When Did You Last Check In With You?

The things we learn to live with

Most women are remarkably good at looking after everybody else. Appointments get made for children, parents, partners. The one that doesn't get made is your own.

It rarely feels like neglect. It feels like sequencing — this month is busy, the symptom isn't that bad, it'll probably settle. And some of what gets deferred is not a character flaw at all. It's how the system is built: one check arrives as a letter in the post, another has to be requested, and a third only happens if you raise it yourself in a ten-minute appointment already full of someone else's questions.

Not the emergencies. The background hum: the heavy periods you plan your week around, the tiredness you blame on work, the twinge you'd mention if there were time, the spot you keep meaning to have looked at. Things that have been true so long they've stopped registering as things at all.

This feature is a gentle interruption, not a lecture. It moves through what changes, what's worth checking, and what's worth saying — and it ends with a page you can take with you.

What has changed?

Doctors are less interested in whether something is unusual for other people than in whether it's unusual for you. Change is the signal. Periods, bleeding, energy, pain, sleep, weight, mood — a shift that has lasted a few months is worth a conversation, even if you can't name what's wrong.

Worth raising

Words you may hear

Iron deficiency is one of the most quietly normalised experiences in women's health. Years of heavy bleeding can slowly drain iron stores, and the result — flat, foggy, breathless on the stairs — gets attributed to everything except blood. A simple blood test answers it.

The checks that are easy to put off

Australia runs three national screening programs relevant to women, and they behave differently from one another. That difference is exactly why one of them tends to slip.

Cervical screening. The test changed some years ago and many people are still picturing the old one. It is now a five-yearly Cervical Screening Test that looks for HPV, offered from age 25 to 74. Self-collection — taking your own swab in privacy at the practice — is available to everyone eligible as an equal choice, not a lesser option. For anyone who has delayed because of discomfort, embarrassment or past experience, this is worth knowing.

Breast screening. BreastScreen actively invites women aged 50 to 74 for a free mammogram every two years. Women aged 40 to 49 and 75 and over are eligible but are not sent invitations — they need to book themselves. A national review has recommended moving over time toward screening based on individual risk rather than age alone; that is on the horizon rather than in place, but it is a good reason to discuss your own family history and breast density with your GP now.

Bowel screening. The one most often missed. From 2024 the eligible starting age dropped from 50 to 45. If you're 50 to 74, a free kit arrives in the post every two years. If you're 45 to 49, nothing arrives — you have to request your first kit. Fewer than half of eligible Australians complete the test, and it is done at home in a few minutes.

Your heart belongs in this conversation

Heart disease is often filed away as something that happens to men in their sixties. It is a leading cause of death in Australian women, and it remains under-recognised — partly because the picture most of us carry, crushing central chest pain, is drawn from studies of men.

How it can present

Numbers worth knowing

Pregnancy history matters here too: gestational diabetes, pre-eclampsia and high blood pressure in pregnancy all raise later cardiovascular risk. Mention them.

The years when things start shifting

Perimenopause is not a single event. It is a stretch of years — often from the mid-forties, sometimes earlier — when hormone levels fluctuate rather than decline neatly. Because the changes are gradual and varied, they're frequently attributed to stress, work, or simply getting older.

Two things are worth holding at once. First, these symptoms are real, treatable and worth raising — there is a genuine conversation to be had about options, and current Australian guidance emphasises individualised discussion rather than one approach for everyone. Second, perimenopause is not the answer to everything in this age range. Thyroid problems, iron deficiency, sleep disorders, depression and other conditions can look almost identical, which is why a check-up is more useful than a self-diagnosis.

Bleeding after twelve months without a period is always worth prompt review. So is menopause arriving before 45, which has implications for bone and heart health worth planning for early.

The things we don't always say out loud

There is a category of symptom that women often mention last, at the door, as an afterthought. Pelvic, urinary, sexual and emotional health sit there almost by default, partly because they've been framed as the ordinary cost of having children, ageing, or being busy.

Commonly minimised

Continence problems are common and often very treatable — pelvic floor physiotherapy alone changes a great deal.

And the harder ones

What does your future self need?

Some of the most valuable things you can do now pay out in twenty years. Bone health is the clearest example. Bone density falls faster in the years around menopause, and the first sign of a problem is often a fracture from a fall that shouldn't have caused one.

Australian guidance has moved away from blanket screening ages toward finding the people at genuine risk earlier. A bone density (DEXA) scan is rebated for women aged 65 and over who haven't had one, and earlier where risk factors are present.

Bone risk factors to mention

Also future-facing

Make the appointment about you

A long appointment exists for exactly this. Ask for one when you book, say it's a general health check, and bring the two or three things that matter most — written down, so they don't evaporate.

Before your appointment

Questions worth asking

Several of the checks in this feature won't come to you. You have to ask for them.