Think it’s safe to ditch your birth control after a certain age or pat on a little talc powder to feel fresh down there? These and other not-so-harmless habits can have a serious impact on the health of your lady parts.
Your vagina didn’t exactly come with an owner’s manual, but after a couple of decades of getting your period, seeing a gynecologist, having sex, and birthing kids, you pretty much know how to take care of it. You know the rules: no douching, don’t leave tampons in too long, and get regular Pap tests. But as you get older — and especially as you approach perimenopause and menopause — you may have new vaginal symptoms or issues you’re not so prepared to deal with. And seemingly harmless habits can have a big impact on everything from your sex life to your cancer risk.
Here, top ob-gyns share the most common vaginal mistakes they see among patients in their forties and older — and let you know how to take better care of your lady parts.
Playing Down Heavy Periods
Girlfriends may have warned that your periods could become heavier as you get older — but that’s not always true. As menopause approaches, your periods may come closer together or farther apart, but they shouldn’t necessarily be heavier. If your periods do become heavier, or if they’re coming way more often (like every two weeks), or you’re bleeding in between periods or after sex, let your doctor know. Heavy bleeding can be a sign of fibroids (benign uterine tumors), anemia, a hormonal issue like polycystic ovarian syndrome, or more rarely, cervical, uterine, or ovarian cancer.
Treating the Wrong Infection
As soon as they experience any itching and discharge, most women assume it’s a yeast infection and apply an over-the-counter anti-fungal cream, but that’s not always the cause. Although yeast infections are common — nearly 75 percent of women have at least one in their lifetime — they are only one of three common vaginal infections. Bacterial vaginosis (BV), caused by an overgrowth of the bacteria in the vagina, and trichomoniasis (trich), a sexually transmitted infection, are the other two.
Both vaginosis and trich can cause symptoms similar to those of yeast infections, which is why it’s so important to make sure it’s really a yeast infection. If left untreated, BV can cause pelvic inflammatory disease, and both BV and trich can make you more susceptible to sexually transmitted diseases. If you’ve had lots of yeast infections and this seems to be exactly the same, you can probably get away with treating yourself. However, if symptoms are slightly different or you’re just not sure, check with your doctor. Yeast infections, vaginosis, and trich are all easily treated. An over-the-counter or prescription anti-fungal cream or prescription pill will treat yeast; prescription antibiotics are needed for BV or trich.
Applying Talcum Powder
Patting on talcum powder (or any powders, including some baby powders, that list talc among their ingredients) to feel fresher isn’t just a harmless hygiene measure. The habit can raise your risk of invasive ovarian cancer by about 30 percent, according to new research presented at the 2011 annual meeting of the American Association for Cancer Research. Frequent, long-term use doubled or even tripled the risk. The study authors speculate that the powder could spread to the genital tract and create an inflammatory reaction. Don’t use it. There are other ways to keep dry. If you’re prone to sweating down there, wearing cotton underwear and changing them often, avoiding tight-fitting pants, and going commando at night (to give the area a chance to breathe).
Forgetting About Kegel Exercises
Maybe you attempted Kegel exercises during or after pregnancy to tighten things up, but not doing them regularly can set you up for urinary incontinence later in life. If you had incontinence then, it’s more likely to strike again when you’re older.
According to a University of Washington survey, urinary incontinence affects more than 40 percent of women in their forties and almost half of all women over age 50. The problem occurs when the muscles in the pelvic area become weaker (due to such issues as pregnancy, childbirth, menopause, or excessive weight), which can lead to urine leaks when you exercise, cough, or laugh. Kegels strengthen those weak muscles and prevent or improve symptoms. Need a refresher? Imagine you’re going to the bathroom, then squeeze as though you’re trying to stop the flow. Aim to do three sets of 12 to 15 a day.
Not Using Birth Control
If you’ve skipped a period or two and have what seem to be hot flashes, you may think you can no longer get pregnant because you’re starting to enter menopause. But you’re wrong. As long as you’re having periods of any kind, no matter how irregular they are, there is always a chance of becoming pregnant. In fact, an analysis by the Pew Research Center found that in 2008, 14 percent of births were to women age 35 and older (compared to 10 percent of births to teen moms).
More than half of all pregnancies in women over age 40 are unintended, according to the Guttmacher Institute, a sexual and reproductive health research organization. So don’t toss out birth control unless you’re okay with getting pregnant. You’re not safe until it’s been at least a year since your last menstrual period.
Skipping Barrier Contraceptives
Adults over age 40 are less likely to use condoms than younger people, according to the National Survey of Sexual Health and Behavior (NSSHB), which evaluated sexual health information collected from almost 6,000 people between the ages of 14 and 94 — and the unsafe habit is affecting their health. In 2009, people between age 50 and 64 accountedfor 15 percent of all new HIV diagnoses.
Diseases such as chlamydia and syphilis are also on the rise among people over 40, according to the latest U.S. government data. Even if you use hormonal birth control, or you’re past menopause and have no chance of getting pregnant, it’s still a good idea to use condoms every time you have sex unless you’re in a mutually monogamous relationship and you and your partner have both been tested for sexually transmitted infections.
Putting Sex on the Back Burner
According to data published last year in the Journal of Sexual Medicine, 30 percent of women in their forties and 50 percent of women in their fifties say they hadn’t had vaginal sexual intercourse in the previous year. And — surprisingly — such a dry spell could affect their health down there.
When estrogen levels drop after menopause, the tissues of the vagina tend to flatten and become thinner, which can cause painful sex, as well as itching, dryness, burning, and discomfort . But having sex regularly can help prevent symptoms by keeping the vagina moisturized and improving elasticity. If you experience vaginal dryness during intercourse, a good lubricant can make things more comfortable. For women who aren’t sexually active, consider self-stimulation with a vibrator and non-hormonal vaginal moisturizers, like Intivar, or vaginal estrogen creams, rings, or pills.
Wearing a Panty Liner Too Often
If your periods are irregular or you’re dealing with incontinence, you may wear a panty liner frequently to avoid embarrassing situations. But this can set you up for infections and irritation. The plastic backing on the panty liner prevents air from flowing through and retains heat and sweat, and wearing the same one for too long can lead to bacterial or fungal infections. Plus, the constant rubbing may cause vulvar irritation. Having a change of underwear, keeping tampons or pads on hand for unexpected periods, and managing incontinence with Kegels, lifestyle changes, or medication may reduce your reliance on panty liners. When you do use them, change your panty liner at least every four hours.
Not Seeing Your Doctor Enough
According to the most recent guidelines from the American College of Obstetricians and Gynecologists, women 30 and older who have had three consecutive, negative (meaning normal) Pap tests need only get Paps every three years. But that doesn’t mean you can skip your annual checkup. Your gynecologist still needs to see you once a year — and the clinical breast exam and bimanual pelvic exam she’ll perform can help detect serious health issues like cancer, ovarian cysts, and fibroids. It’s also a great opportunity to get advice on anything from hot flashes to birth control to your sex drive.