It’s Women’s Health Week. One aspect of women’s health which is often overlooked or unmentioned is sexual and reproductive health.

From pre-puberty, to early adulthood, to decisions around childbearing or not, to menopause and beyond – a woman’s sexual and reproductive health is significant across her lifetime.

We often say that if you have a uterus, you have to learn how to manage it! So here is our lifetime guide to making sure you have great sexual and reproductive health.

Pre-teens

• Girls usually get their first period between ages 9 and 15, about two years after starting to develop breasts. Periods may be quite light and irregular at first and it can take a few years for the cycle to become regular. If regular cycles (it doesn’t matter the length, just the regularity) aren’t established by age 15 or 16, it may be worth a visit to a doctor.
• Girls (and now boys) from 9 years old can get the HPV vaccine free from their doctor, or through their school’s vaccination programme. It’s very safe and most effective when given to young women before they become sexually active. HPV (human papilloma virus) affects most people at some point in their lives without them realising. In most cases it is harmless, but it can cause cancers, including cervical cancer.

Teens/Young adults

• Teenagers may find their periods are irregular, heavy and/or painful, and might need information and advice about how to manage them.
• Teenagers may also need support and information about deciding when or if to have sex, understanding their sexual identity and sexual feelings, and staying safe and healthy.
• Some young women will choose to start having sex at around this age. If she is having sex with a male, choosing a method of contraception that suits her body and lifestyle (and possibly helps her manage her periods) will be important. LARCs (long-acting reversible contraception) are a popular option as they last between 5 and 12 years. These include IUDs and contraceptive implants.
• Taking care of her sexual health is important. Using condoms and having regular STI tests will prevent contracting STIs.
• In New Zealand, the cervical screening programme starts at age 20 and should be repeated every three years until the age of 70.  And if a woman didn’t get the HPV vaccination as a pre-teen, there’s still time to catch up. She is eligible to be part of the free programme until she’s 26 years old.

Childbearing years

• If children are on the agenda, women may switch to a shorter lasting contraceptive, such as the pill or condoms, which she can stop and start herself. She might also want to think about fertility awareness and become more familiar with her own menstrual cycle – this can improve her chances of conception. Thinking carefully about alcohol use and quitting smoking are also important before pregnancy.
• After a pregnancy, or a termination, many women prefer a “fit and forget” type of long-acting reversible contraception (LARC). These methods are also suitable for women who are breast feeding.
• If a woman has completed her family, she might consider permanent contraception, such as tubal ligation, or talk with her partner about vasectomy. Vasectomy is highly effective and not as invasive as a tubal ligation.

Menopause

• Menopause usually happens between 40 and 55 years. Every woman experiences menopause differently, and some women will have no issues at all. For many women though, the main symptoms are: hot flushes, night sweats, poor sleep pattern, vaginal dryness, painful intercourse, and itchy skin.

• Many of these symptoms can be managed and minimised. A woman can talk with her doctor or with staff at one of our clinics for advice on navigating the menopause.
• A woman can still be fertile one year after her last period, or for two years if her last period was before age 50. So, women of this age who are having sex with men may still need to think about contraception. STIs are a risk at any age, so she might want to keep a supply of condoms handy.  

Post-menopause

• Once a woman turns 70, she no longer needs to have cervical smear tests.
• It is normal and healthy to continue intimate relationships into older age. There are ways to help manage any physical impacts of ageing on sexual activity. Talk to your doctor or to Family Planning.
• Post-menopause, there is no need for contraception, which can make things more relaxed and worry-free!