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

Sexually Transmitted Diseases continued...

Another common STD: human papillomavirus (HPV), a viral infection spread through genital contact. At least half of sexually active people will get HPV at some point in their lifetime, according to the CDC, and some 80 percent of women will contract it by age 50. In most cases, your body works HPV out of its system on its own, and you may never know you have it. Some of the more than 100 strains of HPV cause genital or nongenital warts, and 10 HPV strains have been linked with cervical cancer.

Your ob/gyn can detect HPV in conjunction with a Pap smear test, so be sure to have one regularly. If it's positive, you'll need to be monitored again for precancerous cervical cells. You might also want to consider Gardasil, a recently approved vaccine that protects against the four types of HPV that together cause 70 percent of cervical cancer cases and 90 percent of genital warts. Gardasil is recommended for girls and women ages 9 through 26, but some doctors will prescribe it to older women (though it's less likely to be covered by insurance in that case). No matter your age, if you're sexually active and have a new partner or multiple partners, experts recommend annual testing for STDs.

Fibroids

By age 35, up to 40 percent of all American women and 60 percent of African-American women have fibroids, small noncancerous growths in the uterine wall, according to Bill Parker, M.D., chair of ob/gyn at Saint John's Health Center in Santa Monica, CA. That number jumps to as high as 70 percent of all women and 80 percent of African-American women by age 50. Experts don't know what causes fibroids, only that they affect African-Americans more than any other racial group. And most women don't even know they have fibroids — only about 20 percent of women experience related symptoms such as abnormal or heavy periods, painful intercourse, or frequent urination (sometimes a fibroid presses against the bladder). But a fibroid can become more troublesome if it grows into the uterine cavity, which can cause infertility. "It may be that the fibroid changes the shape of the uterus or releases chemicals that prevent embryo implantation," Parker explains.

Your doctor can detect fibroids through a pelvic exam or pelvic ultrasound. Most patients don't need treatment, Parker says, but if you're experiencing heavy menstrual bleeding, birth control pills may help lessen the flow. Other possibilities include surgical removal of fibroids and/or endometrial ablation, a procedure in which cells in the uterine lining are cauterized (burned), but know that ablation usually causes infertility.

Endometriosis

About one in 10 American women have endometriosis, a condition in which uterine tissue grows on the ovaries, fallopian tubes, or near the bowel or bladder. The average age of diagnosis is 27, although the condition can appear in your teens, 30s, or 40s (after menopause prevalence drops because the wayward cells need estrogen to grow). Symptoms include severe premenstrual pain and infertility — in fact, Parker estimates one third of infertile women have endometriosis, although the link is unclear. Experts do know that taking the Pill continuously for three to nine months can eliminate periods and related pain. The progesterin in pills makes endometriosis cells shrink, but symptoms may resume once you stop taking them. For women with more severe symptoms, Parker recommends undergoing laparoscopic surgery to have problem cells removed via a small incision in the navel.

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