On the occasion of International Women's Day, Active spoke to the city's leading health experts to get the lowdown on key health concerns in your 20s, 30s and 40s and above, so that you can get on the fast track to good health
On the occasion of International Women's Day, Active spoke to the city's leading health experts to get the lowdown on key health concerns in your 20s, 30s and 40s and above, so that you can get on the fast track to good health
Beauty
Jamuna Pai, Consultant Cosmetologist
In a woman's 20s and 30s, common skin ailments for women are acne, comedones (black heads), oily skin, hair fall and dandruff. The body undergoes a probable hormonal imbalance, which leads to overactivity of the sebaceous glands. 
That, in turn, causes comedones. These comedones breed the Propinio-bacterium, which is responsible for acne. Unwanted facial hair (hirsutism) is another commonly seen feature, which causes a lot of stress in women in this age group. The scalp being an extension of facial skin also gets oily, dandruff and frizzy hair are common concerns.
It is essential to seek medical intervention in these cases, so that acne can be addressed with medication, and further damage can be prevented. A cosmetic physician can take a detailed history, analyse the skin, identify the cause and thus treat the problem with antibiotics or certain hormonal medication, if the problem is due to hormonal changes, and also prescribe topical creams.
Guide to glowing skin
Use sunscreen: One thing that remains constant in all skin all age groups is the regular use of sunscreen which helps in protecting the skin from photo-damage and premature aging and drying of skin. Irrespective of the climatic changes, or skin types, and for that matter even the Sun Protection Factor (SPF), a sunscreen must be applied every two to three hours.
Drink water and get a good night's sleep: A healthy lifestyle goes a long way in determining the health of your skin. This should include a well-balanced diet, drinking two to three litres of water and getting seven to eight hours of sleep daily.
Regular exercise: A proper routine needs to be followed, which should include exercise in some form, it could be yoga, going to the gym, or even taking a brisk walk for 45 minutes daily. This helps in improving the blood circulation and helps improve the oxygenation of your skin.
Go for regular clean-ups: For skin prone to acne, a clean-up once every four to six weeks helps in exfoliating the dead cells, but should be done under an anti-biotic cover after having visited an experienced doctor. For normal to dry skin, a facial once a month helps in hydrating the skin. Also the face massage included in a facial, helps in improving the blood circulation to the skin and thus rejuvenates the skin.
Essential tests
Over the age of 18, women need to have their blood pressure checked annually; over age 45, have your blood cholesterol and blood sugar checked each year; and if you have a family history of heart disease in a relative younger than age 60, especially in a female relative, ask your physician to do these tests at earlier ages. Consider additional tests such as treadmill testing and other heart disease screening tests.
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Ask for a thorough assessment of your heart disease risk factors: family history, cholesterolu00a0-- especially LDL, HDL and triglyceridesu00a0-- glucose (blood sugar) levels, blood pressure, smoking history, weight, stress and exercise. If you have risk factors, formulate a plan with your doctor to reduce or eliminate them.
- Dr Vijay Surase, Consultant Interventional Cardiologist-heart disease
Cancer prevention
Dr Anil Heroor, Senior Oncosurgeon and Coordinator Dept of Surgical Oncology, Fortis Cancer Institute, Fortis Hospital Mulund 
In the 30s, the most common cancer in this age group tends to be cancer of the breast. The second most common cancer is uterine cervical cancer. The precautions to be taken are regular PAP smears for the uterine cervix. One has to do a regular breast self examination to self detect any lump in the breast. This can be done by examining the breast with the flat of the hand, checking for nipple discharge and change in size and shape of the breast and the nipple.
How to tackle:
* Getting Mammography PAP smear annually is a must.
* General health checks done including USG of the abdomen and pelvis and stool for occult examination.
* There is unfortunately no single blood test commercially available for detecting cancer.
* Tumour markers eg., CA 125 are more for prognostic significance i.e in follow up of cases rather than detection.
* Tumour markers eg., CA 125 are more for prognostic.
Fertility concerns
Dr Rishma Dhillon Pai, Consultant Gynaecologist, Jaslok and Lilavati Hospitals
A young woman in her 20s or 30s, that is, in the reproductive age group may face gynaecological problems such as menstrual problems. 
These may be heavy or irregular menses, painful periods, severe PMS etc. There may be difficulties in becoming pregnant or dealing with unplanned pregnancies. Miscarriage or pregnancy related problems are also common. A common problem is menstrual disturbances in the 40s.
Heavy and irregular menses are common. These may be due to fibroids or hormonal problems or even cancers. Hence in this age group, no symptom should be neglected. Intermenstrual bleeding can be sign of cervical cancer and should not be neglected. An immediate PAP smear or a biopsy of the cervix is necessary in these cases. A good pelvic sonograpy, often an internal (vaginal) sonography, gives a clear view of the womb (uterus) and ovaries and helps pick up uterine or ovarian tumours, swelling or even cancers.
How to tackle:
* Regular gynaecological examinations can prevent and treat many of these problems.
* Sonography is an excellent test which diagnoses common problems such as fibroids, endometriosis or polycystic ovaries
* Problems like PMS which causes bloating, breast pain, mood changes etc can be relieved by simple measures like reducing intake of salt, refined flour and caffeine and increasing intake of vitamin E and evening primrose oil supplements.
* Vaccines such as rubella and the new HPV vaccine which prevents cancer of cervix can be given in adolescents or young adults.
* Early antenatal registration during pregnancy, starting of folic acid before pregnancy and regular follow ups will help take care of most pregnancy problems.
* Cosmetic problems such as acne, hirsutism (excess facial hair), and hair loss are common causes of worry. These result from hormonal problems such as polycystic ovaries.
* A balanced diet with exercise on a regular basis will definitely control weight in normal women.
Planned pregnancies
Dr Nandita Palshetkar, Infertility specialist attached to Lilavati and DY Patil hospital, Mumbai
Obesity is the most pressing problem between the 30s and 40s. Plus, women can face problems such as decreasing ovarian reserve (i.e. the ability to release good quality eggs that can be fertilized by the partner's sperm at the time of intercourse to create a baby). It gets difficult to get pregnant as easily as in a normal 20-something old. And then there maybe the need for a gynaecological consultation. Cysts and tumours of the ovaries and uterus (common is fibroids in the uterus) are also prevalent.
How to tackle:
* Exercise.
* Planned pregnancies: Oocyte cryopreservation by freezing (this is done by the Infertility specialist at an IVF Centre). This option should be opted for by those who know that a delay in pregnancy is unavoidable. Specially if you have not found a partner or are undergoing therapy for cancer.
* Help from the Infertility Specialist should be sought without undue delay especially over the age of 35. The various treatment options would depend on the case. Treatment options include IUI (Intrauterine Insemination), IVF (Invitro fertilization) or the "Testtube baby", and various newer methods like the ICSI (Intracytoplasmic Sperm Injection) or IMSI (Intracytoplasmic Morphologically Selected Sperm injection), and also certain treatments applicable when the male partner has a poor sperm count.
* Regular gynaecological check-ups.
Weight gain
Dr Abhay Agrawal, Laparoscopic Bariatric Surgeon & Medical Director, Centre for Obesity Control, Asian Heart Institute. Bandra-Kurla Complex
Obesity is a common problem that can happen to women from their 20s to the 40s. Women in their 20-40 can have health issues related to pregnancy and weight gain after that. Hypothyroidism could add to the weight gain too. Most young women end up trying to get into shape and maintain their ideal weight in the pre marriage and post pregnancy phase.
The fast food culture has taken the toll on the younger generation. Infertility is also a concern in the child bearing age group. Post pregnancy depression is a known entity. We find many more obese young adults than we did a decade ago. The ratio of women to men undergoing Bariatric surgery is 8:2. Women after 40 years of age usually have slower metabolism and this is a major cause of weight gain.
How to tackle:
* Women need to adopt lifestyle behaviour modification in terms of healthy eating habits and a regular exercise schedule of at least five days a week to maintain good health and ideal weight.
* The women in their 20-30 should refrain from junk food and adapt healthy nutritive lifestyle and women of all age groups should adapt routine exercise schedules.
* They should space out the pregnancy and adapt micronutrients in their diet apart from good healthy nutrition.
* They are more adept at tolerating stress and pain because of their genetics and hormonal structure. Ischemic heart diseases are less common in women compared to men.
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