50 Shades of Sex In the Golden Years

So many seniors think that after sixty sexual intimacy goes into the tank. This is hardly the case as an interest in intimacy and sexual activity continues throughout life even in the golden years. Our society tends to have ageist concept of intimacy, portraying sex among seniors as inappropriate or unnatural. The truth is that many seniors, both men and women, continue to be sexually active and are interested in meeting others with whom they can become intimate. There is documentation that 70% of men and 35% of women continue to be sexually active over the age of 70. This blog will discuss sex and the senior and what you can do if you are having problems with sexual intimacy in your senior years.

While most long-married individuals reported steady declines in sexual activity, those who passed the 50-year marriage mark began to report a slight increase in their sex lives.

And notably, frequency in the sex lives of long-married couples continued to improve. The study, published last month in The Archives of Sexual Behavior, researchers noted that an individual married for 50 years will have somewhat less sex than an individual married for 65 years.

The analysis of this study showed that the warm glow after the 50-year marriage mark, although flickering, was steadier than that of those in marriages of shorter duration. The researchers are sociologists at Louisiana State University, Florida State University and Baylor University.

Sexual frequency doesn’t return to two to three times a month, but it moves in that direction, which was reported by the investigator from LSU.

But the finding that some long-married couples continue to have sex decade after decade was not news to Jennie B., an 82-year-old widow who lives in a village in upstate New York. She married her first and only husband, Peter, in 1956, when they were in their mid-twenties. The couple, married 47 years, remained sexually active until he had quintuple heart bypass surgery two years before his death in 2003.

In this snapshot study of older adults, some were not having sex at all. And a few were even having sex daily. But in the main, the study looked at trends. The average older adult who had been married for a year had a 65 percent chance of having sex two to three times a month or more. At 25 years of marriage, the likelihood of that frequency dropped to 40 percent. If the marriage lasted 50 years, the likelihood was 35 percent. But if the marriage — and the lifespan — of the older adults continued, at 65 years of being together, the chance of having sex with that frequency was 42 percent.

And so, as adults age, their social circles shrink, they know time is limited, they look around and what do they see? Each other. Seniors will often place intimacy as a high priority.

I might add that seniors often engage in intimacy without having intercourse but that intimacy can occur with touching, holding hands and kissing is often just as satisfying and gratifying as sexual intercourse which occurs at an earlier age.

Bottom Line: Sex after sixty is an activity that is normal and should be encouraged. It may take a little creativity and it may take a little more planning and effort but it can happen and both partners feel a sense of enjoyment and pleasure.

Recommended Reading 30 Lessons for Loving, by Karl Pillemer, PhD.

Perhaps even 50 Shades of Grey!

Your Age And Your Vagina

Aging takes its toll on my organs and systems in the body. No one can ever entirely escape the affects of aging. No one can ever completely turn back the biologic clock. But we can conduct ourselves with good nutrition, exercise, and good lifestyle behaviors.

As we all get older, many things change and we often have to make allowances for them. Take our skin, for example. We use creams and moisturizers to combat aging and sagging of our skin as we enter middle age. And, just like our skin, it’s important to remember things internally like our joints, bones, and even vaginal tissue can also change with age.

As a woman enters menopause, vaginal changes may occur. The vagina can become shorter and narrower. And, as a woman’s estrogen levels start to naturally decline with age, the vaginal tissue can become less of a soft cushion for an erect penis to land. This allows more potential for increased friction, and intercourse can become quite painful for some women who have estrogen changes in the vagina.

In your fertile years, estrogen plays a key role in the development of your reproductive cycle and—among other things—helps keep your vagina healthy, i.e., soft, pliable, and accommodating to an erect penis. As a woman approaches menopause, her hormone levels start to plummet. Once menopause occurs, a woman’s estrogen production really starts to decline and can cause her vaginal tissue to change.

A new drug, Osphena® (ospemifene) works like estrogen in the lining of the uterus, but can work differently in other parts of the body.

Taking estrogen alone or Osphena® may increase your chance for getting cancer of the lining of the uterus, strokes, and blood clots. Vaginal bleeding after menopause may be a warning sign of cancer of the lining of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause, so tell them right away if this happens while you are using Osphena®.
You and your healthcare provider should talk regularly about whether you still need treatment with Osphena®.

Possible Side Effects
Serious but less common side effects can include stroke, blood clots, and cancer of the lining of the uterus.
Common side effects can include hot flashes, vaginal discharge, muscle spasms and increased sweating.

Bottom Line: The side effects of menopause are vaginal dryness and often painful sexual intimacy. Help is available. Women who experience these problems can be helped with topical and oral medications.

Menopause Doesn’t Mean Goodbye To Sex

The loss of estrogen and testosterone following menopause can lead to changes in a woman’s sexual drive and functioning. Menopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and foreplay — which can result in decreased interest in sex.
In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to become dry and cause painful intercourse.
A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman’s interest in sexual activity during menopause and after. These include:
Bladder control problems (incontinence)
Sleep disturbances
Depression or anxiety
Stress
Medications
Health concerns
Some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly. Do not use non-water soluble lubricants such as Vaseline, because they can weaken latex (the material used to make condoms, which should continue to be used until your doctor verifies you are no longer ovulating and to prevent contracting sexually transmitted diseases). Non-water soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy or in women who are prone to recurrent urinary tract infections.
Vaginal moisturizers like Replens and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy.
A oral drug taken once a day, Osphena, makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.
Estrogen replacement may help raise the sex drive after menopause which is associated with a decrease in estrogen. Estrogen can also make intercourse less painful by treating vaginal dryness.
Doctors are also studying whether a combination of estrogen and male hormones called androgens may be helpful in increasing sex drive in women.
Bottom Line: Sexual desire and enjoyment from sexual intimacy can be preserved after menopause. It may dry the vaginal lining but it doesn’t have to dry up the desire to be sexually intimate with your partner.

Progesterone May Be a Cause of VD-Vaginal Dryness!

Vaginal dryness is troublesome condition with many causes.  Vaginal dryness can lead to itching, burning and even painful intercourse.  However, one of the most common causes of vaginal dryness is the use of progesterone in either oral or vaginal suppositories.

Progesterone is a naturally occurring hormone that regulates ovulation and menstruation in women. Progesterone can also be used to regulate the menstrual cycle in women who have too little progesterone to cycle on their own. As with any medication, progesterone vaginal suppositories have the risk of side effects.

Other side effects of progesterone include mild nausea, vomiting, bloating, abdominal cramps, diarrhea, constipation, dizziness, drowsiness and fatigue. Other more bothersome side effects may include pain in the vaginal or rectal area or pain during sex. Some women may experience a reduction in libido. Some women will experience pain, swelling or tenderness in the breasts. Other discomforts can include joint or muscle pain and an increase in urination at night. The suppository itself can cause mild vaginal itching, burning or discharge, according to Drugs.com.

In additional to vaginal dryness possible serious side effects include a sudden headache accompanied by numbness or weakness that occurs on one or both sides of the body. These more serious effects paired with shortness of breath, vision problems, speech problems or loss of balance may indicate a stroke or other serious condition. Women should report chest pain, chest heaviness, pain or swelling in the legs, hands, feet or ankles to a doctor. Other serious effects include fever, chills, body aches, flu symptoms, breast lumps, depression, insomnia and mood changes. Some women may experience liver problems with the use of the medication. Drugs.com explains that the symptoms of this include jaundice, clay-colored stools, darkened urine, appetite reduction, low fever or abdominal pain paired with nausea.

Bottom Line: Vaginal dryness is an uncomfortable condition “down there”.  The problem may be related to progesterone or to your birth control pills if they contain progesterone.  For more information speak to your physician.

Read more: http://www.livestrong.com/article/52149-side-effects-progesterone-vaginal-suppositories/#ixzz2PK0gBb9P

Dr. Neil Baum is the co-author of What’s Going On Down There-Improve Your Pelvic Health available from Amazon.com

http://www.amazon.com/Whats-Going-Down-There-Siddighi/dp/1477140220/ref=sr_1_2?s=books&ie=UTF8&qid=1365122701&sr=1-2&keywords=what%27s+going+on+down+there

Female Sexual Dysfunction-Women, You Can Be Helped

It is of interest that women have just as many sexual problems as men. In the past 15 years, more attention has been given to male sexual problems, mostly erectile dysfunction, as medications have been available for treating this common condition. Now women with decreased desire, decreased lubrication, decrased aroiusal, and lack of orgasm can now be treated.

What Causes Sexual Dysfunction?

Sexual dysfunction in women can be a result of a physical and\or psychological problem.

Physical causes. Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause plus such chronic diseases as kidney disease or liver failure, and alcoholism or drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes. These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.

The most common problems related to sexual dysfunction in women include:

Inhibited sexual desire. This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes associated with menopause, medical conditions and treatments (for example, cancer and chemotherapy), depression, pregnancy, stress, and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.
Inability to become aroused. For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. This inability also may be related to anxiety or inadequate stimulation.
Lack of orgasm. An absence of orgasm can be caused by a woman’s sexual inhibition, inexperience, lack of knowledge, and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to an absent orgasm include insufficient stimulation, certain medications, and chronic diseases.
Painful intercourse. Pain during intercourse can be caused by pelvic organ prolapse, endometriosis, a pelvic mass, ovarian cysts, vaginitis, poor lubrication, the presence of scar tissue from surgery, or a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.

The diagnosis of female sexual dysfunction begins with a physical exam and a thorough evaluation of symptoms. The doctor performs a pelvic exam to evaluate the health of the reproductive organs and a Pap smear to detect changes in the cells of the cervix (to check for cancer or a pre-cancerous condition).

An evaluation of your attitudes regarding sex, as well as other possible contributing factors (such as fear, anxiety, past sexual trauma/abuse, relationship problems, or alcohol or drug abuse) will help the doctor understand the underlying cause of the problem and make appropriate treatment recommendations.

Treatment of Female Sexual Dysfunction

Most types of sexual problems can be corrected by treating the underlying physical or psychological problems which include:

Providing education. Education about human anatomy, sexual function, and the normal changes associated with aging, as well as sexual behaviors and appropriate responses, may help a woman overcome her anxieties about sexual function and performance.
Enhancing stimulation. This may include the use of erotic materials (videos or books), masturbation, and changes in sexual routines.
Providing distraction techniques. Erotic or non-erotic fantasies; exercises with intercourse; music, videos, or television can be used to increase relaxation and eliminate anxiety.
Encouraging non-coital behaviors. Non-coital behaviors (physically stimulating activity that does not include intercourse), such as sensual massage, can be used to promote comfort and increase communication between partners.
Minimizing pain. Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. Vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

The success of treatment for female sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.

Hormones play an important role in regulating sexual function in women. With the decrease in the female hormone estrogen that is related to aging and menopause, many women experience some changes in sexual function as they age, including poor vaginal lubrication and decreased genital sensation. Low levels of the male hormone testosterone also contribute to a decline in sexual arousal, genital sensation, and orgasm. Women can use a topical gel containing testosterone or receive a small pellet of testosterone, the size of a grain of rice, placed under the skin which can result in enhancement of their libido and sex drive.

Many women experience changes in sexual function after a hysterectomy (surgical removal of the uterus). These changes may include a loss of desire, and decreased vaginal lubrication and genital sensation. These problems may be associated with the hormonal changes that occur with the loss of the uterus. Furthermore, nerves and blood vessels critical to sexual function can be damaged during the surgery.

The loss of estrogen following menopause can lead to changes in a woman’s sexual functioning. Emotional changes that often accompany menopause can add to a woman’s loss of interest in sex and/or ability to become aroused. Hormone replacement therapy (HRT) or vaginal lubricants may improve certain conditions, such as loss of vaginal lubrication and genital sensation, which can create problems with sexual function in women.

I think it is important to mention that some postmenopausal women report an increase in sexual satisfaction. This may be due to decreased anxiety over getting pregnant. In addition, postmenopausal woman often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

Bottom Line: Many women experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the women and her partner, and can have a negative impact on their relationship. If you consistently experience these problems, see your doctor for evaluation and treatment.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women’s health

Safe Sex For Seniors

The days of the dirty old man are over. Let the truth be told; older men and women want to remain sexually active. Seniors have more open attitudes toward sexuality, better health among seniors, the option for Internet dating, and the availability of medications like Viagra, Levitra, and Cialis, many older adults are remaining sexually active. It is important to emphasize that seniors are also vulnerable to sexually transmitted diseases (STDs) just as younger adults. Therefore it is important that seniors make certain that they are practicing safe sex. This article will provide suggestions for safe sex for seniors.

Do your homework. Seniors need to know your partner’s sexual background before having sex. This includes oral sex, anal sex, as well as vaginal sex. All types of sexual intimacy can spread STDs. It is important for seniors to talk about their sexual histories, and tell one another whether they have recently been tested for STDs and share with each other the results of those tests. It is also important to ask if there has ever been a history of injecting illegal drugs. HIV/AIDS can also be spread via a shared hypodermic needles though the most common risk factor for older women is sex with an infected man.

Make sure you can pass this test! The best way to protect yourself and your partner is for both partners to get tested for HIV and other STDs before starting to have sex. If one of the partners has not been tested, then it is imperative that the tested partner encourage the other partner to obtain testing. Remember that STDs don’t always cause obvious symptoms such as a rash, discharge, fever, or urinary symptoms. Also, some symptoms of STDs or HIV, such as fatigue, can be mistaken for age-related health problems such as low testosterone levels in men.

Condoms count. I suggest that seniors use a condom as well as a lubricant every time you have sex until you are in a monogamous relationship and your know your partner’s sexual history and HIV status. Lubricants such as KY Jelly are important because they can lower the odds of getting a sore or a tiny cut on the penis or inside the vagina. These sores or cuts can significantly increase the risk of getting STDs.

Bring your doctor into the equation. Your doctor can offer additional advice about protecting yourself from STDs. He or she can also recommend treatments for common sexual problems such as vaginal dryness and erectile dysfunction (ED).

It is quote common for senior women to have vaginal dryness as a result of estrogen deficiency. Vaginal dryness results in discomfort when a woman engages in sexual intercourse and can make for an uncomfortable experience. Solutions range from over the counter moisturizers and lubricants or the use of supplemental estrogen prescribed by your doctor. Estrogen can be given by pills, topical vaginal creams and estrogen impregnated rings that are inserted into the vagina.

Though ED is more common with age, it isn’t an inevitable part of the aging process. ED is often due to an underlying medical condition such as heart disease, diabetes, or the side effects of medication. As a result there is a likelihood of nervousness with the onset of a new relationship. Since ED may be the first sign of an underlying medical condition, it’s particularly important to speak with your doctor if you are having difficulty obtaining or holding an erection adequate for sexual intimacy.

It is not uncommon for seniors to have lost a partner and to go without sexual intimacy for months or years after losing a spouse. Consequently, there is anxiety associated with embarking on a new sexual relationship. Occasionally, counseling is in order to help the seniors jump start their sex lives.

There are numerous medications for ED, which are not recommended for men who use any form of nitroglycerin. Other treatments for ED include testosterone replacement therapy for men who have symptoms of decreased libido, lethargy, and falling asleep after meals. Finally, there are operations which includes penile implants for men where oral medications are not effective.

Bottom Line: It is acceptable and even normal of seniors to engage in sexual intimacy. If a man and women are healthy, are free of STDs, and wish to be sexually intimate, they can plan to successfully engage in sexual intimacy. In 2012, no one needs to suffer the tragedy of the bedroom.

When Your Sex Drive Crawls To A Halt

A decrease in your sex drive or a loss of your libido can result in physical and emotional disorders. If this is your problem, you will want to read the rest of this article and learn how to put fuel back in your sex drive.

Sex drive killers

Erectile dysfunction or ED
Nearly 33 million American men suffer from erectile dysfunction. ED is most common in men over age 40 but most men suffer in silence. This is a result of the myth that ED is a normal part of the aging process and it is primarily a psychological problem. The facts are that it is not part and parcel of the aging process and that older men who are healthy and have a partner can expect to successfully engage in sexual intimacy. ED is eminently curable with the help of drugs and injections or surgical procedures.

Menopause
In women, physical changes like menopause can affect physical intimacy and sexual drive. Although, menopause itself does not affect your ability to have sex, the reduced hormone levels may cause certain discomforts like vaginal dryness and pain during sex. This condition is also easily treated with hormone replacement therapy or just lubrication in women who cannot or wish not to take estrogens.

Depression
One of the major hallmarks of depression is reduced interest in sex. Be aware that both depression and antidepressant pills can affect your libido. If you are having a loss of sex drive as a result of using antidepressant medication, tell your doctor as he\she can alter the dosage or change to another medication that doesn’t cause a drop in your sex drive.

Less sleep
There is a direct connection between sleeplessness and reduced sexual urge. Loss of sleep can result in an increase stress hormone cortisol which plays a major role in reducing the testosterone levels, the hormone in both men and women that is responsible for maintaining your sex drive.

Parenting
Parenting is a one of life’s greatest stressors and can affect your physical and mental health including your sex life. A solution may be as simple as taking time for each other and making a regular date that doesn’t include the children.

Excessive alcohol
Excessive alcoholic consumption is linked to ED and infertility in both the sexes. It is true that a few sips of your favorite wine lowers your inhibitions and puts you in the mood for intimacy but it can also put your sex drive in the tank. Like everything in life, moderation can help preserve your sex drive.

Relationship problems
Marital or relationship problems like lack of trust and proper communication can act as major hindrance to experiencing enjoyable and satisfying sex. Counseling to sort out any personal indifference between you and your partner is effective in restoring your bedroom activities.

Bottom Line: One of the life’s greatest enjoyments is sexual intimacy with the partner you love and enjoy. However, the libido is very fragile and can easily be diminished. The good news is that most libido problems can be resolved and intimacy be restored.

Vaginal Dryness-Another “VD” You Don’t Want To Have

For most women sex is fun and enjoyable.  However, if there isn’t enough lubrication and the vagina is dry like the desert, sexual intimacy can be excruciatingly painful with fun placed on the back burner.   It’s especially frustrating when the natural vaginal lubrication a woman is used to “dries up,” making it so much more difficult to enjoy what is one of life’s greatest pleasures— sex after 50!   In spite of the list of physical changes from aging, studies have shown that sexual satisfaction increases, rather than decreases, as women grow older. This article will provide suggestions to fix the problem and help restore vaginal lubrication to its former friction free status that makes intimacy something to look forward to rather than to avoid.

Why women experience vaginal dryness

Menopause is results in a loss of estrogens and this can create more than hot flashes.  This condition that affects every woman in her late forties and early fifties also results in less natural lubrication as the woman ages, resulting in vaginal dryness and dyspareunia, a medical term for post-menopausal thinning of your vaginal walls resulting in painful intercourse.  You are not alone as one in four post-menopausal women experiences pain, either before, during and after sexual intercourse. Unfortunately, many are embarrassed to discuss female dryness and intercourse pain, either with each other or with their gynecologist. It’s time to get over that fear. Every woman experiencing intercourse pain after 50 should seek a doctor who is skilled in vaginal examinations, and one who isn’t afraid to ask you everything you need to know to help you address this pain.

The solution isn’t always at the tip of a pen with a prescription written by your primary care doctor or your gynecologist.  There are several over the counter remedies that will put the slippery back into the bedroom activities.

Liquid Silk is topical cream used by many postmenopausal women for overcoming vaginal dryness.  Another is Carrageenan, which has no smell or taste.  A popular solution is Replens, which is a unique, estrogen-free vaginal moisturizer. It has the advantage of being long-lasting as one application can last three days and women can use it two or three times per week. As a result there is more spontaneity with sexual intimacy and the woman need not excuse herself to apply the cream when the opportunity presents itself. Astroglide’s name says it all as it does make things glide and slide.  Women find this topical gel a nice companion to their toys and accessories.  A little dab and a little water works just great.   OH! Is the name of a product which can fuel the fire down there in a gentle, sensual way.  And finally, don’t over look the ol’ standby, K-Y Jelly, mother of all vaginal lubricants.  It’s inexpensive, effective, and now comes with more exciting names such as Silk-E and His and Hers. For those women who are reticient about requesting these products at the local drug store, you can buy them online at: GoodVibrations.com, A-Womans-Touch.com, or TabuToys.com.

Getting started.  Suppose you may have purchased vaginal lubrication, or you may tried several out and found one that fits your fancy, how do you present this option to your partner.  Two suggestions: First, invite your partner to apply the lubricant. Seeing how it works will probably turn him on, too, and encourage him to make it part of your sex play.  Second is to try using some of the cream or ointment on him during foreplay. The way your hands will slide should make a believer out of him. If he is still resistant and I doubt he will be, try putting some lube on your inner lips of your vagina when you are planning to have sexual intimacy.

First line therapy consists of the vaginal lubricants just described.  However, if lubrication isn’t enough, there are other options usually consisting of vaginal estrogen therapy, which I will discuss in greater detail in a following blog.

Bottom line:  While female dryness which develops at the time of menopause can result in painful intercourse, the good news is that effective treatments exist for vaginal dryness and dyspareunia.

 

When Things Aren’t Right “Down There”-When Women Should Call Their Doctor*

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.  However, there are a few symptoms that warrant a call to the doctor.  This article will cover when you should call your doctor for problems “down there”?
1. Pelvic Pain
Pain at the time of ovulation, is referred to as Mittelschmerz.  However, if you have pelvic pain that persists or doesn’t ease with simple home treatment, call your doctor.
When a woman has chronic pelvic pain, doctors will check for benign uterine fibroids and endometriosis. They will also look for pelvic inflammatory disease, which usually appears as a triad of pelvic pain, vaginal discharge, and fever.
In addition, abdominal pain and vaginal bleeding may signal an ectopic pregnancy, in which a fertilized egg implants outside of the uterus.  This is a medical emergency and you need to visit an emergency room if you can’t reach your doctor.
Ovarian cancer is another condition that can cause pelvic pain.  The symptoms of bloating, pelvic pressure and frequency of urination for more than two weeks is a potential sign that you should be checked for a possible ovarian cancer.
2. Irregular Bleeding
If you’re not on any kind of birth control and you have irregular bleeding that lasts for more than a month or two, you should always be checked.  Irregular bleeding includes: periods that last longer than normal, bleeding mid-month, having two periods per month, bleeding after sex, and other unusual patterns.  Abnormal bleeding may stem from multiple causes that aren’t serious, among them, perimenopause or uterine fibroids or polyps.
If you bleed every time after sex, that may indicate that the cervix is being easily irritated especially if there’s some infection of the cervix.  Sexually transmitted diseases, such as gonorrhea or chlamydia, can cause cervical lesions that bleed with sex.
If you’re postmenopausal, be especially vigilant about any vaginal bleeding; it’s a potential sign of uterine cancer. Uterine cancer, compared to ovarian cancer, is extremely treatable. It’s very curable because it’s generally found in an early stage and it has an early warning sign, which is postmenopausal bleeding.
3. Abnormal Vaginal Discharge
Abnormal symptoms include a strong odor; an unusually large amount of discharge; accompanying itching, burning, or irritation; unusual color; or blood in the discharge.
4. Vaginal Dryness
Vaginal dryness in postmenopausal women or vaginal atrophy can cause spotting after intercourse. Because older women have less estrogen, their vaginal tissue thins or atrophies and becomes dry and irritated.  Not only does vaginal dryness make sex painful, but vaginal thinning also leaves women more susceptible to infections and can contribute to urinary incontinence.
Most women can find relief with estrogen creams, rings, or tablets that are applied or inserted directly into the vagina.
5. Sores or Lumps
Sores in the genital area may point to herpes, a sexually transmitted disease, or cancer. Symptoms of cancer of the vulva include unusual lumps, wart-like bumps, or red, flat sores that don’t heal. Sometimes, the flat sores turn scaly or discolored.
Bottom Line: Most problems “down there” are innocuous but you should know when to call your doctor.  These are the five most common symptoms that need your attention and that of your doctor. 

*Modified from WebMD, 4-20-11