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Your (Very Personal) Health at 20, 30, 40, 50

Painful Intercourse continued...

Sometimes the pain just stops by itself, says Michelle Luthringshausen, M.D., an assistant professor of ob/gyn at Northwestern University. But chronic vulval pain may signal vulvodynia, a condition that affects one in six women, estimates the National Vulvodynia Association (NVA). Experts don't know what causes vulvodynia, and while there is no cure, symptoms can be managed with topical numbing agents, anticonvulsants, and/or SSNRIs (antidepressants also used to combat pain disorders), says Christin Veasley, director of research for the NVA. Women in constant pain may benefit from a type of physical therapy that includes massage of the muscles surrounding the vagina and exercises similar to Kegels, which involve contracting and releasing the muscles used to stop urine flow. To find a therapist who specializes in women's health, go to the American Physical Therapy Association Website at apta.org/consumer.

If you can't pinpoint a physical cause, a certified sex therapist may help. "Intercourse should not be painful," says Beverly Whipple, Ph.D., a coauthor of The G Spot: And Other Discoveries About Human Sexuality. "If it is, you have to explore what's happening, both physically and psychologically. Are you aware of what you find pleasurable? Are you communicating it to your partner? A sex therapist can guide you in finding the answers." To find one in your area, go to the American Association of Sexuality Educators, Counselors and Therapists Website at aasect.org.

Incontinence

You laugh, sneeze, cough, or exercise — and you pee a little in your pants! That's stress incontinence, and nearly 30 percent of American women ages 25 to 44 experience a leak at least once a week, according to the NWHRC report. Childbirth is a top trigger because it can damage the pelvic floor muscles that support the bladder neck and urethra, so you're most likely to experience symptoms in your 20s and 30s (the average American woman has her first child at 25, but 25 percent of us don't get pregnant until our 30s or later, according to the CDC). It can take six or more months after delivery for pelvic floor muscles to regain sufficient strength for incontinence to lessen or stop. You can help speed the process by practicing Kegels. Do 10 to 25 Kegels a day in the morning while you're brushing your teeth, suggests Holly Thacker, M.D., director of the Women's Health Center at the Cleveland Clinic. "It's harder to do these exercises standing up than lying down," says Thacker, so you'll get more out of them. Also, experiment with cutting caffeine, chocolate, dairy, spicy foods, and acidic fruit — such as oranges or pineapple — from your diet. They can irritate the bladder and make incontinence worse.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) can happen at any age, but women in their 20s get them most often because they are the most likely to have multiple sexual partners, says Goist. The two most common STDs — gonorrhea (characterized by painful urination, abnormal bleeding, and vaginal discharge) and chlamydia (typically symptom-free, but it can also cause painful urination and abnormal vaginal discharge) — are treatable with antibiotics. "The key is catching and treating them in time," Goist says. "These diseases can potentially lead to pelvic inflammatory disease, an infection of the uterus and fallopian tubes that can make you infertile."

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