Better Sex Now: The Age-by-Age Guide to Sexual Health

Laura Doss/Fitness MagazineLaura Doss/Fitness MagazineBy Ginny Graves

A healthier, more satisfying sex life -- at any age -- isn't that what we all want? Here, a guide you can start using tonight.

Related: The Age-by-Age Guide to Fertility and Birth Control

What You Need to Know About Your Sexual Health

In your 20s: Your risk of STDs is at an all-time high. Almost half of sexually transmitted diseases occur in people 24 and younger, according to the Centers for Disease Control and Prevention. "Young people tend to have more sexual partners, which exposes them to more bugs," says Hilda Hutcherson, MD, an assistant professor of obstetrics and gynecology at Columbia University Medical Center and author of Pleasure: A Woman's Guide to Getting the Sex You Want, Need, and Deserve. In your 20s, the cells of your outer cervix are more fragile and susceptible to infection. The two STDs you should be most concerned about: chlamydia and human papillomavirus (HPV). If left untreated, chlamydia can scar your fallopian tubes, causing infertility -- and 75 percent of the time, the disease has no symptoms. Ask your doctor to test you annually. "If you test positive, your partner needs to be screened too, or you'll be reinfected the next time you have unprotected sex," says Sarah de la Torre, MD, an obstetrician and gynecologist in Seattle. Treatment consists of a round of antibiotics and a follow-up test three months later.

Get the HPV vaccine, but don't ditch your Pap. And keep using condoms to protect against the virus. The vaccine, given as three shots over six months, is the most significant sexual- health advance in years, but it protects against only 70 percent of all HPV strains that can lead to cervical cancer.

In your 30s: Pay attention to new symptoms. Heavy periods and pain during sex, for instance, can be signs of uterine fibroids, usually benign tumors that affect approximately two in five women in their 30s that can increase the risk of miscarriage. Experts say that fibroids are also the most common reason premenopausal women have hysterectomies -- a drastic, often unnecessary step. "If the fibroids are small, oral contraceptives may alleviate symptoms of pain and bleeding," says Dr. Hutcherson. If they're large, you may need a myomectomy, a surgical procedure that removes the tumors without taking out the healthy tissue in your uterus, or a uterine fibroid embolization (UAE), a treatment that shrinks fibroids by cutting off their blood supply.

Related: The 10 Health Benefits of Having Sex

In your 40s: Don't put up with hormonal havoc. Many women assume that they just have to ride out symptoms of perimenopause, such as vaginal dryness and urinary incontinence caused by fluctuating estrogen levels, but there a lot you can do to feel better, says Suzanne Trupin, MD, a clinical professor of obstetrics and gynecology at the University of Illinois College of Medicine in Champaign. For dryness, try a water-based lubricant or an estrogen cream, which is safer than taking the hormone orally since you apply it directly to a small area. And make love often. "Research suggests that women who have sex frequently lubricate more easily," says Sandra Leiblum, PhD, director of the Center for Sexual and Relationship Health at the Robert Wood Johnson Medical School in Piscataway, New Jersey, and author of Getting the Sex You Want: A Woman's Guide to Becoming Proud, Passionate, and Pleased in Bed. Try Kegels (exercises in which you tighten and release the vaginal muscles) to help with leakage issues. (Go to kegel-exercises.com for details.) If those don't help, ask your doctor about biofeedback, says Dr. Hutcherson.

What You Need to Know to Have the Best Sex Ever

In your 20s: Tell him what you want. A recent study of college students found that couples who talked about their sexual likes and dislikes had happier relationships and more satisfying sex. "The key to sexual pleasure is knowing what you want and saying it," says Valerie Davis Raskin, MD, a psychiatrist in Chicago and author of Great Sex for Moms.

In your 30s: Exercise. Pregnancy and childbirth do a real number on your body, mind, and libido. In a study of first-time parents, over half of the women surveyed said that their changed body image affected their sex life. Another study found that women who worked out regularly during pregnancy were more satisfied with their bodies. "Feeling fit, strong, and flexible helps takes the focus off whether you're back to your pre-pregnancy shape," says Dr. Raskin. (See "Why Fit Women Have Better Sex," below, for more of the sexual perks of staying fit.)

Related: 9 Sex Positions That Double as Exercise

In your 40s: Kissing is key. Finally, science proves our need for foreplay! The idea that you become aroused first, then seek out sex is based on -- surprise, surprise -- studies of men. For women, the latest research shows that many of us don't feel in the mood until after we start kissing and caressing.

Make time to unwind. Stress plays a big role in that not-tonight feeling. "Women in their 40s are often squeezed by the demands of kids, career, and aging parents," says Dr. Hutcherson. "And it can have a major impact in the bedroom." Anything that helps you relax -- exercise, yoga, meditation, leisurely baths, funny movies -- helps keep your libido strong.

Why Fit Women Have Better Sex

Can't get motivated to work out? Try thinking about all the great sex you'll have afterward! Research has shown that regular exercise plays a more important role in sexual satisfaction than many other factors, including testosterone levels, stress, or even the quality of your relationship. Basically, the more you work out, the happier you are sexually. Likewise, Finnish researchers recently found that 42- to 46-year-old women who work out strenuously have more orgasms than those who don't. Here's why:

  • Increased blood flow to the vagina. "The better the circulation is down there, the more easily you become aroused physically and the more intense the orgasm you'll have," says Dr. Hutcherson. And we found proof: In one study, women with low libidos who did 20 minutes of fairly intense cardiovascular exercise (such as fast jogging or taking a step or Spinning class) before watching an erotic video became more aroused than when they watched the film without exercising first.
  • Stress relief. Anxiety makes you tense, which inhibits arousal physically and emotionally, says Dr. Trupin.
  • Body confidence. "Women who feel better about their bodies enjoy sex more because they're less anxious in bed," says Dr. Trupin. And in general, women who exercise regularly tend to feel better about their bodies than those who don't.
  • Increased endurance. Sex is exercise, so the fitter you are, the more energy you'll have to, um, go the extra mile.
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