Be Healthy in Your 20s, 30s, and 40s

In Your 20s

Make a mental list of your three biggest health worries. Odds are they're very different from those of your little sister or older aunt. That's because, depending on where you are in life, your concerns understandably shift. "A 20-year-old isn't going to be thinking about breast cancer and heart disease the way a 40-something woman is. She's going to be more focused on, say, her sexual health," explains JoAnn E. Manson, MD, chief of the division of preventive medicine at Boston's Brigham and Women's Hospital. And rightly so, since your actual risk for certain problems also changes with age. Here, a guide to the issues you should hone in on now -- and expert advice for safeguarding your health through the years.

Top Health Concerns

1. Sexually transmitted diseases. A whopping 19 million new STD infections occur each year, according to the Centers for Disease Control and Prevention (CDC) -- and nearly half of them are in those age 24 and under. "STDs like herpes and human papillomavirus (HPV) are rampant these days," says Steven R. Goldstein, MD, a professor of obstetrics and gynecology at New York University Medical Center. You may be in a monogamous relationship, but that doesn't make you immune. "Some STDs, such as chlamydia and HPV, are asymptomatic, which means you may have one and not know it," adds Dr. Goldstein. Left untreated, chlamydia can lead to pelvic inflammatory disease (a serious infection of the upper genital tract) and infertility. Certain strains of HPV can cause cervical cancer, although the virus often clears up on its own without incident.
2. Skin cancer. "Melanoma is the leading cause of cancer death among 25- to 29-year-old women," says Elizabeth K. Hale, MD, an assistant professor of dermatology at New York University. About 900,000 twenty-somethings are diagnosed with melanoma (the most serious type of skin cancer) each year, in part, she says, because young women don't safeguard themselves as well as their older counterparts do. Plus, many women believe that by the time they're in their 20s, the harm has already been done. "But only 75 percent of sun damage occurs by age 18, which means there's still 25 percent under your control," says Dr. Hale. Any new moles -- or changes in the appearance of existing ones -- should be checked out by a dermatologist.
3. Bone health. "A woman's peak bone mass is reached by the time she's in her very early 20s," says Felicia Cosman, MD, clinical director of the National Osteoporosis Foundation. "We used to believe it was much later -- in your mid 30s." Maintaining that peak level is crucial, because the more bone mass you have going into the next several decades, when it rapidly declines, the lower your risk for osteoporosis will be.

Your Stay-Healthy Checklist

• Get 1,000 milligrams of calcium and 200 to 400 IU of vitamin D daily to keep your bones healthy. It's best to get your calcium from the foods you eat (three servings of low-fat dairy products will do it), or Dr. Cosman recommends taking a supplement that contains both calcium and vitamin D.
• Do regular bone-boosting exercise. High-impact activities (like skipping rope or jumping jacks) have been shown to stress your body in such a way that they spur bone growth, says Dr. Cosman. Another good choice: running. If you're pregnant, talk to your doctor before beginning a fitness plan.
• Be smart about sun exposure. Avoid going out between 10 a.m. and 4 p.m., and always wear a sunscreen with an SPF of 30 or higher.

Tests to Have Administered

• An annual physical, including a blood pressure check and baseline cholesterol screening.
• A yearly Pap smear, which helps detect cervical abnormalities, including those linked to HPV. Some ob-gyns also recommend getting a full battery of STD tests.
• An annual skin check from your dermatologist -- more often if you have a personal history of skin cancer or a lot of moles.