Your (Very Personal) Health at 20, 30, 40, 50 - Page 2

INCONTINENCE

20s 30s 40s 50s

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

20s 30s 40s 50s

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."

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

20s 30s 40s 50s

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.