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

From painful intercourse (which strikes women even in their 20s) to unplanned pregnancy (which happens — surprise! — to about 40 percent of women who conceive in their 40s), a wide array of down-there concerns affect women in every decade. In fact, one third of us will be treated for a pelvic-health disorder by age 60, according to a report from the National Women's Health Resource Center (NWHRC), and experts suspect that many more of us are too embarrassed to tell our doctors about such concerns — and so suffer unnecessarily. Read on for age-coded info detailing which problems are most common in each decade, plus how to find relief.

URINARY TRACT INFECTIONS

20s 30s 40s 50s

Women in their 20s tend to have more sex — and more sexual partners — than older women, says Melissa Goist, M.D., an assistant professor of ob/gyn at the Ohio State University Medical Center. That's great — except it increases the odds that the various types of bacteria that live on skin near the vagina and rectum (yours and your partner's) will ascend into the urethra during intercourse and cause a urinary tract infection (UTI), characterized by frequent and painful urination. Twenty-somethings, compared to others, are also more likely to use condoms for contraception, according to the Centers for Disease Control and Prevention (CDC), and those that come with spermicide can mean UTI trouble. The reason: Spermicides like nonoxynol-9 can upset the normal vagina flora, creating an environment that's hospitable to bad bacteria, according to findings published in the American Journal of Epidemiology.

To help keep your urinary tract free from unwanted bacteria, urinate right after intercourse and always wipe front to back. Opt for breathable cotton underwear — synthetic materials trap heat and moisture in the vulval area, creating an ideal breeding environment for bacteria. And consider sipping two to three 8-oz cups of unsweetened cranberry juice a day: Research suggests that antioxidants called proanthocyanidins in cranberries decrease bacteria's ability to adhere to the bladder lining. No matter what you drink, stay hydrated — it means you'll pee more often and regularly flush bacteria from your urinary tract. If you suspect a UTI, see your doctor, who can treat the infection with antibiotics.

PAINFUL INTERCOURSE

20s 30s 40s 50s

Pain during sex can be felt both inside the vagina and externally on the labia, clitoris, and vaginal opening — and it can happen at any age. The causes are various, so it may take some investigation to find the culprit. For instance, antihistamines can cause vaginal dryness and pain, so if you're taking them, ask your doctor about alternatives. Dryness may also be related to perimenopause or insufficient foreplay, so try using a lubricant. Other conditions such as fibroids can also cause pain during sex, so see your doctor to identify any underlying concerns.

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.