Women’s health checks - what to test at your age

In the UK, 51% of the population identifies as female [1]. So, whether you’re born female or are somewhere along the journey to becoming a transwoman, looking after your health and wellbeing is so important.

Women’s bodies particularly go through many different stages throughout life, and health needs change along the way. Knowing what common health issues to look out for at every stage of life can help keep you well.

1. What to check in your 20s
2. Health focuses in your 30s
3. Health checks at 40
4. Women’s health checks over 50

Women's health checks in your 20s

1. Cervical screening 

Most school-age girls and boys are offered a vaccine to protect against HPV (human papillomavirus). This is a common virus, and there are strains associated with different health issues. They often cause skin warts, including genital warts. Some strains of HPV can also cause changes to the cervix. 

In the UK, anyone with a cervix will also be offered regular cervical screening or a smear test from the age of 25. This is an important screening test that can detect changes in the cervix at an early stage, known as CIN. If left untreated, CIN may eventually progress into cervical cancer. The earlier these changes are picked up, the quicker they can be dealt with. 

A smear test can seem daunting, but it’s very routine and is important for the health of your cervix. Have a look at what to expect and how a cervical screening is done.

2. Period health

For some people, periods can be painful, heavy, or both. Others may experience irregular or absent periods. Neither of these symptoms should be ignored. 

Endometriosis can cause pain and irritation as the lining of the womb (endometrial tissue) grows in places outside the womb. Each month, these patches of endometrial tissue are influenced by the monthly changes in hormones. This pain can occur wherever the tissue is growing, and over time, can cause scarring. 

Sometimes, endometriosis can be associated with difficulties conceiving when trying for a pregnancy, but most women will still be able to have a healthy pregnancy. Women experiencing very painful periods that can’t be managed by simple painkillers like paracetamol or ibuprofen should talk to their GP. 

Irregular or absent periods shouldn’t be ignored, either - particularly if you’re bleeding after sex. Sometimes, polycystic ovary syndrome (PCOS) can be the underlying reason for infrequent periods. Polycystic ovary syndrome affects the ovaries, and causes tiny swellings on the ovaries, in conjunction with changes in hormone levels, and other symptoms such as acne, hair on the face (hirsutism) chest or lower tummy. 

If you’re experiencing PCOS symptoms, a blood test can help you to investigate the cause. Have a look at our Polycystic Ovary Syndrome Blood Test and Advanced Polycystic Ovary (PCOS) Blood Test. 

3. Breast health

Your boobs will change according to where you are in your menstrual cycle, and during and after any pregnancy, so regular self-examination will help you get to know what’s normal for you. 

It’s generally advised that checking just after your period is usually the best time. If you notice any new lumps or bumps, or if the appearance of your breasts changes, you should consult your doctor. 

Find more information on how to self-examine your breasts. 

4. STIs

If you’re enjoying a healthy, consensual sexual relationship, it’s important to have a regular sexual health screen. 

Sexually transmitted infections, like chlamydia and gonorrhoea, can cause symptoms like: 

• Increased discharge
• Pain during weeing
• Bleeding after sex

But, STIs don’t always cause symptoms. If left untreated, they can be passed on to others unknowingly, and lead to complications, including pelvic inflammatory disease and difficulties getting pregnant. 

It’s best to practise safe sex, use a condom, and have a routine check a couple of weeks after you have sex with a new partner, or once a year if you’re in a stable relationship. 

Whether you’re having vaginal, anal or oral sex, will depend on where and how you test for chlamydia and gonorrhoea, but it’s usually done with a simple swab or urine test. HIV, hepatitis and syphilis are also sexually transmitted and can be checked using a quick and easy blood test. 

Our 6-in-1 STI Blood and Urine Test is a quick and comprehensive check for six of the most common STIs – chlamydia, gonorrhoea, HIV, syphilis, hepatitis B, and trichomoniasis. 

Women's health checks in your 30s

1. Fertility

All cis-women are born with a fixed number of immature eggs, although this number will vary for each woman. By the age of 30, fertility starts to decline, and by age 35, the decline speeds up further still. 

While most women will still become pregnant within 12 months of trying, it can be reassuring to check fertility levels to guide when to start planning for a family. Although there are no guarantees a woman could become pregnant, a combination of blood tests and ultrasound tests can be used to try and identify the number of immature eggs or “follicles” present, and scans for this purpose can be arranged on a private basis. Have a look at our guide to pregnancy hormones for more on this. 

Some women may also prefer the reassurance of knowing they are ovulating, which is needed to become pregnant, and changes in progesterone hormone levels usually indicate that ovulation has occurred. This can be helpful as it may indicate when any sexual activity is likely to be more successful and result in a pregnancy, but it can also give an early indication that a couple may need a bit of extra support in becoming pregnant. 

Take a look at our female fertility tests, including our Pregnancy Progress Home Blood Test and Future Fertility (with AMH) Home Blood Test.

2. Pregnancy

If you’re actively trying for a pregnancy, it’s important to make sure your body is prepared. As a general rule, a multivitamin and mineral supplement designed for pregnancy is a good idea, and it’s worth starting this around three months before trying for a pregnancy. 

There are many tests available to detect a pregnancy, including home urine testing kits. While these are generally very accurate, sometimes changes in hormone levels, which may indicate a pregnancy, can occur earlier than urine test kits can detect. 

If it’s important to confirm a pregnancy very early on, or perhaps if some monitoring of hormone levels is required during pregnancy, some women may prefer to take a Pregnancy Blood Test to check HCG levels. 

3. Overactive and underactive thyroid

The thyroid is a gland involved in maintaining metabolism. Changes in thyroid hormone levels occur more commonly in women compared with men and can cause varying symptoms depending on whether the thyroid is overactive or underactive. 

An overactive thyroid usually appears between the ages of 20 and 40, and typical symptoms include:

• Weight loss
• A feeling of nervousness
• Shaking or trembling 
• Sensitivity to heat and warm weather
• Periods can change, often becoming lighter or infrequent

An underactive thyroid is much more common in older women, but can still occur at a younger age. Symptoms are again variable but usually include: 

• Weight gain
• Dry skin and hair
• Sensitivity to cold
• Changes to periods, this time becoming heavier and more prolonged

Either of these could be part of an underlying autoimmune condition, but the good news is a simple blood test, such as our Advanced Thyroid Function Blood Test, can usually detect fluctuations in levels. 

Both over and underactive thyroid conditions are usually managed with appropriate medication which may need the odd tweak now and again, so it’s important to monitor thyroid levels fairly regularly. 

If you have a thyroid condition and are planning on a pregnancy, this should be carefully managed with support from a specialist. Some medications to manage thyroid conditions are more suitable than others while pregnant, and doses can change depending on how far on in your pregnancy you may be.

Women's health checks in your 40s

1. Menopause

As women reach their 40s, hormone levels may start to change. Oestrogen levels begin to decline, and eventually, usually between the ages of 45-53, women may start to go through menopause. 

Menopause symptoms can vary, but typically include: 

• Hot flushes
• Night sweats
• Changes in mood and memory
• Irregular or absent periods
• Reduced libido 
• Vaginal dryness. 

A blood test to rule out other causes, and check hormone levels, including the follicle-stimulating hormone, can sometimes be helpful to confirm whether menopause has taken place, but results can be unclear if women are still using hormonal contraception. 

Any woman experiencing symptoms of menopause before the age of 40 should see their GP for a review. Early menopause may have implications in the long term, such as on bone health. It’s also worth remembering an unexpected pregnancy can often mimic the symptoms of menopause, so it’s worth double-checking! 

Most women can continue to experience menopausal symptoms for several years, but again everyone is different. Whether or not a woman decides to use hormone replacement therapy or other medicines to manage the symptoms of menopause is a personal choice, but these days there is a lot more choice than ever before. 

Take a look at our Menopause Blood Test or article on all you need to know about menopause. 

2. Diabetes

Type 2 diabetes is more common in older women who are overweight or have a family history. Higher levels are also seen in some culturally diverse groups, including Asian and black populations for reasons that are complex and trickier to unpick. 

Any woman who has had a type of diabetes that comes on during pregnancy (gestational diabetes) is also more likely to become diabetic in later life. 

Typical symptoms include: 

• Tiredness
• Needing to pee more frequently
• Feeling thirsty
• Repeated skin or vaginal thrush infections

Sometimes symptoms can be managed through lifestyle changes, but often medication may be needed. 

Our Advanced Diabetes Blood Test can help to assess your sugar control. 

3. Vitamin D

Vitamin D is essential to ensure good bone health. In the summer, we can usually produce enough by simply getting outside and enjoying some safe sunshine. 

In the winter, particularly in the UK, this doesn’t happen, and women with darker skin and breast-feeding mums are particularly susceptible to low levels of vitamin D. Left untreated, this can cause various symptoms, including generalised aches and pains, weakness, concentration and memory problems and low mood. 

A simple blood test, such as our Vitamin D (25 OH) Blood Test, can help identify whether low vitamin D could be responsible, and supplements are usually recommended if that’s the case. Check out our vitamin D health hub for more info. 

Women's health checks in your 50s and beyond

1. Cardiovascular health

After menopause, the cardiovascular protecting effects of female hormones tend to wear off, unless you’ve opted for hormone replacement therapy. In any case, it’s a good idea to re-evaluate your risk. Healthy factors will still be important here, like avoiding smoking, keeping a healthy weight, ensuring blood pressure is not becoming too high, and keeping active. 

Cholesterol can also play a part in cardiovascular health. And, while a little is a good thing and needed to keep the body healthy, too much can lead to the circulation being under strain. Eventually, blockages can occur. A serious blockage can stop blood flowing to areas of the heart or brain, and it’s these blockages that can cause symptoms of angina, heart attacks and even strokes. 

A simple blood test to check cholesterol levels is a good way of determining your risk, and may also be the motivation needed to improve diet and implement lifestyle changes. A risk assessment tool (QRISK3) can also be used to determine whether a cholesterol-lowering medication would be recommended.

At Medichecks, our Heart Disease Risk Blood Test looks at the main risk factors for heart disease, including cholesterol and high sensitivity CRP (which is a measure of damaging inflammation).

2. STIs

Many women will be meeting new partners after entering a new phase in their lives. While contraception is no longer necessary, it’s important to remember to practice safe sex and think about screening for STIs if needed. 

STIs are on the rise in older life, so changes like discharge or pain when having sex or weeing should not be ignored. Any bleeding after menopause, particularly after sex, should also be checked out, so women should ensure they see their GP or gynaecology specialist for a review if this occurs.

Our 6-in-1 STI Blood and Urine Test is a quick and comprehensive check for six of the most common STIs – chlamydia, gonorrhoea, HIV, syphilis, hepatitis B, and trichomoniasis. 

3. Breast health

It’s important to continue to regularly check for changes in the breasts, and attend regular screening appointments. Breast cancer is now the most common cancer in the UK, and around 1 in 7 women will develop breast cancer during their lifetime [2].

Changes to the breast should not be ignored. If you feel a new lump or notice discharge from the nipple or changes to the skin of the breast or nipple, such as eczema or an “orange peel” appearance, please speak to your GP who will usually examine you and get you referred for a check-up with a specialist. 

If you are registered as female with your GP, you’ll usually be invited for your first breast screening every three years between the ages of 50 and 71. Screening tests involve a mammogram, which is a special type of X-ray that can detect changes in the breast tissue that might not be apparent when examining the breast. As always, if breast cancer is present, the earlier it is detected, the earlier treatment can begin and the better the long-term prognosis. 

If you are a trans woman and registered as a male with your GP, you will not usually be invited for screening. In contrast, people transitioning from female to male and registered as female will still be invited. It’s worth discussing this further with your GP if you are concerned you may or may not be called for screening.

4. Urinary symptoms

After menopause, women can find they are more prone to accidentally leaking urine or may develop frequent urine infections or UTIs, particularly if enjoying healthy sex. This is related to changes as a result of low oestrogen, as the vulval skin becomes thinner and dryer, and makes infections of the bladder more common. 

Urine infections can cause symptoms including:

• The need to wee more often
• Needing to wee in the night
• Pain and discomfort when weeing
• Confusion

Occasionally, if left untreated, they can travel up the pipework in the urinary system and affect the kidneys, which can cause a much more serious illness. 

Treatments are available, including creams to moisturise the vulval skin, and sometimes topical hormones may be appropriate to keep the skin more supple. If you feel you are having symptoms of a UTI, cutting back on caffeine and alcohol, and seeing your doctor for further advice and investigation is recommended. 

5. Female-specific cancers

Other female cancers are less common overall. But when they do occur, they tend to affect older women.

• Uterine or womb cancer is the fourth most common cancer in women and is much less common in women aged 40 and under. Symptoms include unusual bleeding from the vagina, especially after menopause, and sometimes bloating or swelling of the lower tummy.
• Ovarian cancer is more common in women aged over 50, but symptoms can be a little vague and difficult to pick up. Women should be on the lookout for feelings of pain and bloating in the tummy area, feeling a need to wee more frequently, changes in the bowels, particularly if more constipated than usual, and unexplained weight loss and tiredness. 

6. Bowel cancer

The risk of bowel cancer increases as we get older, and in the UK bowel cancer is the third most common cancer in women [3]. As always, the earlier the cancer is detected, the better the long-term prognosis. Changes in bowel habits, blood in the stool, unexplained weight loss, or a feeling of bloating and incomplete opening of the bowels are all commonly associated symptoms. 

NHS screening is offered between the ages of 60-74 to detect early cases when people may not have any symptoms and occurs every two years. The process is straightforward and involves a test kit that allows a small stool sample to be taken and sent back to a lab for testing. 

Women’s health checks

It’s really important to pay regular attention to what’s going on with your body to help identify any changes that could need investigating. 

No matter your age, making healthy lifestyle choices, including eating a well-balanced diet with plenty of fruit and veg, avoiding smoking, and taking care to drink alcohol safely will all help to keep you well for longer. Ensuring your weight is within a healthy range and keeping active will also help keep you in tip-top condition and promote physical and mental wellbeing. 

Of course, if you are experiencing any symptoms then get in touch with a health professional and investigate the cause. Getting to know your body and finding out what’s normal can help you spot any changes.

Our Advanced Well Woman Blood Test is our most comprehensive general health check, testing for thyroid function and female hormones as well as vitamins and minerals for energy and long-term health.

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References

1. Statistics, O., 2022. Male and female populations. [online] Ethnicity-facts-figures.service.gov.uk. Available at: <https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/demographics/male-and-female-populations/latest#:~:text=This%20data%20shows%20that%3A,same%20male%20and%20female%20populations> [Accessed 21 February 2022].
2. Cancerresearchuk.org. 2022. Risk factors for breast cancer | Breast Cancer | Cancer Research UK. [online] Available at: <https://www.cancerresearchuk.org/about-cancer/breast-cancer/risks-causes/risk-factors#:~:text=It%20is%20by%20far%20the,is%20called%20a%20risk%20factor> [Accessed 21 February 2022].
3. Cancer Research UK. 2022. Bowel cancer incidence statistics. [online] Available at: <https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/incidence#:~:text=In%20females%20in%20the%20UK,and%2056%25%20are%20in%20males.> [Accessed 21 February 2022].