Your 20s come with a lot of big life changes — you may move to a new city, get a job, pay bills (who knew electricity cost so much?), gain and lose relationships — and amidst that roller coaster, health can become a second-tier priority.
But you’re only given one body. And believe it or not, the health decisions you make in your 20s will map the landscape of your life down the road.
We talked to young adult health experts from around the country to find out the biggest health mistakes women make during those first years in the real world, and to learn what you can do to give yourself the best shot at a healthy 30’s, 40s, 50s and beyond.
1. You skip the most important test.
What’s the one yearly test that every sexually active woman under 25 should be getting?
A sexually transmitted infection (STI) screen — specifically for gonorrhea and chlamydia. And that applies even if you’re not having risky sex.
In 2013 alone, there were over 1.4 million reported cases of chlamydia and over 300,000 cases of gonorrhea in the U.S., of which the vast majority affected people in their 20s. STIs can happen at any age, but younger women are at highest risk because they’re dating around and more likely to have multiple sexual partners.
“They can have a lot of long-term health complications, like infertility, and sometimes they can be asymptomatic, which is why screening is so important,” Dr. Nancy Keating, a primary care physician at Brigham and Women’s Hospital, warned TODAY.
Fortunately, if caught early, both gonorrhea and chlamydia are entirely treatable. All it takes is a simple urine test, which any doctor or clinic can provide, and it could mean this difference between one dose of antibiotics and a more serious infection that could require hospitalization, surgery or even leave you infertile.
2. You only wear sunscreen at the beach.
By now, we all know that baking in the sun dramatically increases your risk of skin cancer. But you don’t just get rays at the beach.
Incidental sun exposure from everyday outdoor activities counts, too, and it can cause more than just skin cancer.
“When you’re in your 20s, your skin is perfect, and it doesn’t seem possible that you will get wrinkles in your 40s. But it'll happen,” said Keating. She recommends wearing a daily moisturizer with at least SPF 30 in order to keep your skin looking young and fresh for years to come.
3. You don’t use the most effective birth control.
"The Pill" continues to be most popular form of birth control, but did you know that nine out of every 100 women who use it will still get pregnant within the first year?
And condom's statistics are even worse. With roughly 50 percent of all pregnancies in the U.S. unintentional, it’s time for a change. The good news is, there’s better answer out there, and it seems to be gaining in popularity.
“There’s increasing evidence that the long acting reversible contraception — the IUD and the implant — are really effective and something every woman should think about, especially younger women,” said Keating. They're so effective, in fact, that the failure rate is less than 1 percent. That’s more than 20 times more effective than the pill.
4. …but you focus all your energy on NOT getting pregnant.
According to a 2014 study in Fertility & Sterility, about 50 percent of reproductive age women have never discussed their reproductive health with a medical provider. Whether or not we want to talk about it, the scary truth is the “biological clock” is a real thing, and fertility begins to decline gradually at age 32, before declining more rapidly after 37, according to the American College of Obstetricians and Gynecologists.
That doesn’t mean you should go out and get knocked-up right away, but if there’s any chance you might want kids in the future, talk to your ob-gyn and get educated.
Why? Because it’s not just about fertility, Dr. Cheryl Iglesia, vice chair of patient education at the American College of Obstetrics and Gynecology, told TODAY.
"You want to make sure you’re in tip-top shape for when you do decide to get pregnant — you’re taking the folic acid, you’ve got all your vaccinations, you’ve been tested for HIV — so you're having the healthiest babies.”
5. You blow off your bones.
Osteoporosis, or low bone density, may seem like it's just a problem for your grandmother to deal with. But the truth is, the best time to prevent it is now.
“The bones you leave adolescence with are the bones you have for the rest of your life,” Dr. Charles Irwin Jr., director of Adolescent and Young Adult Medicine at UCSF, told TODAY. Women reach their peak bone density by around age 30, and by the time they reach menopause, it starts rapidly declining, leaving them at risk for dangerous fractures.
So, what can you do? A healthy diet is key, for one thing.
“A tablet isn’t the answer. I’m not saying supplements don’t help, but really the best predictor of good bone health is good eating habits,” said Irwin.
That means getting plenty of calcium and vitamin D from things like dairy (yes, ice cream counts, too), leafy green vegetables, and even seafood. Weight-bearing exercises — like walking, running, and weight lifting — can also help build bone density.
What to avoid? This is the one time when being too thin can cause problems.
“Unhealthy eating behaviors like anorexia and bulimia put you at a huge risk for bone problems later on,” said Keating.
6. You get all your healthcare at the walk-in clinic.
If Dr. Irwin could give one piece of advice to 20-something women, what would it be?
“Get yourself some kind of primary health care doctor or system — it might be a nurse practitioner or a gynecologist — but find some place that knows you.”
A primary care practitioner will make sure you keep up-to-date on all the necessary screenings and tests —from pap smears to vaccines. Plus you’ll have someone who knows your medical history when emergencies arise. Not only will this give you better, more convenient care, but many insurance companies charge extremely high co-pays for going to urgent care clinics.
“I don’t think most young people know this, but if you have insurance, that annual general checkup is no-copay. So you essentially go for free,” says Irwin, “It’s the best kept secret.”