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" From painful intercourse (which strikes women even in their 20s) to unplanned pregnancy (which happens \u2014 surprise! \u2014 to about 40 percent of women who conceive in their 40s), a wide array of down-there concerns affect women in every decade. In fact, one third of us will be treated for a pelvic-health disorder by age 60, according to a report from the National Women&amp;#039;s Health Resource Center (NWHRC), and experts suspect that many more of us are too embarrassed to tell our doctors about such concerns \u2014 and so suffer unnecessarily. Read on for age-coded info detailing which problems are most common in each decade, plus how to find relief. Urinary tract infections 20s 30s 40s 50s Women in their 20s tend to have more sex \u2014 and more sexual partners \u2014 than older women, says Melissa Goist, M.D., an assistant professor of ob/gyn at the Ohio State University Medical Center. That&amp;#039;s great \u2014 except it increases the odds that the various types of bacteria that live on skin near the vagina and rectum (yours and your partner&amp;#039;s) will ascend into the urethra during intercourse and cause a urinary tract infection (UTI), characterized by frequent and painful urination. Twenty-somethings, compared to others, are also more likely to use condoms for contraception, according to the Centers for Disease Control and Prevention (CDC), and those that come with spermicide can mean UTI trouble. The reason: Spermicides like nonoxynol-9 can upset the normal vagina flora, creating an environment that&amp;#039;s hospitable to bad bacteria, according to findings published in the American Journal of Epidemiology. To help keep your urinary tract free from unwanted bacteria, urinate right after intercourse and always wipe front to back. Opt for breathable cotton underwear \u2014 synthetic materials trap heat and moisture in the vulval area, creating an ideal breeding environment for bacteria. And consider sipping two to three 8-oz cups of unsweetened cranberry juice a day: Research suggests that antioxidants called proanthocyanidins in cranberries decrease bacteria&amp;#039;s ability to adhere to the bladder lining. No matter what you drink, stay hydrated \u2014 it means you&amp;#039;ll pee more often and regularly flush bacteria from your urinary tract. If you suspect a UTI, see your doctor, who can treat the infection with antibiotics. Painful intercourse 20s 30s 40s 50s Pain during sex can be felt both inside the vagina and externally on the labia, clitoris, and vaginal opening \u2014 and it can happen at any age. The causes are various, so it may take some investigation to find the culprit. For instance, antihistamines can cause vaginal dryness and pain, so if you&amp;#039;re taking them, ask your doctor about alternatives. Dryness may also be related to perimenopause or insufficient foreplay, so try using a lubricant. Other conditions such as fibroids can also cause pain during sex, so see your doctor to identify any underlying concerns. Sometimes the pain just stops by itself, says Michelle Luthringshausen, M.D., an assistant professor of ob/gyn at Northwestern University. But chronic vulval pain may signal vulvodynia, a condition that affects one in six women, estimates the National Vulvodynia Association (NVA). Experts don&amp;#039;t know what causes vulvodynia, and while there is no cure, symptoms can be managed with topical numbing agents, anticonvulsants, and/or SSNRIs (antidepressants also used to combat pain disorders), says Christin Veasley, director of research for the NVA. Women in constant pain may benefit from a type of physical therapy that includes massage of the muscles surrounding the vagina and exercises similar to Kegels, which involve contracting and releasing the muscles used to stop urine flow. To find a therapist who specializes in women&amp;#039;s health, go to the American Physical Therapy Association website at apta.org/consumer. If you can&amp;#039;t pinpoint a physical cause, a certified sex therapist may help. &amp;quot;Intercourse should not be painful,&amp;quot; says Beverly Whipple, Ph.D., a coauthor of The G Spot: And Other Discoveries About Human Sexuality. &amp;quot;If it is, you have to explore what&amp;#039;s happening, both physically and psychologically. Are you aware of what you find pleasurable? Are you communicating it to your partner? A sex therapist can guide you in finding the answers.&amp;quot; To find one in your area, go to the American Association of Sexuality Educators, Counselors and Therapists Website at aasect.org. Incontinence 20s 30s 40s 50s You laugh, sneeze, cough, or exercise \u2014 and you pee a little in your pants! That&amp;#039;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&amp;#039;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&amp;#039;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&amp;#039;re brushing your teeth, suggests Holly Thacker, M.D., director of the Women&amp;#039;s Health Center at the Cleveland Clinic. &amp;quot;It&amp;#039;s harder to do these exercises standing up than lying down,&amp;quot; says Thacker, so you&amp;#039;ll get more out of them. Also, experiment with cutting caffeine, chocolate, dairy, spicy foods, and acidic fruit \u2014 such as oranges or pineapple \u2014 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 \u2014 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) \u2014 are treatable with antibiotics. &amp;quot;The key is catching and treating them in time,&amp;quot; Goist says. &amp;quot;These diseases can potentially lead to pelvic inflammatory disease, an infection of the uterus and fallopian tubes that can make you infertile.&amp;quot; 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&amp;#039;s positive, you&amp;#039;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&amp;#039;s less likely to be covered by insurance in that case). No matter your age, if you&amp;#039;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&amp;#039;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&amp;#039;t know what causes fibroids, only that they affect African-Americans more than any other racial group. And most women don&amp;#039;t even know they have fibroids \u2014 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. &amp;quot;It may be that the fibroid changes the shape of the uterus or releases chemicals that prevent embryo implantation,&amp;quot; Parker explains. Your doctor can detect fibroids through a pelvic exam or pelvic ultrasound. Most patients don&amp;#039;t need treatment, Parker says, but if you&amp;#039;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. Endometriosis 20s 30s 40s 50s About one in 10 American women have endometriosis, a condition in which uterine tissue grows on the ovaries, fallopian tubes, or near the bowel or bladder. The average age of diagnosis is 27, although the condition can appear in your teens, 30s, or 40s (after menopause prevalence drops because the wayward cells need estrogen to grow). Symptoms include severe premenstrual pain and infertility \u2014 in fact, Parker estimates one third of infertile women have endometriosis, although the link is unclear. Experts do know that taking the Pill continuously for three to nine months can eliminate periods and related pain. The progesterin in pills makes endometriosis cells shrink, but symptoms may resume once you stop taking them. For women with more severe symptoms, Parker recommends undergoing laparoscopic surgery to have problem cells removed via a small incision in the navel. Perimenopause 20s 30s 40s 50s This transition period into menopause can last up to 10 years as estrogen and progesterone levels shift. While the average age of onset is between 47 and 52, perimenopause can start as early as 35 (this is more likely if your mom experienced early menopause or if you have certain health conditions such as heart disease). Signs include hot flashes, low libido, mood swings, and erratic periods. Let&amp;#039;s face it: Perimenopause is no fun \u2014 but you can get relief. Taking the Pill can lessen hot flashes and night sweats and reduce menstrual irregularities. Another reason to use birth control: Four in 10 pregnancies among women in their 40s are unplanned, according to the Guttmacher Institute. Remember, if you are still ovulating, you can have a baby \u2014 no matter how wacky your periods are. Lifestyle changes can also help ease perimenopause symptoms. Getting at least 30 minutes of exercise on most days has been shown to help relieve night sweats and anxiety. Thacker also advises eating fish, walnuts, and other foods rich in mood-lifting omega-3 fatty acids. And to increase desire, &amp;quot;don&amp;#039;t focus on the genitals,&amp;quot; suggests Whipple. Instead, enjoy other sensual experiences with your partner: Feed each other forkfuls of dessert or watch a provocative film. &amp;quot;Your desire has a good chance of naturally returning when your focus is elsewhere,&amp;quot; she says. Yeast infections 20s 30s 40s 50s Vaginal yeast infections are common to women of all ages; about 75 percent of us will experience some of the telltale signs \u2014 itching, excess discharge, and painful urination \u2014 at least once during our lifetime. They&amp;#039;re caused by an overgrowth of the yeast that occur naturally in the vagina, and many factors can contribute, including stress, lack of sleep, taking the Pill or antibiotics, or pregnancy. If you suspect you have a yeast infection, an over-the-counter (OTC) antifungal treatment such as Monistat may be all you need. But OTC treatments may not be properly formulated to treat the types of yeast causing your symptoms. What&amp;#039;s more, two thirds of women purchasing these products don&amp;#039;t have a yeast infection at all, according to the CDC: Yeast infections can be hard to distinguish from bacterial infections such as bacterial vaginosis (see below). Before self-treating, try taking an at-home vaginal-infection test like the Vagisil Screening Kit (vagisilkit.com) \u2014 results could suggest bacterial infections and the need for prescription antibiotics. If the test indicates yeast infection and an OTC treatment doesn&amp;#039;t clear your symptoms within a week, or if you have repeat infections, see your doctor. Bacterial vaginosis 20s 30s 40s 50s The most common vaginal condition in women of childbearing age, bacterial vaginosis (BV) occurs when there&amp;#039;s an overgrowth of &amp;quot;bad&amp;quot; bacteria found normally in the vagina. Symptoms are similar to those of a yeast infection, though typically milder. While researchers aren&amp;#039;t sure what causes the bacterial imbalance that leads to BV, they do know it tends to happen to women in their 20s and 30s who are very sexually active or who have a new sexual partner or multiple partners. Douching can also disrupt bacterial balance, so don&amp;#039;t do it, says Thacker. If you suspect you have BV, see your doctor for antibiotics. Left untreated, the bacteria can increase your susceptibility to STDs or UTIs, or cause complications if you&amp;#039;re pregnant.  Menstrual irregularities 20s 30s 40s 50s Infrequent periods or irregular bleeding may signal polycystic ovarian syndrome (PCOS), a condition linked with high levels of androgens (hormones) that affects one in 10 women in their reproductive years and is usually diagnosed in women in their 20s and 30s. Other signs include ovarian cysts, obesity, and facial-hair growth, and it&amp;#039;s the most common cause of female infertility. While PCOS can&amp;#039;t be cured, it can be treated, so see your doctor, who will run a series of tests (a physical exam, blood tests, and an ultrasound) to confirm the diagnosis. She may prescribe the Pill to help regulate your cycle and androgen levels. Maintaining a healthy weight is also key, since fat tissue elevates hormone levels. If you are trying to conceive, fertility drugs can help normalize ovulation. For women age 40 or older, irregular or heavy bleeding may signal a polyp, a usually benign uterine growth that commonly occurs in women in their 40s and 50s (experts don&amp;#039;t know why). If symptoms are disrupting your life, polyps can be surgically removed. Another source of period upset for the 40s set: thyroid problems. The thyroid gland powers brain regions that help regulate the ovaries. Once you hit 40, get a thyroid test every five years, since thyroid function naturally decreases with age, says Goist. Meds are available to treat an underactive or overactive thyroid. Ovarian cancer 20s 30s 40s 50s Though it&amp;#039;s more common among women who are 50 and older, ovarian cancer can strike in your 40s (or, rarely, even earlier). Symptoms are subtle \u2014 in fact, until recently doctors believed there were none \u2014 but the American Cancer Society (ACS) now identifies the following as possible warning signs: bloat, pelvic or abdominal pain, difficulty eating or feeling full quickly, and frequent urination. If you have these symptoms daily for at least three weeks, talk to your doctor \u2014 but don&amp;#039;t panic. &amp;quot;Just because they&amp;#039;re present doesn&amp;#039;t mean you have ovarian cancer,&amp;quot; says J. Leonard Lichtenfeld, M.D., deputy chief medical officer of the ACS. &amp;quot;But play it safe and get checked out.&amp;quot; Diagnosis involves an exam and/or an ultrasound, and treatment typically begins with removing the ovary and testing lymph nodes to see if the cancer has spread. Ovarian cancer is relatively rare \u2014 an estimated 22,430 new cases will be diagnosed in the United States this year \u2014 but your risk is higher if you have a close relative with ovarian or breast cancer. If so, you may wish to get tested for a mutation of the BRCA1 and BRCA2 genes: Women with a BRCA gene mutation have about a 27 percent to 44 percent lifetime risk of developing ovarian cancer, compared with a less than 2 percent risk for the general population. If you carry a BRCA gene mutation, a cancer specialist can help you decide if preventive measures such as birth control pills or hysterectomy are right for you. All women who have taken the Pill, had multiple pregnancies, and breast-fed are at less risk of the disease, says Linda Duska, M.D., a gynecologic oncologist at Massachusetts General Hospital. &amp;quot;These women ovulate less in their lifetime, and we suspect that the more you ovulate, the more likely your ovary is to be disrupted.&amp;quot; For more info, go to the National Ovarian Counsel Coalition website at ovarian.org. Pelvic prolapse 20s 30s 40s 50s Though more common among older women, pelvic prolapse \u2014 a condition in which weakened pelvic floor muscles allow the bladder, uterus, and/or rectum to drop to or even through the vagina \u2014 can occur in women in their 40s. Risk factors include obesity, pregnancy, and \u2014 possibly \u2014 being blonde: Fairer women may experience pelvic prolapse more often, likely because their collagen, a protein that helps form the connective tissue that strengthens internal organs, is less resilient, says Thacker. If you&amp;#039;re pregnant, over 40, and have other risk factors for pelvic prolapse, talk to your ob/gyn about delivering by cesarean section, says Emily Lukacz, M.D., a specialist in pelvic floor disorders at the University of California San Diego Medical Center. If you do experience prolapse, it can interfere with urination, bowel movements, or sexual activity, so tell your doctor. It can be treated with a pessary, a plastic device inserted into the vagina to push up organs and hold them in place. Surgery can also be performed to reinforce pelvic floor muscles and relocate shifted organs. If the uterus seems likely to drop again, says Thacker, hysterectomy may be the best solution. No matter what your private health woe, keep in mind that statistics about age and rates of occurrence for all pelvic health conditions are only averages, so be vigilant about regular checkups and see your doctor anytime you sense there&amp;#039;s a problem down there. 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