Last updated: Jan 29, 2010
womens-health
Linda Churilla

The vagina is an amazing piece of equipment. It cleans itself, ushers new life into the world, and brings you untold pleasure—so treating it right just makes sense. Heres a decade-by-decade plan.


Your 30's

Prep for a healthy pregnancy
Many 30-something women are eager to get on with baby-making, and eating right can help. “Fill up on healthy foods like veggies rather than foods that cause a blood sugar spike, like high-carb and sugar-loaded items,” says gynecologist Rebecca Booth, MD, author of The Venus Week.

A carb-and-sugar diet can trigger insulin resistance, thought to be a main cause of polycystic ovarian syndrome (PCOS), an endocrine disorder and the primary infertility culprit among women of childbearing age in the United States. Symptoms include missed periods, acne, facial-hair growth, and weight gain. See your doctor if you notice these symptoms and have been trying unsuccessfully to get pregnant for more than six months.

Youre already pregnant? Congratulations! Your next move: Get a flu shot. Although many common medicines are off-limits while youre pregnant, seasonal- and swine-flu shots arent. Being pregnant puts you at greater risk of health complications from the flu, so you should receive both vaccines no matter what trimester youre in.

The shots protect your growing baby, too. New research suggests that babies who were in utero when their moms had the flu may be 20% more likely to develop heart disease as adults. If you do get the flu, you may need antiviral meds.

Ask for the HPV test
Once you hit 30, your regular gyno checkup should include an HPV test, which looks for the 13 strains of the human papillomavirus that are associated with cervical cancers. This DNA test is usually run on the same cell sample taken during your Pap smear, and insurance typically covers it. If your results are normal, you can safely wait up to three years before getting another test.

Seek help if sex hurts
The 30s are a supersexy time for many women. But 16% may see their sex lives derailed by pain in the vulvar region, a condition known as vulvodynia. A new study suggests that multiple urinary tract infections, yeast infections, or genital warts may up your risk. Vulvodynia may be linked to herpes, too, says Melissa Goist, MD, an assistant professor of obstetrics and gynecology at the Ohio State University Medical Center. The good news: A number of treatments can help, including antidepressants and topical anesthetics to block pain.

Your 40s

Fix your flow
Your periods turned into a tidal wave? The hormonal ups and downs of perimenopause—the 5 to 10 years before menopause—may cause higher volume than ever. A low-dose birth control pill or an intrauterine device (IUD) can help lighten things up, Dr. Goist says.

Your doc may also check for fibroids; up to 25% of women over age 35 have at least one. “If youre passing very large clots, experiencing pelvic pain, or having periods that last longer than seven days, its wise to get checked out,” Dr. Goist suggests. Several fixes are available.

Stay alert for STDs
With about half of first marriages ending in divorce, many women find themselves back in the dating game in their 40s. If youre one of them, take precautions. “Use condoms and get an STD screening—including tests for HPV, chlamydia, and gonorrhea—if you havent practiced safe sex,” says Donnica Moore, MD, director of Sapphire Womens Health Group.

That holds true for every year in which youre not in a monogamous relationship, according to the Centers for Disease Control and Prevention (CDC), which recently found that chlamydia infections are higher than ever in women in their early 40s.

Skip fixer-upper surgery
The vagina, like other body parts, takes a hit from pregnancy and natural aging, so getting a down-there makeover may sound appealing. But vaginal rejuvenation—surgical tightening of vaginal muscles and tissue or trimming and shaping of the labia—isnt the answer. The American College of Obstetricians and Gynecologists warns against it because of infection risks, severe pain, and altered sensation.

Want a safe way to regain a youthful look and feel? Try that old standby: Kegel exercises. Some physical therapists even specialize in teaching women how to do them. Find one at WomensHealthAPTA.org; click on “Consumers.”

Your 50s+

Get some glide
The hormonal plunge that comes with menopause can leave your vaginal tissue thin and parched—and stop you from wanting to hop in the sack. “I call it vagina Sahara,” says Lovera Wolf Miller, MD, a certified menopause practitioner in Indiana and co-author of the forthcoming book Womenopause: Stop Pausing and Start Living.

For some women a little lube does the trick (go to women-friendly Babeland.com for a great selection), while others may find relief with hormonal treatments like estrogen or testosterone. “Testosterone cream, applied vaginally, can relieve dryness and boost orgasm—and, whats more, a recent study found that it can boost a womans memory. Its worth discussing with your doctor,” Dr. Miller says.

Wash carefully
Another consequence of estrogen decline: Your vaginal pH rises, upping infection risk, especially bacterial vaginosis. BV can cause a fishy-smelling discharge and pain around the vagina. Too much soap can worsen the risks by makingyour vagina even more hospitable to bad bacteria.

You really dont need soap, but if it makes you feel cleaner Dr. Miller recommends Cetaphil cleanser (unlike soaps, it has the same pH as a healthy vagina). Also, she suggests taking 2,000 IU of vitamin D a day to help you stay infection-free: “It may have something to do with the makeup of D, which is more like a hormone than a vitamin.”

Know your surgical options
By the time you reach your 50s, youll probably know someone who has had a hysterectomy. Its the second most common surgery among American women; one in three women have had one by age 60, usually to treat abnormal bleeding, fibroids, endometriosis, gynecological cancers, pelvic pain, or a uterus thats sagging into the vagina due to weakened tissues and muscles.

If youre told you need the surgery, ask about alternatives, Dr. Miller says. In some cases, such as fibroids and bleeding, other treatments may be safer, with fewer side effects. The surgery can be done two ways—through an incision in the abdomen (the most common type) or through the vagina. But recent studies show that vaginal hysterectomy is less expensive, carries less risk of infection, and requires less recovery time.