Vagina.

Reading the word alone probably made you cringe a little. But talking about your vagina shouldn’t be awkward at all. For real, it’s the epicenter of life! Plus, every other rap song refers to “that p*ssy” in some form or another, so we shouldn’t we be more open to having a more honest, open dialogue about a body part that half the population has?

“We come from a society that has not addressed our anatomy correctly—we are not just our vaginas,” shares Director of Gynecology and Reproductive Endocrinology at NYU Langone Hospital-Brooklyn, Dr. Dorcas C. Morgan, MD. “Our vaginas are taboo because we have been raised to be embarrassed because we have one. We should speak correctly about our genitalia from early in our lives including school life. It should not only be addressed during sex-ed class.”

Many of us don’t even know all the parts our lady parts actually even consist of...so, Dr. Morgan has broken down the inner (and outer workings) as a quick refresher:

“The female genitalia encompasses the labia majora and minora—better known as the ‘lips’ of our genitalia. The opening is the introitus. It is covered by the hymen, which is disrupted during the initial coital encounter (a.k.a. losing your virginity) and the area that leads into the vagina. At the top of the vagina is the cervix. The cervix is the opening to our uterus. It dilates during labor and the fetus passes through it and then into our vagina and thereafter is expelled through the Introitus when we give birth,” she explains.

“At the top of our uterus are fallopian tubes. The sperm and egg meet there and produce an embryo, which is then transported to the uterus where it develops and grows until birth. If infected with organisms like chlamydia trachomatis, they can be damaged and cause infertility or an ectopic pregnancy. Our ovaries are organs that are attached to the uterus by ligament and have the eggs (oocytes) to create our baby. They also produce the female hormones needed for breast development. They stop working when we go through menopause.”

Beyond being integral reproductive organ, your vagina is a complex, individual masterpiece that changes as we age, just like everything else—sometimes in ways you don’t even expect!  To help you navigate, we consulted health experts to give us the lowdown on what is really going on “down there” as each year passes. See below for a decade-by-decade guide.

In Your 20s:

This is likely the first time you’ll ever make a trip to the gynecologist after “graduating” from your primary healthcare physician. “This is the best time to discuss sex, contraception use and options,” explains board-certified OB/GYN and women’s health expert, Dr. Jessica Shepherd. “You may also start to inquire how to prepare for or prevent pregnancy, and vaginal anatomy which can impact your vagina during your 20s.”

If you are sexually active or recently started taking birth control, you also might start noticing an increase in yeast infections. “Yeast infections are a common nuisance for many women, and three-quarters of women will experience one in their lifetime,” explains Dr. Shepard. [Editor’s Note: Yeast is made up of tiny organisms that grow in harmless amounts in the mouth, digestive tract, and vagina.] 

“Vaginal yeast infections are caused by a fungus called candida albicans. The key to reducing yeast in the vagina is to keep the normal pH around four or five,” adds Dr. Shepard. “Vaginal yeast begins to proliferate and cause a yeast infection when the vagina becomes less acidic, allowing yeast to thrive and multiply.” Other triggers that make young women more susceptible to infections include tight clothing, diets high in sugar, antibiotics, diabetes, stress, and heavily scented soaps or body washes.

According to author and R&D Director for Nelly De Vuyst, Manon Pilon, during your daily cleansing process “it is very important not to use any products containing sulphate, MIT or perfume as these ingredients can alter the pH and ultimately cause problems. This is why it is important to seek out a product that has been specially designed for the intimate feminine region.”

She suggests trying Cleansing Foam by Elle from Nelly de Vuyst, a vegan cleanser that’s  certified organic by COSMOS and Ecocert.

In Your 30s:

Around this timeframe, many women are considering becoming mothers or currently have children. “With vaginal childbirth our vaginas stretches to allow for delivery of our children. It returns close to its original size thereafter,” explains Dr. Morgan. Whew!

According to Dr. Shepard, the shape of the vagina can change minimally during different times of the menstrual cycle, intimate arousal, pregnancy, childbirth and in menopause.“These changes are due to hormones, however the vaginal tissue is very elastic and forgiving when stretched,” she adds.

Making the most of your OB-GYN visits is more important than ever—start by having a list of questions prepared that you would like to discuss. “Your insurance expects providers to perform a breast and pelvic exam during your annual visit,” Dr. Morgan reminds us.

“If you have pelvic pain or painful sexual intercourse, please mention it. If you desire to change your contraceptive or start a new contraceptive, open the dialog with your physician. Also ask about the HPV vaccine if you have not received it. Make that visit count for you!” she encourages.

Unfortunately, many women cite bladder leakage and change in their sexual experience post-child. “Most postpartum urinary incontinence resolves and there is no need for intervention,” elaborates Dr. Shepard. “However if it continues or gets worse over time, seeing a pelvic physical therapist can also help improve the strength of the pelvic muscles.” Brands like ICON address this by creating chic, pee-proof underwear to help you avoid unexpected leaks.  

One condition to be aware of is vaginal prolapse (more common as women advance in age) but whereby whereby certain structure such as the uterus, rectum, bladder, urethra, small bowel or the vagina itself begin to “fall out of their normal position. Anything that is out of the ordinary should be discussed with your doctor,” adds Manon.

In Your 40s & Beyond: 

According to Dr. Morgan, vaginal health in your 40s  can become “a little trickier” because as the ovaries begin to produce less of the female hormone, causing some women to experience some dryness. “Our vaginas may also become more lax. There are exercises, like kegels,  that we may do to improve these changes.”

There may be a few comedy skits about menopause, but it’s truly no laughing matter. “It is the point where our ability to reproduce is gone. We may develop symptoms like hot flashes or night sweats that are the hallmark symptoms reported by women as we transition. However, not every woman has these experiences,” she adds. 

By definition, menopause occurs when a woman has not had any menstruations during a one-year period. This usually occurs in our early 50s. Often, it can be noted that there are symptoms prior to menopause during perimenopause. Perimenopause is the period during the transition to menopause. It usually starts in a woman’s 40s but can occur earlier.

Sex is a key component for most relationships at any age—however lack of moisture can make intercourse much more uncomfortable as we age. “The decrease in estrogen physiological impacts libido, mood and cognitive function, sleep patterns and vaginal lubrication yet we often are not prepared for these changes,” explains Dr. Shepard. “There are options to help with libido and vaginal dryness such as hormone replacement therapy, bioidentical hormones, lubricant and also, vaginal rejuvenation.”

Dr. Morgan recommends starting the conversation with your partner who is willing to listen to your new needs. “See if foreplay may be increased to allow for more lubrication at any age including menopause. Over the counter lubricant may be tried. If not improved, then consider vaginal estrogen if not contraindicated for a short period of time,” she suggests.

For those looking for an over-the-counter or drugstore fix, the ingredient list is key. “It is particularly important to use a lubricant that does not contain any perfume, alcohol or silicone as these can damage the body’s microbiota and unbalance the pH in the long-run,” adds Pilon.

We know that a changing body can be frustrating, however women have to take the time to empower themselves and  take care of their reproductive organs. “They belong to us,” Dr. Morgan explains. “We share them with others. Do so discreetly.”