can lead to cancer, according to ACOG recommendations.

In Your 30s

According to a 2022 report by the U.S. Census Bureau, the median age for women giving birth is now 30. Moreover, statistics show that over the past three decades fertility rates among women ages 35 to 39 increased by 67%.

For women who are planning to become pregnant, it is important to talk with a gynecologist about pre-conception planning and prenatal care to ensure a healthy pregnancy for mother and baby.

In addition, women in their 30s are at greater risk for developing fibroids and ovarian cysts.

Women experiencing pain, abnormal bleeding, or trouble getting pregnant, should see their gynecologist. Many conditions can be treated safely and effectively with minimally invasive procedures.

Also, women who are age 30 to 65 have three options for cervical cancer screening and HPV testing according to ACOG guidelines:

  • A Pap test and an HPV test (co-testing) every five years.
  • A Pap test alone every three years.
  • An HPV test only every five years.

In Your 40s

The 40s are typically marked by shifts in hormonal patterns, signaling the start of perimenopause and, ultimately, menopause. Menstrual cycles may become irregular, and women may start to experience a range of physical and emotional changes — such as hot flashes, night sweats, and brain fog.

Additionally, incidences of pelvic pain and pelvic organ prolapse are more common in women in their 40s.

During these years, women should continue to receive regular gynecologic care to treat and monitor any health issues and explore approaches, including hormone replacement therapy, for managing menopause symptoms.

Your 50s, 60s and Beyond

The average age for menopause, characterized by the absence of a period for 12 consecutive months, is 51. But just because your periods have stopped doesn’t mean your annual visits to the gynecologist should stop too.

Gynecologic care remains critical, especially considering as women grow older. A women’s risk for cancer, including breast, ovarian, and uterine cancer increases, so does her risk for osteoporosis, heart disease, and stroke.

During regular gynecologic visits, your doctor will perform a physical exam and may recommend screenings for bone density, breast cancer, and other age-related health conditions. They can also address any ongoing symptoms related to menopause such as vaginal dryness, sexual dysfunction, and trouble sleeping.

Most women over age 65 will no longer need Pap tests, according to ACOG.

Penn Medicine Princeton Health provides comprehensive gynecologic care for women of all ages. Specialists in women’s health offer preventive care and treatment for a range of gynecologic issues, such as fibroids, abnormal bleeding, and symptoms tied to menopause.

In addition, Princeton Health offers minimally invasive surgery to treat a range of gynecologic conditions such as cervical and uterine cancer, uterine fibroids, endometriosis, and uterine prolapse.

For more information or to find an OB/GYN affiliated with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.

Christopher A. Naraine, MD, is a board-certified gynecologist specializing in minimally invasive surgery. He is a fellow of the American College of Obstetricians and Gynecology and a member of the Medical Staff of Penn Medicine Princeton Health.

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