Women in Singapore often neglect their health as they have to juggle work, family and a myriad of other commitments. It is thus not surprising that their health often takes a back seat. Apart from health issues related to the female reproductive system such as menstrual and fertility issues, various chronic conditions such as osteoporosis, arthritis and cancers like breast and ovarian cancers are typically more prevalent in females.
Awareness is the first step towards preventing and treating health concerns. For a start, understanding the various health complications that affect women at different stages of their lives would help you take control of your health. In this article, read about the common conditions women face from their 20s to 50s and Physician Leow’s recommendations on how to #BeTheBestYouCanBe.
For women in their 20s…
Women in their 20s typically experience the fewest health problems. As recorded in the Yellow Emperor’s Canon of Internal Medicine (黄帝内经): “四七，筋骨坚，发长极，身体盛壮”, which details women at the age of 28 (4 x 7) develop tough and strong tendons and bones, and their body is at its optimal condition. However, it is still important to be proactive in taking care of one’s health.
Conditions affecting women in their 20s
- Menstruation concerns
The flow should typically become more consistent in the 20s compared to irregularities in the teenage years. However, there might be unpleasant symptoms accompanying each cycle, such as menstrual cramps, premenstrual syndrome (PMS), breast tenderness etc.
- Mental health
Conditions such as anxiety and depression are also more prevalent among women in their 20s. This comes with stressors such as stress from studies or learning to transit to the working world. In the Singapore Mental Health Study, it was reported that the lifetime prevalence of Major Depressive Disorder (MDD) is more common in females (7.2%) than in males (4.3%), and that women with MDD were mostly in the 18 – 34 years old range. 
Health tips for women in their 20s
- Make exercise a habit
Regular exercise can help in the management of various menstrual discomforts. Exercising helps release endorphins which can act as a natural painkiller, providing relief during menstrual cramps.  You can opt to do light exercise such as walking or low-intensity cardio during your period to help reduce the occurrence of cramps. Apart from pain relief, regular exercise is also beneficial for relieving symptoms of PMS and improving one’s mood. As aerobic exercise leads to the release of endorphins, it can help elevate one’s mood, reducing feelings of sadness, irritability, or anger during periods. Studies have shown that regular aerobic exercise can help reduce symptoms of PMS. Other exercises such as yoga can also help as it elevates levels of gamma-aminobutyric acid (GABA), which is associated with better mood and decreased anxiety. 
- Eat a balanced diet with calcium and iron rich foods
A well-balanced diet is also important for women’s health. Consuming more calcium or low-fat dairy in your diet helps in bone health by preventing osteoporosis and also helps improve one’s mood. One study has shown that consuming calcium supplements boosts serotonin levels, which acts as a mood stabiliser, helping to regulate anxiety and reduce depression. It is also recommended to consume more iron-rich foods such as lean meats to replenish the iron lost during periods. If you are vegan, you may speak to your doctor about iron supplements. In general, eating a healthy and well-balanced diet is beneficial.
- Routine screening
In addition, it is advisable to go for routine cervical cancer screenings starting from the age of 25. Based on recommendations from the Health Promotion Board, women between the ages of 25 and 29 and have ever had sex should go for a Pap smear test once every three years, while women above the age of 30 should go for a Herpes Simplex Virus (HPV) test once every five years.
For women in their 30s…
Many health concerns that women experience in their 20s can also be seen in their 30s. The Yellow Emperor’s Canon of Internal Medicine (黄帝内经) also details: “五七，阳明脉衰，面始焦，发始堕”, which explains women at the age of 35 (5 x 7) will experience depletion of their Yang Ming Channel, after which the initial signs of aging such as sallowness in the face and hair fall will start to show.
Conditions affecting women in their 30s
- Fertility concerns
Fertility issues are also one of the main health concerns for women in their 30s. Based on the United States of America (USA) Office of Women’s Health, a woman’s chances of conceiving a baby rapidly decreases every year after the age of 30.  There are a few reasons why aging can decrease a woman’s chances of having a baby:
- Lesser number of eggs left
- Ovaries ability to release eggs reduces
- Quality of eggs decreases
- Additional health conditions that might affect fertility
- Higher chances of miscarriage
Furthermore, women are also giving birth at a much later age than before. In the 1980s, the fertility rates were highest among females aged 25 – 29 years, while in 2020, the fertility rates were highest among females aged 30 – 34 years.  However, pregnancy at a higher age can put the mother at risk of:
- Gestational diabetes
- High blood pressure
- Difficult labour
- Mental health
Postpartum psychiatric disorders are another health concern for all pregnant women and they can be divided into three categories:
- Postpartum blues
Postpartum blues refer to a transient condition characterised by irritability, anxiety, decreased concentration, insomnia, tearfulness, as well as mild and rapid mood swings from elation to sadness.
- Postpartum depression
Postpartum depression refers to depression that often develops in the first few months after giving birth, typically within the first five weeks. However, it can start any time within the first year postpartum. Several key risk factors include:
- History of postpartum depression
- History depression prior to conception
- Family history of depression, particularly postpartum depression
iii. Postpartum psychosis
Postpartum psychosis is considered the most severe form of postpartum psychiatric disorder, with patients presenting with symptoms resembling an acute manic episode or psychotic depression, such as delusions and hallucinations that are frightening to them. Additional symptoms may also be present and resemble a delirium, such as distractibility, labile mood and transient confusion.
Health tips for women in their 30s
- Pay extra attention to bone health
The same good lifestyle habits for women in their 20s also apply to women in their 30s. In addition, women should start paying attention to their bone health in their 30s. Even though there tend to be minimal changes in total bone mass for women between age 30 and menopause, most women experience massive bone loss in the first few years of menopause. Calcium, potassium and vitamin D are three nutrients that can help rebuild bone mass,  so you may speak with your doctor about how to keep your bone mass high through diet, exercise and supplements.
For fertility issues, you may wish to speak to a medical professional to have a clearer understanding of the potential causes, treatments and strategies. In terms of diet, you may refer to our article ‘Top 30 Foods You Should Eat to Boost Your Fertility’.
- Don’t hesitate to seek medical help
If you notice any changes in your moods, poor sleep and lack of energy, especially after childbirth, it is crucial to seek medical help as soon as possible. There are also programmes like the Postnatal Depression Intervention Programme (PNDIP) established by the KKH Women’s Mental Wellness Services which aims to provide comprehensive evaluation and ongoing care to women suffering a variety of psychiatric disorders .
- Routine screening
In addition, women should continue their regular cervical cancer screening in their 30s, and they should also start performing breast self-exams for any abnormalities and lumps.
For women in their 40s…
The 40s is when the body is transitioning into middle age and the most common concern would be menopause. As recorded in the Yellow Emperor’s Canon of Internal Medicine (黄帝内经): “六七，三阳脉衰于上，面皆焦，发始白；七七，任脉衰，太冲脉衰少，天癸竭，地道不通，故形坏而无子也。” For women at the age of 42 (6 x 7), the three Yang channels (Tai Yang, Shao Yang, Yang Ming) begin to decline, and the face starts to wither while the hair starts to turn white. As for women at the age of 49 (7 x 7), both the Ren and Chong Channels are declining and menstruation ceases and they are unable to conceive, while their physique turns weak and feeble.
Conditions affecting women in their 40s
Menopause typically occurs in women between the ages of 45 to 50, with the average age of natural menopause for Singaporean women being 49. The years leading up to menopause are referred to as perimenopause. During this stage, our hormone levels start to fluctuate, with our estrogen and progesterone levels declining. As such, women will experience symptoms such as:
- Period irregularities, such as heavier or lighter periods, or longer and shorter times between periods
- Hot flushes
- Night sweats
- Vaginal dryness
- Weight gain
- Chronic conditions (3-highs)
Apart from menopause, women in their 40s are at higher risk of chronic conditions such as heart disease, stroke and diabetes. In Singapore, cardiovascular disease is the leading cause of death among women. As for stroke, it is the fourth leading cause of death in women in the USA and it causes more deaths in women than men. Diabetes is also a cause of concern, being the number 6 killer among women aged 45 – 54 and the number 4 killer of women aged 55 – 64. Many women are at risk of these health conditions at this stage in life due to menopause as well as certain pregnancy complications such as high blood pressure and gestational diabetes.
Cancers are also another health concern for women of any age and there are a multitude of risk factors for various cancers, ranging from genetic predisposition to poor lifestyle choices. The top three most common cancers in females are breast, colorectal and lung cancer.
Health tips for women in their 40s
- Maintain a healthy weight with a balanced diet and exercise
Again, lifestyle habits like having a balanced diet and regular exercise play a crucial role. Maintaining a healthy weight is also vital since many women are likely to gain weight due to menopause. Apart from lowering the risk of the aforementioned chronic health conditions, a study has shown that postmenopausal women who lost at least 10 lbs (4.5 kg) of their weight or lost at least 10% of their body weight over a year were more likely to reduce their symptoms of hot flushes and night sweats.
- Routine screening
It is crucial that early screening and detection of cancer be done so that relevant medical treatments can be done at the early stages. For example, it is recommended that women aged 40 – 44 should start yearly breast cancer screening with a mammogram if they wish to, while women aged 45 – 54 should get a mammogram done yearly. For colorectal cancer, it is recommended to start screening at age 45.
Women should also do regular health check-ups such as routine blood tests to make sure the various parameters are within normal range, such as cholesterol and blood sugar. If there are any parameters that are outside of the normal range, it is recommended to seek medical advice to help ensure that they are under control or fall back within the normal ranges.
For women in their 50s and 60s…
When women reach their 50s, the body starts to show more signs of aging. The Yellow Emperor’s Canon of Internal Medicine (黄帝内经) records: “年半百而动作皆衰”, which means when people reach the age of 50 (half of 100), their ease of movement starts to decline, which is a sign of aging. In addition, some women in their 50s might still be experiencing the symptoms of menopause.
As women go on into their 60s, the signs of aging would be amplified, and the risks for various chronic conditions also increase.
Conditions affecting women in their 50s and 60s
The risk for osteoporosis and osteopenia, which is lower bone density that is not within the range of osteoporosis, is typically higher in females as our bones are smaller and less dense than males. The hormone estrogen is essential to bone health as it promotes the activity of osteoblasts, which are the cells involved in bone production. That is why during menopause, as estrogen levels decline, women are at higher risk of osteoporosis. Common symptoms of osteoporosis include:
- Back pain
- Fracture in the spine, wrist, hip or other bones
- Loss of height over time, with a stooped posture
- Stress Incontinence
Another potential health concern among older women would be stress incontinence which occurs when an activity such as coughing, sneezing, exercising, laughing, or lifting heavy objects causes leakage of urine or even a complete loss of control of your bladder. Stress incontinence is usually a result of weakened bladder muscles and can be due to bodily changes from pregnancy, childbirth and menopause.
- Chronic conditions and cancer
Most of the chronic conditions, such as heart disease and stroke, and cancers that females are at a higher risk of in their 40s also apply to their 50s. The risk of heart diseases and stroke also increases significantly for women going into their 60s. Furthermore, our immunity weakens as we age, putting us at higher risk for all diseases, especially those that we typically brush off such as the common cold or seasonal flu.
- Signs of aging
Women in their 60s would also notice many signs of aging. Apart from the increased number of age spots, the skin becomes generally drier and more fragile. Many women in this age group also report a decline in their hearing ability.
Health tips for women in their 50s and 60s
- Lifestyle habits
Unfortunately, there is no cure for osteoporosis, but prevention is always better than cure. Sufficient intake of calcium and vitamin D and incorporating adequate low impact weight-bearing exercises will help slow down the signs of osteoporosis.
To help with stress incontinence, you may opt to do some kegel or pelvic floor exercises to help strengthen the pelvic muscles.
At present, scientists are unsure if there is a prevention for age-related hearing loss. However, it is advisable to protect your ears from overly loud sound for a prolonged period of time, such as loud music and leaf blowers. This is to protect your hearing and hopefully limit the amount of hearing loss that might happen as you get older.
As for aging dry skin, here are a few ways to help manage the symptoms:
- Use a moisturising and gentle body wash that is fragrance free.
- Use warm water when you shower. Avoid showering with hot water as that can strip your body of its natural oils.
- After showering, gently pat dry your body with a soft towel. Leave a bit of water on your skin before moisturising as this can help hydrate the skin.
- Use moisturisers such as lotions, creams or ointments throughout the day.
- Use a humidifier to add moisture to your room.
- Keep a close eye on your health
As our immune system weakens as we age, it is important to stay up to date on vaccines like the flu shot, and also to practice good hygiene habits like regular washing of hands. If other symptoms of aging such as loss of hearing and drier skin are of a concern to you, speak with a medical professional to see what treatment option would be best for you.
As prevention is better than cure, it is best to practice good lifestyle habits such as healthy diet and adequate exercise from young to reduce the risks of many of these health issues as we age. Apart from changes in lifestyle habits and routine screenings, it is also important to seek medical advice and treatments where necessary. Traditional Chinese Medicine (TCM) may be an option to help alleviate the various symptoms and improve your body’s overall constitution. In addition, the technology-enhanced therapies at Oriental Remedies such as Electro-Lymphatic Therapy (ELT) and Negative Ion Therapy are also beneficial for boosting our body’s immune system and body functions, as well as improving our overall wellness.
Your healing is the most important!
At Oriental Remedies Group, our physicians are trained in both Biomedical Science and TCM at Nanyang Technological University (Singapore) and China for a minimum of 5-8 years before being certified to practice in Singapore.
If you would like to find out how you can achieve optimal wellness to #BeTheBestYouCanBe , call/WhatsApp us at +65 8742 2163 for a personalised consultation with our bilingual
This article is written by Physician Julie (Oriental Remedies Group, Singapore), a registered TCM physician certified by the Traditional Chinese Medicine Practitioners Board (TCMPB).
Note: all words in Italics mentioned henceforth refer to the TCM organ system and not the anatomical organs/terms referenced in western medicine.
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