Wellness

The Biggest Health Fear Women Have In Their 20s

A guide to health at every age.

Health complaints change over the decades. What worries us at 25 is very different than our concerns at 40. We asked the HuffPost Lifestyle Facebook community to tell us what they worried about most and then conferred with experts. Here's what we learned. (Find all ages here.)

We asked: What is your biggest health worry?

You answered: "Infertility and not being able to get straight answers about those fears because the doctor thinks I'm too young to have to worry about it." -- Facebook user Meg Ash

Face your fears

When we informally surveyed 20-something women about their health worries, many responded that infertility was chief among their concerns.

Safeguarding fertility is very important and worthy of consideration: Approximately 11 percent of women will experience problems trying to get pregnant or carrying a baby, according to the Centers for Disease Control and Prevention.

Doctors aren't particularly worried about this issue among 20-something women, adding to the frustration some may feel. But according to Dr. Cheryl Iglesia, who specializes in pelvic medicine and reconstructive surgery at the MedStar Washington Hospital Centerer, this lower level of concern is based on public health data that shows what types of illness and injury tend to bring young women to the doctor -- and they typically aren't reproductive in nature.

"Up to 35, we’re really thinking more about injuries from driving, motor vehicle accidents, skin exposure and then depression, suicide, tobacco and alcohol use," she said. That doesn't mean you shouldn't be thoughtful about reproductive health and, in fact, there's a lot you can do in your twenties to keep healthy in this regard.

Safeguarding fertility

One important way in which 20-something women can focus on their fertility, according to Iglesia, is preventing sexually transmitted infections. "Even though you are using birth control, the only thing that really prevents infections are barrier methods," she said. "You want to prevent a lower genital track infection like pelvic inflammatory disease that can then cause scarring of the tubes and the ovaries and lead to future infertility."

Gonorrhea and chlamydia are the most common causes of pelvic inflammatory disease, which affects more than 1 million women every year. Unless you are in a mutually monogamous relationship and both partners have been tested for STIs, condoms are a must. "People don’t realize that," Iglesia said.

Along with protecting future fertility, safeguarding against unwanted pregnancy should be on the list for women in their 20s who don't want children. Many women don't realize how many options they have for contraceptive methods, including the long-acting reversible methods like the intrauterine device and implant contraceptive. Though twice as many women use birth control pills than use long-acting methods, a recent New York Times report showed that when effectiveness rates were controlled for human error, or what's known as "typical use" among clinicians, the birth control pill's effectiveness dropped to 68 percent -- compared to 96 percent effectiveness for IUDs.

Even more important for women to know is what to do if a chosen birth control method fails. If a condom breaks, for instance, clinicians generally recommend a five-day window to obtain an emergency contraceptive (the makers of emergency contraceptive brand Plan B recommend a 72-hour window).

If you develop a fertility condition

For women with fertility conditions such as polycystic ovary syndrome and endometriosis, not being able to get pregnant is a legitimate concern.

As many as 1 into 10 women have PCOS, a hormonal disorder in which ovaries become enlarged and develop small cysts inside them. The cysts disrupt the menstrual cycle, making ovulation, and therefore pregnancy, more difficult.

Endometriosis is a painful disorder where uterine tissue grows outside the uterus, affecting up to 10 percent of reproductive-age women.

"What has always seemed to help [women with PCOS] is getting their periods regularly with or without a low-dose birth control pill," said Dr. Carolyn Alexander of the Southern California Reproductive Center, who also recommends low-dose birth control for endometriosis.

"By keeping the menstrual cycle regular, the tendency is that when they are ready to try to get pregnant, it’s a little bit easier to help them than women who skip their periods for months on end."

Consider getting tested

Fertility conditions aside, are there reasons why some women face precipitous fertility declines after the teen years? Like most health conditions, it's a complicated mix of factors -- some environmental, some inherited.

"It’s partly our genetics," Alexander said, noting that quality of life, proper nutrition, getting enough sleep and low stress are all important factors, too. If you're still concerned or want to have children but are planning on delaying childbearing, some OB-GYNs offer an anti-Mullerian hormone (AMH) test. AMH levels peak during your mid-20s, and the level of the hormone in your blood is thought to reflect the egg reserve in your ovaries (AMH levels are also used as a test for PCOS).

AMH blood tests aren't cheap and aren't approved by the FDA, but some fertility specialists, including Alexander, recommend them anyway. "It can be a tool to help women better understand their ovarian reserve," she said.

Other health questions to ask your doctor, according to the experts:

  • Is it a problem if I don't get my period every month?
  • When should I start thinking about my fertility?
  • What should I do about irregular or painful periods?

Beyond contraception and STI prevention, the American Congress of Obstetricians and Gynecologists -- Iglesia is a past chair of the group's Committee for Gynecologic Practice -- put together an informative checklist of screenings, immunizations and evaluations that are important for women in their 20s.

The Cleveland Clinic's Health Maintenance Guidelines for women is another great resource.

This story has been updated to note that the makers of Plan B recommend obtaining their product within 72 hours, as opposed to the five days recommended by other organizations.

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