When you’re in your 20s and 30s you probably feel you know your vagina pretty well – after all you may be busy having periods, sex and babies. And you know the rules about douching (don’t), leaving tampons in (not for too long) and getting regular cervical smear tests.
But once we get into our 40s and older, sometimes our long-time friend can get a bit neglected. Here are some helpful tips that every woman over 40 should read, pay attention to – and share with her friends. They come from top gynaecologists in Chicago, Massachusetts and Pittsburgh.
- Not using contraception. If you don’t want to get pregnant then use reliable birth control. Just because you’re on your way to the menopause or your periods are getting lighter or less frequent, doesn’t mean that you can’t get pregnant.
If you’re having periods of any sort – heavy, occasional, light – means you could get pregnant. You’re not truly safe to stop your contraception until you’ve had a full year without periods.
Have a look at our article dedicated to birth control choices before and during the menopause.
- Not using barrier contraceptives. While we’re talking about preventing pregnancy, we also need to think about preventing disease.
You may be shocked to learn that cases of sexually transmitted infections (STIs) such as chlamydia and syphilis are rising sharply in people over the age of 40. In fact, in 2009 15% of all new HIV diagnoses were in the 50-64 age group. And that figure is still rising.
Unless you know you’re in a 100% exclusive relationship and both of you have been tested for HIV and other STIs, don’t assume ‘Not me’. Do consider ‘What if…’
If you’re in a new relationship and are nervous about asking about your partner using a condom, we hope this article will help: How to ask your sex partner to use a condom.
- Not having enough sex. Yes, really! As we get older the tissues of the vagina get thinner and drier because our oestrogen/estrogen levels are falling.
This in itself can make sex uncomfortable, but having sex actually helps to maintain some of the elasticity and moisturisation down there.
If you’re worried about discomfort then use a dedicated lubricant such as SYLK or Replens. This article talks about sex as we get older.
If you’re not sexually active for other reasons, consider masturbation using a vibrator with lubricant.
- Using talcum. Many women, like their mothers before them, use talc to feel fresh down below.
Recent scientific studies show that using talc or any powder that has talcum as an ingredient can dramatically increase your risk of ovarian cancer.
2011 scientific papers show that this risk can increase by 30% and long term use can double or triple the risk.
To feel daisy fresh without talc:
- Wear only cotton panties
- Change panties daily/as needed if more often
- Avoid tight fitting trousers/pants
- Avoid tights/pantyhose and use stockings or pantyhose with the crotch section cut out (easy to find in department stores)
- Don’t wear panties at night so that the air circulate
- Not having the correct treatment for infection. If you’re used to getting yeast infections (and most women have at least one in their lives) then an itch or odd vaginal discharge is just another one – right?
Even if you don’t get these vaginal infections, it’s easy to assume that it’s a yeast infection and treat it with over the counter preparations.
However, did you know that infections like Bacterial Vaginosis (BV) and trichomoniasis (trich) also have itching and discharge as their symptoms? Left untreated these infections can cause all sorts of problems (from pelvic inflammatory disease to making you more likely to get STIs). So if you’ve treated the problem with an over the counter drug but the symptoms are still there, see your doctor. Trich and BV are easily treated but they may need a prescription.
- Not seeing your doctor about heavy periods. There are several reasons why your periods get heavier – thyroid problems, fibroids, using a copper IUD for example – but nearing the menopause isn’t always one of them.
So if your periods are getting heavier or more frequent, you’re bleeding after sex or between periods, see your doctor to pin down the cause. Other causes include:
- Benign uterine (womb) tumours
- Hormone problems
- Uterine cancer (rare)
- Ovarian cancer (rare).
- Not doing your pelvic floor exercises. You probably did your Kegel exercise after the birth of a baby or if you’ve had previous problems with continence. However they are an ongoing exercise.
If you had problems with leaks when you cough/laugh/exercise when you were younger then it’s likely you will have them again as you get older. In fact over 40% of women in their 40s and over half of women in their 50s have some incontinence. So you’re not alone.
Your Kegel exercises will strengthen the pelvic muscles. These muscles sit like a hammock between the pubic bone (where your pubic hair is) and the tail bone, which is the base of the spine. The vagina, bowel and urethra (from the bladder) pass through these muscles and they should tighten when you cough, sneeze, laugh etc to prevent leaks.
Do them by:
- Imagine you’re going to pee.
- Squeeze the muscles tight as if you’re going to stop the flow.
- Relax the muscles.
- Repeat x 12-15 times
- Aim to do 3 sets of 12-15 each day and you’ll begin to notice a difference.
They’re easy to do in the car, in the office, standing in line at the market – anywhere. No one will know!
- Wearing a panty liner too often. Panty liners are great for helping us avoid embarrassing situations. However they can create problems of their own.
They have a plastic backing as part of their construction, but this can mean that air can’t circulate well and the area stays hot and sweaty. This can make you more prone to fungal (yeast) or bacterial infections.
Panty liners can also chaff the delicate vulval area, making it sore.
To remedy this:
- Change your cotton panties more than once a day if you need to.
- Make lifestyle changes and practice your Kegel exercises, and/or talk to your doctor about medication if you need to wear incontinence liners.
- Carry tampons/pads with you in case of bleeding/periods.
- When you use them, change the pad every 4 hours to stay fresh.
So there you have 8 tips for maintaining vagina comfort and function after age 40. It may seem like a high maintenance area of the body but it’s worth the effort if it sits quietly and doesn’t trouble you!
If you need to talk to a doctor about intimate health issues but are embarrassed, read this article for help.