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Women's health

Beyond period basics

The things that quietly shape women's energy, hormones, bones and long-term health, and the checks worth doing at every age.

§ 01Essentials

Six things worth knowing

Iron and hidden deficiency
Periods make iron deficiency common. It can cause tiredness and reduced fitness long before it becomes anaemia.[8] Ask for a ferritin test, not just haemoglobin.[9]
Thyroid
An underactive thyroid is several times more common in women. It can cause tiredness, weight gain, feeling cold, low mood and changes to your periods. A simple TSH blood test checks for it.[10]
PCOS
PCOS is diagnosed from irregular periods, signs of higher male hormones, and ovary findings. Insulin resistance is common with it. Healthy lifestyle habits are the first step, and there are medical treatments for specific symptoms.[11]
Build bone early
Bone mass peaks around your late twenties and falls faster after menopause. Resistance training and impact exercise protect bone better than walking alone.[12]
Lift weights
Women gain muscle at a similar rate to men relative to their starting size, and gain upper-body strength even faster.[13] Lifting builds strength and protects bones and blood-sugar control. It doesn't make you "bulky" by accident.
Perimenopause
Changes often start in your 40s: irregular cycles, hot flushes, and changes in sleep and mood. For most healthy women under 60, or within 10 years of menopause, hormone therapy's benefits outweigh its risks for these symptoms.[14] Talk to your doctor.

§ 02Your cycle

What your cycle does, and doesn't, change

A cycle has four phases: menstruation, the follicular phase, ovulation, and the luteal phase. Ovulation happens about 14 days before your next period. In a 28-day cycle that's around day 14, and in a 35-day cycle it's around day 21.

Training. Popular "cycle syncing" advice says you should train hard in some phases and back off in others. The research doesn't support fixed rules. On average, performance changes only slightly across the cycle, and strength training works just as well in every phase.[15,16] Train by how you feel on the day.

Period pain. Anti-inflammatory painkillers such as ibuprofen work well for most women,[17] and regular exercise also reduces pain.[18]

Nutrients. Get iron with a vitamin C source; calcium and vitamin D for bones; protein at 1.2–1.6 g per kg of body weight, which your cycle doesn't change; and vitamin B12 if you're vegetarian.[21] If you might become pregnant, the WHO recommends 400 µg of folic acid a day.[20]

§ 03Screenings

Checks worth doing, by age

CheckAt 25At 35At 50
Blood pressure[1]At least every 3 years, and yearly once you turn 40.At least every 3 years, and yearly once you turn 40.Every year.
Blood sugar (HbA1c or fasting glucose)[2]From age 35. Start earlier if your BMI is 23 or above and you have another risk factor, such as a parent or sibling with diabetes, high blood pressure or PCOS.Every 3 years, or more often if a result is borderline.Every 3 years, or more often if a result is borderline.
Cardiovascular risk check[3]——Cholesterol (lipid profile) together with your other risk factors, to estimate your 10-year risk.
Cervical screening[6]The WHO recommends an HPV test from age 30, repeated every 5–10 years. Many countries start at 25, so follow your local programme.The WHO recommends an HPV test from age 30, repeated every 5–10 years. Many countries start at 25, so follow your local programme.The WHO recommends an HPV test from age 30, repeated every 5–10 years. Many countries start at 25, so follow your local programme.
Breast screening (mammogram)[7]——The WHO recommends a mammogram every 2 years from 50 to 69. Some programmes start at 45, so ask your doctor what applies to you.
Bowel (colorectal) cancer screening[5]——From 50 to 74, through your local screening programme.

§ 04Red flags

Signs worth a doctor's visit

Any bleeding after menopause
See a doctor promptly, every time.
Heavy periods, bleeding between periods, or after sex
Get checked by a gynaecologist. Heavy bleeding also drains your iron stores.[19]
A missed period
Take a pregnancy test first. If it's negative and your periods stay irregular, see a doctor.
Irregular periods with acne, excess hair growth or weight gain
Ask your doctor about PCOS and a thyroid test.[11]
A new breast lump or change
Get it examined promptly. Most lumps are not cancer, but every one needs checking.
Severe mood changes before your period
If they disrupt your life, this can be PMDD, not "just PMS" — and it is treatable.

§ 05Premium

Cycle tracker

References

  1. 1.2024 ESC Guidelines for the management of elevated blood pressure and hypertension. European Heart Journal, 2024.doi:10.1093/eurheartj/ehae178
  2. 2.Diagnosis and classification of diabetes: Standards of Care in Diabetes—2025. Diabetes Care (American Diabetes Association), 2025.doi:10.2337/dc25-S002
  3. 3.2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 2021.doi:10.1093/eurheartj/ehab484
  4. 4.EAU–EANM–ESTRO–ESUR–ISUP–SIOG Guidelines on Prostate Cancer. European Association of Urology, 2024.
  5. 5.Council Recommendation on strengthening prevention through early detection: a new EU approach on cancer screening. Council of the European Union, 2022.
  6. 6.WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, 2nd ed.. World Health Organization, 2021.
  7. 7.WHO position paper on mammography screening. World Health Organization, 2014.
  8. 8.Iron-deficiency anemia. New England Journal of Medicine, 2015.doi:10.1056/NEJMra1401038
  9. 9.WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. World Health Organization, 2020.
  10. 10.Hypothyroidism. The Lancet, 2017.doi:10.1016/S0140-6736(17)30703-1
  11. 11.Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology & Metabolism, 2023.doi:10.1210/clinem/dgad463
  12. 12.Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database of Systematic Reviews, 2011.doi:10.1002/14651858.CD000333.pub2
  13. 13.Sex differences in resistance training: a systematic review and meta-analysis. Journal of Strength and Conditioning Research, 2020.doi:10.1519/JSC.0000000000003521
  14. 14.The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 2022.doi:10.1097/GME.0000000000002028
  15. 15.The effects of menstrual cycle phase on exercise performance in eumenorrheic women: systematic review and meta-analysis. Sports Medicine, 2020.doi:10.1007/s40279-020-01319-3
  16. 16.Current evidence shows no influence of women's menstrual cycle phase on acute strength performance or adaptations to resistance exercise training. Frontiers in Sports and Active Living, 2023.doi:10.3389/fspor.2023.1054542
  17. 17.Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2015.doi:10.1002/14651858.CD001751.pub3
  18. 18.Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2019.doi:10.1002/14651858.CD004142.pub4
  19. 19.The two FIGO systems for normal and abnormal uterine bleeding symptoms. International Journal of Gynecology & Obstetrics, 2018.doi:10.1002/ijgo.12666
  20. 20.WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization, 2016.
  21. 21.Position of the Academy of Nutrition and Dietetics: vegetarian diets. Journal of the Academy of Nutrition and Dietetics, 2016.doi:10.1016/j.jand.2016.09.025

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