Evolving Wellness

Holistic, Natural, and Green Approach to Optimal Wellness

Women's Sexual Health: From Puberty to Menopause

This article is written for Evolving Wellness by Dr. Mary Jane Minkin.

My clinical experience has taught me that sexual health is really an ageless issue that is important for women of all ages to understand.

First of all, never sell yourself short – you are a valuable person, and never let anyone demean you. Self esteem is probably the most important issue for good sexual health. Never let anyone take advantage of you because you don’t have a good self image.

You should never engage in sexual activities just for the sake of engaging in sexual activities. Don’t have sex because everyone else is doing it, or the guy you’re with will leave if you don’t have sex with him. If you need sexual satisfaction, there is nothing wrong with masturbation. And if all the guy is interested in is sex, let him find someone else.

Sex in the context of a relationship is a different story. If the relationship is solid and loving, sex is likely to be a very important part of the relationship. And in that relationship, communication is extremely important. As far as the sexual activity itself, remember to tell your partner what you like, and what you don’t like; (s)he should do the same.

Remember that sex does have consequences, other than emotional ones. In the United States, half of all pregnancies are not planned. That’s a very scary and true statistic. Pregnancy is a wonderful event, too – but only when it’s planned. No pregnancy should just happen.

And who can get pregnant? Basically, most women between the ages of 12 and 50. (I have personally delivered from an 11 year old, and 3, 47 year olds – and all of those pregnancies were not planned events). So use contraception. Oral contraceptives are very reliable and safe for almost all women who are at risk for pregnancy. Speak to your health care provider about options. The website www.thepill.com is also a great site for more pill-related information. If you don’t have a health care provider, go to your nearest Planned Parenthood. And condoms are available 24 hours a day; all pharmacies stock them.

And all women are at risk for sexually transmitted diseases. Remember, every time you are having sex, you are having sex with every person your partner has ever had sex with before you. Condoms greatly reduce the risk of sexually transmitted infections. An excellent combination: condoms and an oral contraceptive.

Now to particular age related issues: early in one’s reproductive life, most of us are trying not to get pregnant. However, when the time arrives later on in your life that you are ready for a pregnancy, go for it. But remember, you want to wait till you can care for that child, emotionally and financially. But don’t wait too late. Fertility does start declining in our late 30′s – so if you are in a good spot to have a baby early in the 30′s, go for it! And although it’s not impossible to have a child in your 40′s, if you are trying and not achieving a pregnancy, speak to your health care provider sooner rather than later, to see what interventions might be appropriate to speed things up.

And remember, your activities as a younger person do have consequences later on in life. So if you have Chlamydia, a sexually transmitted infection, when you are a teenager, it can scar your Fallopian tubes permanently, and lead to tubal infertility in your 30′s. And smoking causes your ovaries to poop out 1-2 years early; so smokers deal with infertility problems comparatively earlier in life. Eat and exercise regularly; being either too thin or too heavy can significantly affect ovulation.

Of course, sexual health is important after childbearing times are over. Indeed, many women are really happy to go through menopause because they don’t have to worry about an unintended pregnancy. The major issue after menopause is vaginal dryness; but that can be remedied by safe applications of estrogen to the vagina-so no problem!

Unfortunately, many illnesses and medications can contribute to sexual health problems, so if you are experiencing sexual issues later on in life, do not hesitate to speak with your health care provider – there are usually alternatives to medications, and health problems can be worked on.

So basically, sexual health is really just good health in general – and when my friend Dr. Ruth Westheimer says there is no reason that women cannot stay sexually healthy until they are 99 years old, I always ask her, ” Why should they stop then?”

About Dr. Minkin

Mary Jane Minkin, M.D., is a clinical professor of obstetrics and gynecology at Yale University School of Medicine and has a private practice in New Haven, Connecticut.

Dr. Minkin is co-author, with Carol Wright, of “A Woman’s Guide to Menopause and Perimenopause”, “The Yale Guide to Women’s Reproductive Health” and “A Woman’s Guide to Sexual Health”, which is an update of the Yale Guide to Women’s Reproductive Health.

Dr. Minkin is lead author and co-author of articles in numerous peer-reviewed journals, and she also advises and gives lectures to the menopause support group PRIME PLUS/Red Hot Mamas.

For more information on Dr. Mary Jane Minkin or on women’s sexual health, check out obgynmenopause.com

Published Jan 14th 2009
Updated Feb 9th 2013

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