Women’s health surveillance includes regular monitoring throughout of life, from menarche (first menstruation), through the fertile years, pregnancy, perimenopause, menopause (last menstruation), and post‑menopause . The goal? To promote health and a healthy lifestyle; To prevent disease; To carry out screenings that allow for the early detection of common conditions in women. This surveillance should be adapted to each woman’s age, individual risk factors, and clinical history. Adolescence and beginning of reproductive life Even before menarche, it is important to start talking about menstruation. The average age of menarche has been decreasing and is currently between 12 and 13 years of age. Talk about the subjects early, explaining the menstrual cycle and what to expect in the first years after menstruation begins, helps menstrual hygiene to be addressed in a more natural and uncomplicated way . This is also the time when the following topics should be discussed: Sexual and reproductive health ; Contraception ; Prevention of sexually transmitted infections . The American College of Obstetricians and Gynecologists (ACOG) recommends that the first routine gynecological consultation take place between the ages of 13 and 15. In addition to age, symptoms such as severe menstrual pain, heavy menstrual bleeding, or very irregular cycles, among others, is also a reason to seek medical consultation. During adolescence and the early reproductive years, it is also important to emphasize the need for screening for sexually transmitted infections, which is recommended up to the age of 25, or beyond this age in the presence of risk factors. Vaccination against the human papillomavirus (HPV) is a key measure for the prevention of cervical, vulvar, vaginal, anal, and oropharyngeal cancers. This vaccine is included in the Portuguese National Vaccination Program for girls and boys at the age of 10. Reproductive age During reproductive age, regular gynecological surveillance allows for: Monitoring of menstrual health ; Discussion of contraceptive methods ; Addressing issues related to fertility or family planning . Throughout this period, cervical cancer screening is performed through cervical cytology or HPV testing. The screening interval depends on the method used and previous results. Screening for sexually transmitted infections may also be indicated, particularly when there are risk factors. Breast cancer screening begins between the ages of 40 and 45, depending on personal and family history and on the recommendations of the international societies that are followed. Perimenopause Around the age of 40, changes in the menstrual cycle associated with the transition phase known as perimenopause may begin. During this phase, it is important to assess, among many other symptoms: Menstrual irregularities ; Abnormal uterine bleeding ; Vasomotor symptom s; Sleep or memory change s. At the same time, screening and evaluation for chronic and oncological diseases that are most prevalent in women become increasingly relevant. Breast cancer screening using mammography, tomosynthesis, and breast ultrasound; Assessment of cardiovascular and metabolic risk, as cardiovascular disease remains the leading cause of morbidity and mortality in women. Adopting healthy habits and lifestyle choices, including weight‑bearing physical activity, good sleep hygiene, stress reduction, and a healthy, balanced diet, are essential and should always be considered and prioritized. Menopause and post‑menopause After menopause, medical follow‑up continues to play an important role. At this stage, the following issues become even more relevant: Genitourinary symptoms of menopause ; Changes in sexual function ; Pelvic floor disorders , such as urinary incontinence or pelvic organ prolapse; Bone health , including assessment of osteoporosis risk. Cervical cancer screening in women at low risk should continue until the age of 69. A woman‑centered approach Rather than a rigid set of exams, women’s health surveillance should be understood as continuous, lifelong follow‑up . Each consultation is an opportunity to address not only gynecological issues, but also lifestyle factors, mental health, sexuality, and overall well‑being . An individualized, woman‑centered approach allows examinations and interventions to be tailored to the specific needs of each stage of life, contributing to improved quality of life and healthy aging, with an emphasis on prevention, early disease detection, and health promotion. The frequency and types of tests vary according to age, risk factors, and personal and family history. Author : Patrícia Isidro Amaral (obstetrics-gynecology ) Meet the obstetrics-gynecology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
