No matter your age, sexual healthcare is important for every woman. But what does sexual healthcare look like in your teens and 20s? And how does it differ in your 40s or 60s – or beyond?
We sat down with Jean Hailes Specialist Women’s Health GP Dr Amanda Newman to talk about some common issues that crop up at different ages, and how to best take care of your sexual health throughout your life.
Regardless of your current age, be sure to read over all the sections below. We’re all on different paths and as our lives, relationships and health changes, so too do our sexual healthcare needs.
For many young women, contraception is key to sexual health. Dr Newman reminds us that there are many different types of contraception and many factors to consider.
“Working out what is most suited to you and your situation is best achieved with your doctor,” says Dr Newman. “And remember, as your life or relationships change, the best-suited option may change too, so keep checking in.”
Of course, pleasure is an essential part of a healthy sex life too. And that begins with open, honest and clear communication between you and your partner, to ensure you’re both enjoying yourselves and are satisfied.
Regular STI (sexually transmissible infection) screenings are a must-have for sexually active younger women, along with knowing the basics of safer sex.
Dr Newman said younger people are at an increased risk of contracting chlamydia. “This STI can be silent with no obvious symptoms – so that’s why a chlamydia test is recommended at least once a year, when you’re under the age of 30. This can be done with a simple urine test.”
Cervical screening tests begin when you’re 25 years old and continue until 74 years.
“Even if you’ve been vaccinated for HPV (the virus that causes cervical cancer), screening is essential,” says Dr Newman.
A test is carried out every five years, if your results are normal. Read more about the cervical screening test.
“For younger women, it’s also important to talk about period problems with your doctor. Periods can often be irregular in adolescence, but the main thing to ensure is that your period pain and/or heavy bleeding is not impacting your quality of life or stopping you from going to school or playing sport.”
“That goes for all women across the lifespan”.
As we move into our 30s, for many women the focus of sexual healthcare shifts from contraception to fertility planning.
Dr Newman explains that the ability to have a baby depends to a large degree on the age of your eggs.
“Women younger than 35 and men younger than 40 have a better chance of having a baby than people who are older,” she says.
Read more about the factors that affect fertility on the Your Fertility website.
With fertility planning comes preconception healthcare. You can read about that here.
With pregnancy, the focus turns to perinatal healthcare (that is pre- and postnatal health), which you can read about here.
If you choose not to have children, sexual healthcare is usually the same as it was in your 20s, ensuring you’re practising safer sex and having STI and cervical screening tests as needed.
The 40s can be a time of hormonal change, and possibly a time of hormonal chaos.
Although the average age of menopause (that is, the final menstrual period) is 51 years, the changes that come with it often begin 4-5 years earlier, during what is called perimenopause – the lead-up to menopause.
Many women find their periods start to become irregular and often heavier. “A common pattern is, you have heavy periods as a teenager, things settle down in your 20s and 30s, and then you have heavy periods again,” says Dr Newman.
Read more about heavy bleeding and how to know if your periods are too heavy.
“As your periods start to slow down, women often start thinking about stopping their contraception, as they believe that pregnancy isn’t possible,” says Dr Newman. “If you don’t want to conceive, use contraception for 1-2 years after your last period.”
And, remember, you still need to protect yourself from STIs after your periods stop.
Libido can be another part of sexual health that is affected by changing hormones, but Dr Newman says we shouldn’t be too quick to generalise.
“There is some evidence that libido drops with age, but it also drops with the age of the relationship and for a whole variety of other reasons – stress, certain medications and relationship issues are just a few examples,” she says. “And it happens across the lifespan.”
“It’s important to know that women of a certain age don’t lose interest in sex. Sex is not just a young people’s thing.”
Many women are re-entering the dating scene in their midlife years, after the end of a marriage or long-term relationship. Dr Newman says that this puts safer sex education and STI screening back on the center stage.
“You may think that because you’re older the same risks and rules of STIs don’t apply,” she says. “But anyone can catch one.”
For tips on talking about condoms and safer sex, read our article, How to have the talk with your new partner.
A common issue for women in this age group is vulval and/or vaginal dryness and a lack of vaginal elasticity. “These symptoms often occur in women in their 50s, but it tends to be more common in your 60s,” says Dr Newman.
“After menopause, our bodies no longer make much oestrogen,” explains Dr Newman. “Because of this, our skin in general, and the vulva and vagina in particular, become drier.”
With these changes, sex can become painful without some extra help.
“Two important things that can help with this issue are a vaginal oestrogen or using a good-quality lubricant when you have sex, so speak to your pharmacist or doctor,” says Dr Newman.
A pelvic floor physiotherapist can also help to relax and release overtightened muscles of the pelvic floor and treat some causes of painful sex.
When it comes to enjoying a healthy sex life, Dr Newman reminds us that age need not be a barrier.
“When you’re in your 70s, you don’t have to worry about the kids barging in on you and you’re not distracted by stress from work, so it can be a great time to enjoy sex,” she says.
Watch a video from Jean Hailes Medical Director and gynaecologist, Dr Elizabeth Farrell, talking about Five things to know about sex in later life.
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