Women: 18-30

Each week the average 20-year-old woman has sex once or twice and drinks 9.5 units of alcohol. Most are in the peak of good health. But by 30 your skin will have begun to age visibly and an unhealthy lifestyle will be starting to take its toll

SEXUAL HEALTH

One in ten young Scottish women carries the sexually transmitted disease chlamydia, which can lead to infertility if untreated. Many carriers show no symptoms and are completely unaware they have it, so now is a good time to get tested for this and other STDs.

Doctors also strongly recommend getting into the habit of having a smear test every three years to check for the early signs of cervical cancer.

If you are one of the 3.5 million British women who take the contraceptive pill, you will be enjoying the benefits of relatively painless periods and improved skin. However, if taking the pill has led to you suffering headaches and nausea and gaining weight (all fairly common side-effects), it could be time to change brands.

ALCOHOL

Liver damage is symptomless in its early stages so you may not be aware of what effect drinking to excess is having on you. Experts are already seeing signs of cirrhosis in women in their 30s who have been binge-drinking since their teens.

Safe limits for women are 14 units in a week and no more than three units in any day. Yet a quarter of young Scottish women exceed these figures. Just one small (125ml) glass of wine has 1.5 units of alcohol. The more you exceed the limits, the greater your risk of developing breast cancer and obesity.

DIET AND EXERCISE

The 20s are the peak age for yo-yo dieting – following ultra-strict, very low-calorie diets and then giving up and overeating. But in the long term this almost always leads to weight gain. Nutritionists instead recommend eating a low GI diet, with at least five portions of fruit and vegetables every day, and drinking plenty of water.

Good foods for this age-group are high in calcium to strengthen bones and ward off osteoporosis. These include low-fat dairy products, nuts and green leafy vegetables. Getting out and about in the daylight will give your body vitamin D to absorb calcium from food.

Fitness experts recommend women in this age group take 20 minutes of resistance exercise a day, such as weights or sit-ups, and 40 minutes of cardiovascular training, such as aerobics, three times a week. Personal trainer Sabrina Severo says, "This helps shape up the body, build muscle and improve bone density."

HEALTH

Common reasons for visiting your GP now are motherhood stresses and work pressures. Physically, your body is at its peak for taking on the hard work of having a baby – but emotionally many women are not ready for another few years.

GP Gary Hamilton urges those in their 20s to think about their fertility while they are still young: "Women in this age group should be concerned about contraception, sexually transmitted infections, alcohol and drugs, and getting enough calcium in their diet to avoid osteoporosis in later life. They should also at this age think about their fertility. About one in five couples has difficulty conceiving and this is something women should bear in mind before they get to the age when it will be too late."

Another problem is painful periods, with 10% of women regularly bedridden and 40% saying the pain is enough to stop them concentrating at work. Exercise and good diet can help prevent cramping and pains, as can anti-inflammatory drugs and the contraceptive pill.

One quarter of Scottish women smoke, despite all the warnings and the risks they face. If you smoke, the sooner you stop the better. For a start, all the money you save could be put aside for a private health insurance plan. You're in such good health you won't need it now, but you could reap the benefits when you get older.

And although it can be tempting to wear high heels every day, this can create foot health problems for the future, including bunions and corns, as well as back problems (see p.31).

GROOMING

The most common skin complaint among this age group is acne, which can be treated by your GP. But visible skin ageing starts around the age of 25 as the natural process of regeneration slows. Non-smokers and those who stay out of the sun will look younger for longer – sun-worshippers will show clear signs of ageing as young as 30.

However, it may be your hair that reveals your age first. Stylist Neil Stitt says he sometimes sees grey hairs on girls as young as 16. "It can happen at any age," he adds.

MENTAL HEALTH

"People don't work on their mental health," says Dr Hamilton. "That's why they get stressed. They spend all their money on shoes then wonder why they can't pay the bills. Consumerism affects people's mental health and you need to be aware of what you really want as an individual."

Counsellor Sonya Steller says common problems at this stage include depression and stress. Leaving home and becoming a student can be a difficult adjustment, and eating, sleeping and taking care of yourself often take a back seat. "Belonging to a social group is important and sometimes leads to excessive behaviour involving alcohol, sex or drugs," she explains. "Being young is seen as a carefree time but many people in this age group find that becoming an adult is a long and painful process."

CASE STUDY

Emma Hill, 21

Emma Hill, a student from Edinburgh, says she has no anxieties about getting older and is happy to divide her time between studying, working and partying. And despite her pressurised lifestyle, she has no worries about her health.

She admits feeling stressed when time is tight before university deadlines and exams, but at weekends she feels she has earned the right to reward herself. "I'm a student and enjoy the party lifestyle, but I work hard and play hard," says Hill. "I don't go out madly or anything, but I like to have a good time."

Good food is very important to her, so she cooks at home most of the time and eats plenty of vegetables and pasta. Sometimes after a night out she'll go for the occasional fry-up, but is usually pretty healthy. "I try to eat well and take exercise – albeit in small doses," she adds. Her exercise regime consists of about ten to 15 minutes of activity at home each day, doing sit-ups, press-ups and stretches.

"I try to stay as healthy as I can now and see how it goes. I don't worry too much about getting older other than in terms of vanity, and don't have any health-related concerns."

Hill says she is probably happier than other people she knows and is not worried very much about her health – except when it comes to her teeth. The high cost of private dentistry combined with a shortage of NHS dentists in Edinburgh taking on new patients have prevented her from seeing one as often as she would like.

Action plan: 18–30

Lunges With your legs hip-width apart, step your front leg forward and your back leg back so that you are in a long stride position. Make sure your feet are facing forwards and that you are in a tall, upright position. You should have the heel of your back foot raised so that you are balancing on the ball of your foot. To start the exercise, bend your front and back knee slowly down towards the floor so that your front knee bends at a 90¼ angle. Avoid letting your front knee travel beyond your toes – try to lead with the back knee. Use your legs' strength to push you back up to the start position. Maintain a tall posture throughout. Practise building up to 30 repetitions on each side, three times per week.