No matter how old you are — 21 or 34 or 47 or 55 — you should have a fun and satisfying sex life if you want it. Good partners, good self-knowledge and plenty of sex education throughout your life go a long way. But each decade also has its own challenges and issues that can get in the way of your best sexual self.
What happens in our 20s, 30s, 40s, 50s and beyond that define the kind of sex we have during that time? Although every woman’s life experience is unique, there are things most of us can’t avoid, like menopause. I spoke with Dr. Katharine O’Connell White, an assistant professor of obstetrics and gynecology at Boston University School of Medicine, about some common themes in women’s sexual health as they go from teenager to postmenopausal.
The years between the onset of puberty and settling as an independent adult in your late 20s are marked by lots of sexual exploration and experimentation. "It's the time when you figure out who you are as a sexual person. It can be exciting, but it needs to be tempered by two concerns: sexually transmitted infections and pregnancy," says White.
Indeed, the highest incidence of STIs is found in this age group, influenced by a sense of invulnerability and lower sensitivity to risk. The CDC recently reported that 2016 was the third year in a row with an increase in STI rates; specifically, rates of chlamydia, gonorrhea and syphilis increased for both men and women in the 15 to 19 and 20 to 24 age groups.
White also notes that it's never too early to learn your boundaries and how to maintain them: "Keep yourself safe and recognize how you should be treated," she advises. "Know what sexual harassment is and remember that it's not OK and not your fault."
More and more women are having children in their late 20s and early 30s, which means the parenting years can easily extend through to the late 40s. Birth control and controlling pregnancy are major concerns during this period.
"Find a method that you can easily stop once you are ready for pregnancy. You should also think about birth control in-between pregnancies," White says.
When it comes to your sex life, pregnancy, childbirth and child-rearing can also have a big influence. "Part of it is exhaustion. When you have a baby, your body is being used by someone else all day long, so it's hard to feel sexual at the end of the day," she explains. She recommends setting aside some time to connect with partners and to remind yourself that you are a sexual being, too.
And of course, just because a person is in their 30s does not mean they need to be a parent. Sex for the purpose of pleasure continues to be important throughout this decade as well — especially as you become surer of yourself and your unique sexual needs.
Few women keep having children once they hit 40, but pregnancy still remains a risk of sexual activity. "Until you've gone through menopause, you can still get pregnant. That's why once your family is complete, you should consider a long-acting or permanent form of birth control," says White.
The mythical "sexual peak" of the 40s is something some women may look forward to. White explains this is mostly due to children being older and more independent, "so you have more space to be you." But women in their 40s also have to contend with the effects of aging, and this may negatively affect their sex drive. "Accept the signs of aging on your body: stretch marks, C-section scars," she says. "Fighting aging is not conducive to feeling sexually free."
White mentions that once a woman has gone through menopause, her sex drive might increase significantly. "You get to have sex just for pleasure, and adult children leaving the nest means you get more time with your partner."
However, some women go through a period of mourning once they know they cannot have children anymore. For them, it's an emotional time that may make it difficult to engage sexually with their partner.
The CDC has reported a 20 percent increase in STI rates in the 45-plus age group, something aging women should keep in mind as well.
"Although some consequences of STIs, like infertility, are not an issue past menopause, they are still a major concern," says White. Other health conditions like diabetes, arthritis and heart disease may also interfere with sexual activity. "Speaking with your doctor about these conditions is the best way to maintain your overall and sexual health," she advises.
A common complaint of postmenopausal women is vaginal dryness. "Vaginas are 'use it or lose it.' The less you have sex, the more painful it will be," White explains. She recommends engaging in regular sexual activity to stay healthy and pain-free.
The course of our sexual lives is marked by major changes in our bodies: puberty, pregnancy, child-rearing and menopause. The key to a healthy sex life across the decades is to understand these changes and how they can influence our sexual health. Knowledge and compassion for yourself and your aging body are the keys to great sex for as long as you want it.
A version of this article was originally published in January 2018.
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