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A Healthy Vagina At All Ages

Medically reviewed by Susan Kerrigan, MD, Karyn Eilber, MD and Marianne Madsen on January 2, 2023

It’s a cliche, but, nevertheless, it’s true. Nothing stays the same. That is especially true when it comes to our bodies. Many of our inner and outer parts will change throughout our lifetime, some more dramatically than others. For women, some of the most significant changes occur in their vaginal area. From puberty through pregnancy and on to menopause, a woman’s vagina will change as her body matures. Any woman must know what is required to maintain a healthy vagina at each stage of her life.


Your 20s


For many people, their 20s are the best years of their lives. People are typically starting new careers, moving to new places, and meeting a lot of new people. They are also among the best years for your vagina. During your 20s, your sex hormones, including estrogen, are usually at their peak. Estrogen is the hormone that helps maintain the elasticity of your vagina and keeps it well lubricated.


It’s not only your sex hormones that are in an elevated state. Your libido is also typically higher during this period in your life, meaning that many women want to have  sex more frequently. This means that there is a high chance of contracting urinary tract infections (UTIs), a common occurrence related to sexual activities. Although definitive data is lacking, urinating as soon as possible after sex may prevent UTIs.  This is also a time of increased risk of sexually transmitted disease so use of condoms is recommended. Keep in mind that lubricated condoms often contain chemicals that can be irritating to the vagina. 


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Sexually Transmitted Infections - Overview

Sexually Transmitted Infections - Overview

Thankfully, your 20s are most likely the time when your vagina needs the least amount of maintenance. During this time in your life, you shouldn’t need to do more than wash your genital area with mild soap and water. Douching is not necessary nor is it recommended. The vagina typically cleans itself by producing a white or clear discharge–this is completely normal. This discharge should be odorless and painless. If it smells bad or is painful or itchy, that could be a sign of bacterial vaginosis, vaginal yeast infection, or a sexually transmitted disease, so it’s time to see a doctor.  


Your 30s


Many women decide to start a family during their 30s. Often after childbirth, your vagina will lose some of its elasticity due to the stretching and tearing of the muscles and connective tissue of the pelvis. While many women return to how they were before pregnancy, you may need to do some Kegel exercises to strengthen your pelvic floor muscles. Kegel exercises can help by strengthening pelvic floor muscles and restoring vaginal tone. 


Your 40s


As you reach your 40s and begin to approach menopause, your vagina goes through several significant changes. The estrogen levels that were keeping your vagina lubricated begin to decrease, which often leads to vaginal dryness and atrophy and a thinning of the vagina’s walls. Your doctor may suggest several treatment options. If estrogen loss is causing the problem, you may want to try some estrogen therapy which can be in the form of vaginal suppositories, creams, or time-release intravaginal rings. There are also lots of lubricants and moisturizers out there to combat dryness, but be careful of some that contain certain chemicals that may cause irritation. Check with your doctor–or your friends–to see what they recommend, and try different choices until you find something that works for you.


Another option is to make sure you continue to have regular sex throughout your 40s. This may slow the effects of vaginal atrophy by increasing blood flow to the area and maintaining your vagina’s elasticity.


Your 50s, Menopause, and Post-Menopause


With menopause, your estrogen levels become even lower, raising the chances of vaginal atrophy. Hormone therapy, moisturizers, and pelvic floor exercises may help to reduce the symptoms of atrophy.


Next Video >>

Menopause - Hormone Replacement Therapy Symptom Relief

Menopause - Hormone Replacement Therapy Symptom Relief

With estrogen levels falling, the pH of your vagina increases. This changes the balance of the microbiome  in the vagina and may lead to an increased risk of infections. If this is a continual battle for you, consider using vaginal estrogen or boric acid  to minimize the risk of vaginal infections.


As early as your 40’s and beyond, you may also experience vaginal prolapse where the pelvic organs either partially or fully fall into the vaginal canal. Urinary incontinence, or involuntary loss of urine, is also very common. While Kegel exercises can help reduce some of the symptoms of vaginal prolapse, and incontinence, you may need to use a device called a pessary to support the prolapsed area or urethra. In many cases, surgery  is the best option.


Caring for your vagina is an intensely personal but necessary experience. As you age, you will gain a greater understanding of what your vagina needs in the way of care and attention. At any age, regularly exercising your pelvic floor, having responsible sex, and making sure you have regular gynecological check-ups will ensure your vagina stays happy and healthy throughout your life.

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