A woman writes in a journal with a pen.
Young women need to start their health care journeys early on. (For Spectrum Health Beat)

Most women in their young 20s feel great and don’t have many complaints about their health.

Their periods are regular, their weight makes sense, energy level is fine, skin looks and feels great, and moods are predictable and stable.

When there is an issue at such a young age, however, it can be a gift to make you take stock: Figure out why there is an issue, look at your options, make necessary changes and develop a plan.

By doing all of these things, you can help ensure good health in your future.

The truth is, we often don’t think about our health unless we have a complaint or simply don’t feel well. Having just one issue can be difficult, but when you have several complaints at once, it can be very frustrating and difficult to understand why these changes are occurring.

I recently saw a patient, who I’ll call Katie, who came to me because she was experiencing many of these issues and her body was not behaving as she expected it should at her age. At 22, she was excited because she had just graduated from college, and was looking forward to finding a teaching job and living on her own.

Instead, she had embarrassing acne, weight gain that didn’t make sense, mood swings, and irregular, heavy periods with cramps. These complaints were hard enough, but she was especially frustrated because she didn’t understand why these changes were happening to her at such a young age. Katie was feeling betrayed by her body and feeling like her health was out of her control.

To understand why these changes sometimes affect women (like Katie) at such a young age, it’s important to look at several factors: genetics, how we have treated our body in the past in terms of diet, exercise, and stress management, and our current health habits.

For Katie, we started with her family history, and learned that several women in her extended family were obese and suffered from diabetes. Therefore, it is likely that her body is programmed to be insulin resistant at a lower weight than someone else without that history.

Insulin resistance can trigger irregular periods, acne, and unexplained weight gain. Next, we discussed her past diet and exercise habits compared to her current plan. Katie had always been active in sports during high school and continued to enjoy running. Unfortunately, with final exams and student teaching taking up much of her time, her level of activity had decreased, with fewer runs and less strength training. In addition, her diet had suffered as a result of her busy schedule, and she had been eating more simple carbs like pretzels and boxed cereals.

It wasn’t hard to see why she was having the problems that she was complaining about when she came into my office.

Everyone has a tipping point at which their system can go haywire; for Katie, it was only 10 pounds, several months of stress, less exercise, and added simple carbs in her diet. And, her blood tests showed it as well—her cholesterol, triglycerides, and blood sugar levels all went up, but her thyroid was normal.

What happened to Katie can easily happen to other young women in similar situations. Even small lifestyle changes for some women can result in a downward health spiral that may never be reversed and can lead to early heart disease. Stress and overindulging on simple carbs can cause your blood sugar to increase and cause more insulin to be released.

With higher insulin, your body craves sugar, and with insulin resistance, your ovaries don’t work properly, causing irregular and heavy periods. Unfortunately, even a small weight gain plus irregular periods can cause skin issues (acne) and even dark chin hairs. Throw stress into the picture, and your metabolism gets worse, causing mood swings.

And if your brain chemical levels drop too far, there isn’t enough left for feeling happy and being nice all of the time. If this vicious cycle isn’t stopped, your mood swings can become out of control, causing anxiety and depression, and eventually affecting your relationships, job performance and overall well being.

Thankfully, there are changes you can make at age 22 (or 32 or 42) that can make you feel better and keep you from becoming obese or developing diabetes. For Katie, we talked about how she wanted to be now and in the future, and we helped her develop some goals: understand her body, regain a sense of control, lose weight, get the acne under control, and formulate a plan to avoid these same issues later in life.

In addition, we broke down her diet and exercise routine, and worked around her barriers (hectic school and work schedule): She focused on interval training (boot camp) during the week and long runs on the weekends, and traded simple carbs (pretzels and cereal) for complex carbs (slow-cook oatmeal, brown rice and whole wheat bread).

I’m happy to report that six months later, Katie is feeling much healthier. Her acne has improved significantly, her weight is under control, and she is gaining control of her moods. Small, simple changes worked for Katie, and they can work for you, too.