As women enter their 30s, most major health concerns are like those they faced in their 20s. But prioritizing health becomes more challenging since thirtysomethings are often taking on more life responsibilities and working harder to balance career and family.
That makes it more important to maintain or work toward the healthiest lifestyle in terms of nutrition, physical activity, sleep, and stress management.
“The reason they call them the basics is that if you do all those things, you’re going to help yourself maximize your health,” Jill Rabin, an OBGYN at Northwell Health in New York, says.
Of those basics, the one that often slips through the cracks most easily is sleep, but it’s also the one that can have the most profound effects on the rest of your health.
“Sleep patterns and a good circadian rhythm very much affect hormone release and can have impacts on things as disparate as your inability to lose the three pounds you want to lose to having regular menses to being able to get pregnant,” says Mary Gover, an internal medicine doctor at Montefiore Einstein Advanced Care in New York. “Good” sleep refers to duration but also your sleep schedule and quality. And poor sleep “can contribute to anxiety, depression, mood disturbances, and physical symptoms like headache, fatigue and the misfiring of hormones,” she said.
Sexual and reproductive health
For most of history, women’s child-bearing years peaked in the 20s, but the average age of first-time motherhood has steadily crept up, reaching 27.5 years old in 2021. Even more telling is the median age of motherhood, which hit 30 in 2022, according to the U.S. Census Bureau. That means half of all women who become mothers start that journey at age 30 or later.
Fifth in our six-part series
Most people know the basics of living healthy: eat and sleep well, exercise, schedule an annual check up, and get the recommended vaccinations. But keeping up with self-care plus getting screenings for cancer and other diseases can be daunting. “Health” also varies for women at different stages of their lives. So, we’re bringing you a women’s health series that covers the most important health issues for women in each decade. Here is the fifth of those, reviewing where women in their 30s should be putting their focus to live their best, healthiest life.
Now many women are thinking about fertility and pregnancy in their 30s. If that’s your plan, it’s important to start taking prenatal vitamins before attempting to conceive and “establish a relationship with your OBGYN so that you can see what else you need to fill in the blanks to maximize your health before you get pregnant,” Rabin says.
There are large sections of libraries and bookstores dedicated to advice on pre-conception and prenatal care, and your OBGYN can help you prioritize what’s most important for your health. It’s also important to be aware of the high risk of perinatal and postpartum depression and anxiety, which conservatively affect upwards of one in eight women. But many women may not realize the impact pregnancy can have on their lifetime health.
“We really view pregnancy as a window to future cardiovascular health,” says Kathryn Lindley, a cardiologist at Vanderbilt University Medical Center in Nashville, Tennessee.
That is because as women enter their 30s, their risk of pregnancy complications can increase, such as gestational diabetes, preterm birth, and preeclampsia and other hypertensive disorders of pregnancy.
“We know that all of those pregnancy complications are indicators of increased risk of heart attack, stroke, heart failure, and developing heart-related risk factors like diabetes, high blood pressure and high cholesterol down the line,” Lindley says. “I view this as an important time for patients to talk to their healthcare team about how their pregnancy complications might put them at higher risk for heart disease long-term and whether they may need more intensive screening, counseling, or preventive care to keep them healthy.”
Of course, women not seeking pregnancy have important reasons to keep those annual OBGYN visits as well, particularly for effective contraception and screenings for sexually transmitted infection (STI) screenings and gynecologic cancers.
“The pelvic exam is not just about the cervix,” Rabin says. “It’s about the vulva and the vagina too, and you want to make sure there’s no lesions, lumps or bumps that shouldn’t be there,” including any abnormal masses in the uterus or ovaries.
Cancer screenings
The one cancer screening that all women in their 30s should regularly undergo is cervical cancer screening, but the recommendations change slightly once you enter your third decade. Instead of getting cervical cytology (a Pap smear) alone as in the 20s, women aged 30 to 65 can choose from three options:
1) Cervical cytology alone every three years
2) A high-risk test for human papillomavirus (HPV), the virus that causes 99.7 percent of all cervical cancer, every five years
3) Co-testing with the high-risk HPV test and cytology every five years
The decision depends on women’s personal preference and risk factors, which she should discuss with her provider.
No other cancer screenings are routinely recommended for all women in their 30s, but there are several that women in higher risk groups may opt to undergo. By their 30s, most women should have a good understanding of their family medical history; if not, this is the time to gather that information.
National cancer screening recommendations are based on what’s appropriate for the general population overall, so it’s aimed at women with average risk for disease, Gover says. That means guidance may differ for those at higher risk for certain conditions due to family history or preexisting conditions.
If a first-degree relative, such as a parent or sibling, had colorectal cancer or breast cancer in their 40s or 50s, it’s recommended you take “a more personalized approach to cancer screenings,” says Suresh Nair, a medical oncologist at Lehigh Valley Network in Allentown, Pennsylvania. A good rule of thumb is to start screening for either of those cancers 10 years before the youngest age of diagnosis of a relative, he says. Ideally, you’d “meet with a genetic counselor and develop your own individual risk profile and shared decision model,” he says.
Colon cancer rates are rising among younger adults, so it’s important to know whether you’re in a higher risk group that would benefit from starting screening earlier. Similarly, a baseline mammogram isn’t typically recommended until women turn 40, but the calculus changes for those with a strong family history of breast cancer or who carry a genetic mutation, such as a BRCA gene, that increases their risk.
(Colon cancer is rising among young adults. Here are signs to watch for.)
Finally, people with a strong family history of melanoma will want to be more vigilant about self-checks for evidence of potential skin cancer.
These aren’t the only cancers that run in families, but they’re the ones for which routine screening methods exist. If you’re at risk for a family cancer syndrome or have a known genetic mutation that increases your risk of a particular cancer, you should be having ongoing conversations with your PCP about whether there are other screenings you should consider.
Metabolic and vascular health
The two arguably most important organs in your body are your heart and your brain, both closely linked to your metabolism. Working on those lifestyle habits, including following physical activity recommendations, is the biggest part of cardiometabolic health, but you should also get your first diabetes screening at age 35 if you haven’t already begun.
You’re likely getting your blood pressure checked at every health visit of any kind, but if it heads north of 120/80 mmHg, you may need more checks or interventions. Similarly, be sure you’re getting cholesterol (lipids) checked every five years, or more often if it’s high.
Above the neck
As career and family obligations stack up, it’s easy to forget about self-care. If you’re feeling particularly stressed, or experiencing symptoms of depression or anxiety, talk to your PCP or seek out a therapist.
Women who don’t have corrective lenses should get two eye exams in their 30s, and don’t skip your routine dental cleanings and oral check-ups. They’re the best way to screen for oral cancers, and periodontal disease increases later risk for heart disease.
Then there’s your skin and hair. Keep applying sunscreen before exposure to direct sunlight —and reapply if you’re still exposed. Use the ABCDE rule monthly to look for moles or skin discolorations that may indicate early cancer.
More and more younger women are coming in with questions about anti-aging products and routines, largely due to TikTok’s influence, says Jenna Lester, a dermatologist at University of California San Francisco and founder of the center’s Skin of Color Program. The biggest way to prevent skin aging is sun protection and nightly application of a retinol or retinoid.
(This is the biggest health challenge women face in their 40s)
But another top reason women see dermatologists in their 30s is hair loss. “There are lots of different types of hair loss,” and the cause can be genetic, infectious, autoimmune, or lifestyle-related. If you’re noticing thinning on your scalp or more hair shedding than usual, seek out a dermatologist.
Vaccinations
Routine vaccines recommended in women’s 30s are mostly the seasonal flu and COVID vaccines, but there are additional ones to consider during pregnancy.
Since 2011, a Tdap vaccine—a tetanus-diphtheria-pertussis booster—has been recommended in the third trimester of pregnancy to prevent whooping cough in children’s first few months of life. Not only is Tdap vaccination in pregnancy just as safe as influenza and COVID vaccination during pregnancy—both also recommended—but it’s the only reliable way to cut your newborn’s risk of a potentially fatal pertussis infection before they’re old enough to get their own pertussis vaccination.
Starting in 2023, families have finally been able to protect their newborns from another serious respiratory illness—respiratory syncytial virus (RSV). It took over six decades to get here, but an RSV vaccine is now finally available for women to get during pregnancy so that their bodies can develop and pass along antibodies to the fetus, protecting them from RSV after birth. (If you missed the RSV vaccine during pregnancy, there’s another option for newborns.)
RSV vaccines and preventive drugs have arrived. Which one is right for you?
Independent of pregnancy, there’s the HPV vaccine to consider. Though only recommended through age 26, women can continue to get this vaccine through age 45 if they never received it. Why get a vaccine that’s not formally recommended for your age?
“Not only does it prevent cervical cancer, but it can prevent anal, throat, vaginal, and vulvar cancer,” Nair says, adding that cervical cancer cases are still increasing among women in their 30s. The recommendation ends at 26 because you get less benefit with more exposure to HPV strains, which typically increases with more sexual partners as you get older. But since it’s unlikely you’ve been exposed to all nine strains in the vaccine, some benefit is better than none.
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