It’s no secret that sex is an important part of life. For some women, thinking about sex started early, even before puberty, and lasts well into their later years. Learn about the best ways for women to maximize their sexual health across their lifetime.

Nichole Tyson, MD an obstetrician-gynecologist and pediatric/adolescent specialist at the Kaiser Permanente Roseville Medical Center, talks to women every day about a range of sexual health concerns, ranging from HPV vaccines to sexual identity. Look insideKP Northern California sat down with Dr. Tyson to learn more about these important issues facing women throughout their lifetime. 

Describe what women — ages teens through 30s — should be thinking about when it comes to their sexual health.

First, before a woman even enters her teen years, I recommend that she complete the HPV vaccine. The earlier the better, around ages 11 or 12, but women have until their 27th birthday to complete the series.

Many women are presented with a series of risks in this age group — leaving home and having sex for the first time and exposure to drugs and alcohol. In an ideal world, women are screened for STIs regularly, have sex with a condom, obtain birth control before they have sex, and have an open dialogue with their partner about their sexual history before engaging in sexual activity.

Chlamydia is the most common STI in women under age 25 and does not present with any symptoms 75 percent of the time. This means it’s even more important to get screened regularly because chlamydia can cause long-term damage to the fallopian tubes, which can cause infertility. Women should be screened every year or when they switch partners.

I also want to drive home that the decision to have sex for the first time (and every time after) is up to each woman, not anyone else! Sexual identity and sexual preference can also be fluid or change — women should not judge themselves or others.

And what about women ages 40s through 60s?

There are many physiological and environmental issues that come up for women during this time —women often struggle to balance work and family, which leads to stress and difficulty carving out time for themselves. This often causes a decreased sex drive or decreased sexual desire. Some women in this stage of life share with me that the most intimate thing for their partner to do is put the dishes away or go to the grocery store! If a woman has children, I recommend carving out date nights and finding time to be intimate away from the kids. Also, finding time for herself to exercise or do things that make her feel healthy and happy is a great way to promote healthy sexuality.

Women go through menopause in this age range. It’s technically called menopause after a woman has gone 12 months without a menstrual period. The average age is 51 in the United States. But, menopausal symptoms can occur briefly for some, or for many years, for others. It’s a natural, biological process, but the physical symptoms, such as hot flashes, vaginal dryness, as well as emotional symptoms, such as mood changes, may disrupt a woman’s sleep, lower energy, or affect mental health. Regular, vigorous exercise is one of the most effective ways to ease these symptoms — both physically and emotionally. A discussion with their health care provider about the pros and cons of hormone therapy can be helpful at this time. We are seeing shifting of the hormone therapy pendulum as there are more benefits and fewer risks in the younger population of menopausal woman starting hormone therapy.

How about women over 65?

There is no age that a woman can’t have sex — it’s more based on overall health limitations. For women, vaginal estrogen (cream, pills, ring) makes sex more comfortable since many experience dryness or burning due to less estrogen production that thins the vaginal walls. It’s also important to have an understanding partner to work with — someone who is patient and open to trying different things in a presumably less mobile and agile stage of life.

I know some couples that have better sex when they’re 80 than when they were 30 — it’s all so individual and depends on the relationship. I also remind my patients that sexual intimacy is not always defined by penile/vaginal intercourse or orgasm. For many women of all ages, intimacy needs are often met with varying levels of sexual activity from intercourse to mutual touching to simply hugging and cuddling. 

Any closing thoughts?

There is a great interest in the arena of women’s sexual health and physicians are just now starting to expand our knowledge, expertise, and ability to counsel patients on this topic. I would love to see the media portray sexuality in a more honest and realistic way. It would also be hugely beneficial to see responsible sexual behavior portrayed in movies and popular television shows. As an ob-gyn and pediatric/adolescent specialist, I particularly enjoy helping women become more educated and empowered about their health and sexuality. Ob-gyns have a unique opportunity to help women in some of their most vulnerable and intimate times of their lives.

Read the companion piece on men’s sexual health. 

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