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What You Need to Know About Vaginal Health at Every Age

Medically reviewed by Patricia Geraghty, RN, FNP, MSN on October 3, 2016Written by Annette McDermott

vaginal itch

As you age, your body goes through many changes. This includes your vagina. Your vagina is a soft tissue canal. Your vaginal opening is part of your vulva, which also includes your clitoris, labia, and pubic mound. Your internal vaginal canal connects your vulva to your cervix and uterus.

Throughout your life your vagina may appear and feel different. To keep your vagina healthy, it’s important to understand what’s going on “down there.”

Vaginal health in your 20s

Your 20s are some of your vagina’s best years, mainly due to a peak of the sex hormones estrogen, progesterone, and testosterone. Estrogen is responsible for keeping your vagina lubricated, elastic, and acidic.

Your vagina is surrounded by two sets of skin folds known as the inner labia and outer labia. The outer labia contain a layer of fatty tissue. In your 20s, the outer layer thins and may appear smaller.

Your libido may be on overdrive during your 20s. If you’re sexually active, especially if you have sex frequently, you may experience urinary tract infections (UTI) as bacteria travel from the vagina to the urethra. To help minimize your risk of developing a UTI, urinate as soon as possible after sex to help force bacteria out of your vagina.

Your vagina is self-cleaning. As it cleans itself, it produces a white or clear discharge. Hormonal changes during your menstrual cycle affect the amount of discharge your vagina produces. Unless you’re having symptoms such as pain during sex, itching, a foul-smelling discharge, or burning, your vagina needs little maintenance in your 20s — other than a daily washing with mild soap and water.

Vaginal health in your 30s

During your 30s, your inner labia may darken due to hormone changes. If you become pregnant, vaginal discharge may increase and appear milky. It may have a mild odor, but should not be green, yellow, or smell bad or fishy.

After giving birth, your vagina may lose some of its elasticity and stretch more than usual. Over time, most vaginas will return to almost prebirth size. Kegel exercises can help by strengthening pelvic floor muscles and restoring vaginal tone.

Oral contraceptives may cause vaginal changes such as increased vaginal discharge, vaginal dryness, and breakthrough bleeding. These symptoms often resolve on their own. If they persist, consult your doctor. You may need to try a few oral contraceptives to find one that works for you.

Vaginal health in your 40s

Thanks to perimenopause, the timespan just before you stop menstruating, your vagina goes through significant changes in your 40s. As estrogen levels in your body decrease, your vaginal walls become thinner and drier. This is known as vaginal atrophy and may cause:

  • vaginal burning
  • vaginal redness
  • painful sex
  • vaginal discharge
  • vaginal itching
  • burning during urination
  • shortening of the vaginal canal
  • increased risk of sexually transmitted diseases

Having regular sex helps slow the progression of vaginal atrophy by increasing blood flow to the vagina and keeping it elastic. Over-the-counter vaginal moisturizers or applying a vaginal estrogen cream may also help combat vaginal dryness. Vaginal estrogen is available in tablet form or as a replaceable ring as well. If you prefer the natural route, olive oil and coconut oil can help keep your vagina moisturized.

Your pubic hair may thin or turn gray during your fourth decade.

Vaginal health in your 50s and beyond

By now, you’ve probably stopped menstruating and your estrogen levels are quite low or depleted. Your vulva may appear shrunken. Vaginal atrophy is a common problem for many women in their 50s.

Low estrogen may change the acidity in your vagina. This may increase your risk of infection due to bacteria overgrowth. Low estrogen doesn’t only impact your vagina. It also impacts your urinary tract. Atrophy may occur in your urethra and lead to urine leakage, overactive bladder, and urinary frequency.

Oral or vaginal hormone therapy may help reduce the symptoms of vaginal and urinary atrophy. Even so, hormone therapy isn’t a good option for all women. Other remedies include:

  • doing bladder training exercises (biofeedback)
  • using a vaginal dilator to improve vaginal elasticity
  • eating a healthy diet
  • maintaining a healthy weight
  • reducing or eliminating caffeine from your diet
  • stopping smoking
  • doing Kegel exercises and other pelvic floor exercises
  • using vaginal lubricants
  • using vaginal moisturizers

Postmenopausal women are at risk of vaginal prolapse. Prolonged labor and vaginal childbirth are also risk factors. Vaginal prolapse occurs when all or part of the vaginal canal falls into the vaginal opening. Vaginal prolapse often involves other organs such as the bladder, rectum, and uterus.

Vaginal prolapse symptoms may include a heavy sensation in the pelvis, vaginal discomfort, and a low backache that improves when you lie down. Vaginal prolapse treatments are pelvic floor exercises, insertion of a pessary (supportive device) to hold the prolapsed area in place, or as a last resort, surgery.

The bottom line

The vagina is an amazing organ. It plays a role in sexual pleasure and is capable of bringing forth life. Still, as you age, your vagina will too. Having an aging vagina doesn’t have to be a negative experience. Some women come to love their vaginas more than ever as they age. You may feel freer during sex, thanks to the risk of pregnancy being eliminated. And because with age comes wisdom, you may also feel more comfortable in your own skin — and vagina.

You can’t prevent every effect aging has on your vagina, but you can treat it with tender loving care and keep it as healthy as possible by:

  • getting regular gynecological checkups, including a cervical screening
  • practicing responsible sex
  • regularly performing Kegel exercises at all ages
  • not using douches, scented vaginal deodorants, or vaginal cleansing products

No matter your age, consult your doctor if you have:

  • vaginal burning or pain
  • green or yellow vaginal discharge
  • thick vaginal discharge that resembles cottage cheese
  • vaginal discharge that smells bad
  • unexplained vaginal bleeding
  • painful intercourse
  • persistent vaginal itching
  • any concerns about your vaginal health
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