How to Keep Your Vagina Healthy in Your 20s, 30s, 40s, and 50s

Just as everything changes with age, your vagina does, too. While natural shifts in pelvic floor strength and vulvar skin thickness don’t occur overnight, you just might be able to be more prepared for those changes by being aware of when and what goes down.

We consulted women’s health experts and trusted resources to tell you how your vagina changes throughout your lifetime and what you can do to keep it in tip-top shape. Whether you’re 20 or 65, wondering about pubic hair or pregnancy, here’s a decade-by-decade guide with your vagina in mind.

Sex, contraception use, pregnancy, and birth are all factors that can impact your vagina during your 20s. The average age for an American woman to have their first child is 26 years old, according to the Centers for Disease Control and Prevention (CDC).

Although more and more people are waiting until their 30s to have a child, scientific literature states that, if based on optimal fertility and overall health outcomes, your 20s may be the better time to conceive. We spoke with Kara Earthman, a women’s health nurse practitioner (WHNP), to get a better understanding of the vagina during this decade.

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“The color of the vulvar skin will vary based on your unique genetics, but generally skin will be lighter in this decade than in later decades,” says Earthman. “The skin will likely not be as thick as it was in teenage years, so it may appear thinner than you remember in high school.”

Pubic hair, however, doesn’t thin. On the contrary, she says that it’s fully developed during your 20s. But of course, what you actually have down there, whether it’s a landing strip or au naturel, is totally up to you.

Prior to childbirth, the pelvic floor is at its prime. Earthman explains: “Women in their 20s have little or no issues with weak muscles for the most part,” she says. “However, the opposite may be an issue. Sometimes, pelvic floor muscles may be too tight and strong during this time, causing painful intercourse or difficulty with tampon insertion.”

Sex

How are things between the sheets during this decade? According to Earthman, your vagina generally doesn’t struggle with natural lubrication during your 20s. “The only thing that may impact this is if you’re on birth control pills, which can decrease vaginal lubrication.” She adds that sexual libido and stamina are typically at their peak now, too.

If you’ve noticed a decrease in lubrication since using birth control pills, Earthman suggests reaching out to your doctor, as switching to another brand or contraceptive option will often address the problem. She also recommends a lubricant, like Good Clean Love Almost Naked Lubricant to help with painful tampon insertion and sexual intercourse.

To protect yourself from sexually transmitted infections (STIs), keep in mind that coconut oil isn’t recommended to be used with latex condoms. If your partner uses a condom, you should also avoid petroleum-based lubricants. They’re known to damage condoms and prevent them from working properly.

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In your 20s, especially in the age of social media, it’s common to feel pressure to do something to improve your appearance. Your vagina is no exception.

“‘Honolulu Floral’ may seem like a great scent for your vagina, but this is where I see younger patients make mistakes that compromise their vaginal health,” says Earthman. “Your vagina is not meant to smell like a flower bouquet.” Instead of choosing artificially-fragranced products, she advises cleaning your vagina with warm water and unscented soap on a daily basis.

In other words, reserve that pumpkin spice-scented body wash for your pits.

Though your vagina may be physically primed for birth during your 20s, this doesn’t mean 20-somethings are actually having the most babies. For the first time ever, American women in their 30s have become the group with the highest birth rate.

On the other side of things, it’s also possible to start experiencing perimenopause, the time leading up to menopause, in your 30s.

Here’s what else you can expect:

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“Pigmentation of the vulva may change after childbirth or with age, generally getting slightly darker,” says Earthman. “Pubic hair and skin elasticity are generally the same in this decade as they were in the 20s, though skin may lose some elasticity and fat with age.”

She says that one of the most notable vaginal changes is a decrease in pelvic floor strength. Since the pelvic muscles support the bladder, uterus, and bowel, a myriad of issues like urinary incontinence (especially when you sneeze, cough, or laugh), bowel changes, a feeling of vaginal heaviness, and even prolapse (when the uterus, bladder, or bowel slips out of place) can occur when pelvic floor strength is lost with age. Vaginal birth can intensify these symptoms.

Earthman adds that if you give birth vaginally in your 30s, your vagina may take a little longer to heal than in your 20s.

Sex

Earthman tells us that there’s not much of a difference between sexual libido and stamina levels in your 20s and 30s. However, they may take a temporary back seat — possibly next to your kid’s car seat. “Libido can be tied to life circumstances, which may be more pressing in your 30s when you might be dealing with a mortgage, kids, and career,” she says. “This inability to ignore other responsibilities may make sexual libido and stamina feel like they’ve taken a hit.”

For those who are pregnant or breastfeeding, Earthman notes that the body may also enter a temporary menopause-like state, causing uncomfortable physical symptoms like vaginal dryness, which can lead to painful intercourse.

In the meantime, a lubricant, doctor-prescribed estrogen vaginal cream, or vaginal moisturizer like Replens Long-Lasting Vaginal Feminine Moisturizer, can help with vaginal dryness or discomfort during sexual activity.

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Before and after vaginal births is the prime time to double down on Kegels as a pelvic floor exercise. “Kegels, Kegels, Kegels!” emphasizes Earthman.

“Kegels and pelvic floor physical therapy before and after vaginal deliveries can train your pelvic floor muscles to contract and release more effectively, which prevents damage during delivery, assists in retraining your muscles post-birth, and decreases the chance of bladder and bowel issues, pressure, and prolapse.”

If you feel like your sex life hasn’t been as exciting (or existent) since a significant life change, Earthman advises practicing mindfulness, perhaps in the form of meditation, yoga, deep breathing, or self-care, as well as honest communication. “Openly communicating with your partner is an important part of being proactive about both your emotional and physical health.”

The North American Menopause Society says that most women experience menopause between the ages of 45 and 55, with 51 being the average. Based on this data, many will go through perimenopause in their 40s. “On average, perimenopause, which means ‘around menopause,’ lasts for four years before the complete transition into menopause, though it can be longer,” says Candice Vaden, WHNP.

Perimenopause occurs when your estrogen levels slowly and sporadically decrease — imagine a chart with many spikes that downtrend over time. As a result, life-changing symptoms such as irregular menstrual cycles, vaginal dryness, and hot flashes can occur and change your vagina.

Though menopause may be looming, some women give birth during this decade, too. Essentially, your 40s can be marked by fertility and the end of fertility.

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“Decreases in estrogen lead to decreased blood supply to the vagina and vulva, less collagen in the vulvar tissue, and changes in vaginal pH, to name a few,” says Vaden. “A woman may notice that her pubic hair is thinning, her vulva and vagina have become drier, and that her labia [appear looser] due to less fat content.” She emphasizes that these perimenopausal symptoms are very individualized — some women barely notice them while others experience them in a more pronounced manner.

Vaden says that along with previous vaginal deliveries, body weight can also impact pelvic floor strength. “Pregnancy and vaginal delivery place great strain on the pelvic floor, while increased abdominal weight also puts pressure on it.”

Coupled with decreasing estrogen levels, any of these factors can result in less pelvic floor tone, which may show up as unintentional urine leakage or vaginal prolapse. Vaden recommends keeping up with Kegel exercises and staying healthy to maintain pelvic floor strength. “Exercises like Pilates and barre, which focus on core and pelvic strength, are also great options,” she adds.

Similar to your 30s, if you do become pregnant in your 40s, Vaden adds that the vagina may take longer to heal after a vaginal delivery than before.

Sex

Here’s where two common perimenopause symptoms may affect your sex life: a decrease in vaginal lubrication, particularly during sexual arousal, and general vaginal dryness. Beyond using a lubricant to address dryness, Vaden suggests allowing plenty of time for foreplay and clitoral stimulation prior to intercourse. If vaginal dryness persists, she adds that doctors can prescribe a low-dose topical estrogen cream.

Physically, your body may not be the same as it was when you were in your 20s. In other words, it’s totally normal for sex to be accompanied by a few joint cracks. “Women in their 40s may find that aging joints and muscles are not cooperating for certain positions,” says Vaden. “I suggest people try new positions that are easier on joints and muscles, like spooning.”

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Hormonal symptoms, combined with others like hot flashes, mood changes, and sleep disturbances, can negatively impact your eagerness for physical intimacy. After all, the last thing we want to do is cuddle after waking up drenched from night sweats. But don’t worry, there are natural remedies to help with these symptoms.

But our favorite piece of advice from Vaden? “If you don’t use it, you lose it!” she says. Often, we think we need to be in our prime to have sex — but it can be the other way around. Having sex brings out our healthiest self. “As women age and estrogen levels decrease, the vagina can become less elastic, shorter, and more narrow, which in turn makes intercourse uncomfortable. This is why continuing sexual activity can help prevent changes in the size and shape of [the] vagina.”

The skin of the vulva is also likely starting to thin during this time, so watch out for harsh scrubs and be cautious with waxing, which can damage the skin. “Declining hormone levels also change the pH of the vagina, so the amount of healthy vaginal flora decreases,” says Vaden. “This sets women up to be more prone to vaginal infections and vulvar skin infections, which a probiotic supplement for vaginal health can help offset.”

Labdoor, an independent company that tests, grades, and ranks supplements based on label accuracy, product purity, efficacy, and more, reports that Culturelle Digestive Health Probiotic is the best probiotic supplement in terms of quality.

“Most women are either postmenopausal or are beginning to experience menopausal changes when they enter their 50s,” says Dr. Erin Fagot, a doctorally-prepared WHNP. “The average age of menopause in the United States is 51.”

Though menopause brings on changes, you can also feel confident knowing that you’ve already accumulated plenty of knowledge and tools to care for your vagina during the previous decades, like practicing open communication and using good ol’ lube.

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“Menopausal changes include pubic hair becoming sparse and gray,” she says. “The vulva, vagina, and cervix can also become smaller in size, more pale in color, and the skin can become thinner due to estrogen levels continuing to decrease.”

Though it’s unusual for a woman to become pregnant or give birth in their 50s, they may still cope with the physical impact of pregnancy and labor, similar to what Earthman and Vaden previously described. “Sometimes, the bladder, uterus, or bowel can prolapse or slip out of place during this time,” says Fagot. “If this occurs, women can have changes in bladder or bowel function, or a feeling of vaginal pressure.”

Medications like vaginal estrogen, pessaries, physical therapy, and surgery are options for prolapse treatment.

Sex

As estrogen levels continue to slowly drop in your 50s, you may notice even less vaginal lubrication. Over time, Fagot says the internal vaginal tissues can tear with penetration because they’ve become so thin, fragile, and poorly lubricated, which often causes vaginal pain and bleeding with sexual contact. “But as women progress through menopause, these symptoms tend to plateau and then cease,” she says.

Experiencing these disconcerting (though natural) physical changes and painful intercourse can absolutely influence your interest in getting frisky. If you’re experiencing vaginal dryness or discomfort during sex, Fagot suggests taking it slow, ramping up the foreplay even more, and continuing to rely on a lubricant.

Plus, intimacy doesn’t always have to mean intercourse. Oral sex, masturbation, rubbing the genitals together, or introducing a vibrator or sex toy into the bedroom can be just as enjoyable.

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During menopause, Fagot says that estrogen levels drop to the point where they often cause an increase in urinary tract infections (UTIs) for some women. UTIs need to be treated with an antibiotic prescription, which you can get by visiting your doctor or an urgent care clinic.

Like Earthman, Fagot emphasizes the importance of communication. “The first step in abating these symptoms is to talk with your partner,” she says. “Let them know how you are feeling, inform them of these changes, and that they are a normal part of the aging process.” She also suggests openly communicating your sexual needs and how they may have changed from previous decades, which is normal.

Though words like “decrease” and “thinning” may be used more frequently as you get older, don’t forget: Wisdom also comes with age (along with a few gray pubic hairs).

Even though your pelvic floor strength may naturally lessen over the course of your life, your knowledge of your own body will only increase, and with that the tools to support the path you’re on. No matter what decade you’re in.

English Taylor is a women’s health and wellness writer based in San Francisco. Her work has appeared in The Atlantic, Refinery29, NYLON, Apartment Therapy, LOLA, and THINX. She covers everything from tampons to taxes (and why the former should be free of the latter).