Sexual and reproductive health is an essential part of your overall well-being, extending far beyond just preventing STIs or managing periods. It's about understanding your body, feeling empowered in your sexual choices, and taking proactive steps toward your long-term sexual and reproductive health goals. This is not your high school teacher’s sex ed, filled with limited information for cis, straight people only. This guide is designed to provide you with empowering and real insights, tailored for people who menstruate, whether you’re a cis woman, trans man, nonbinary, or otherwise gender diverse, and no matter who you partner with.
Understanding Your Body in Your 20s
Overall Health Needs
In your 20s, establishing strong health habits can set the foundation for years to come. This might be the decade when you’re choosing your own doctors for the first time, or figuring out how to get and navigate your own health insurance. There are some key health screenings for your 20s you’ll want to start taking care of, too.
Prioritize tuning into yourself, integrating sustainable movement, eating nutritious food, and learning stress management, as these support not only your physical body but your mental and sexual health as well. Your body is learning, growing, and changing—take time to pay attention and care for it. You’re the expert on you, and your doctors and providers are here to be partners in your care.
Hormonal Changes
If you have ovaries, your body is still undergoing significant hormonal shifts in your 20s that impact various aspects of your health. Hormones—like estrogen, progesterone, and even testosterone—play crucial roles in regulating your body’s functions, from your menstrual cycle to your mood and energy levels. During this decade, your body is still finding its rhythm, and these fluctuations can sometimes feel unpredictable. However, understanding that these shifts are a normal part of your body’s development can help you feel more in control and aware of what’s happening.
Understanding Hormonal Balance
Hormonal balance is vital for everything from skin and hair health to mood regulation and energy levels. Estrogen, often thought of as the primary “female” hormone, helps regulate your menstrual cycle, maintain bone density, and influence your mood. Progesterone, another key hormone, plays a critical role in the second half of your menstrual cycle, preparing your body for potential pregnancy. Whether that’s something you care about or not, those hormones have an impact! Testosterone, though typically more dominant in those with male bodies, is also important in those with ovaries, contributing to muscle mass, libido, and overall vitality.
In your 20s, you might start to notice how these hormones ebb and flow throughout your menstrual cycle. For some, these shifts are predictable, with clear changes in mood, energy, and even skin condition as you move through different phases of your cycle. For others, especially those with conditions like Polycystic Ovary Syndrome (PCOS), these patterns can be harder to track due to irregular cycles or inconsistent hormone levels.
Tracking Your Body’s Signals
One of the best ways to stay in tune with your hormonal health is by tracking your body’s signals. This could mean using a cycle-tracking app or simply noting changes in a journal. Keeping track of when you feel most energized, when your mood dips, or when your skin breaks out can help you recognize patterns in your hormonal cycle. This information is not just useful for understanding your body better—it can also be invaluable if you need to discuss symptoms with a healthcare provider.
For example, you might notice that your energy levels are highest just before ovulation, when estrogen peaks, or that you experience mood swings and cravings in the days leading up to your period, when progesterone is dominant. On the other hand, if you’re dealing with symptoms like irregular periods, hair loss, or unexpected weight changes, these could be signs of hormonal imbalances that might require further investigation.
Common Hormonal Concerns in Your 20s
Some common concerns you might encounter in your 20s include:
- Adult Acne: Hormonal fluctuations, especially increases in androgens like testosterone, can lead to breakouts, even if you didn’t struggle with acne in your teens. This is particularly common around your period, when hormone levels are shifting.
- Irregular Periods: While it’s normal for your cycle to vary slightly from month to month, consistently irregular periods can be a sign of conditions like PCOS or thyroid issues. It’s important to monitor these changes and consult a healthcare provider if you notice significant irregularities.
- Hair and Skin Changes: Hormones also influence the health of your hair and skin. For some, the 20s bring changes like increased hair shedding or shifts in skin texture. These changes can be normal but should be monitored, especially if they seem abrupt or severe.
- Energy and Mood Fluctuations: It’s not uncommon to experience changes in energy and mood as your hormone levels rise and fall. This can manifest as feeling particularly motivated and energetic during some parts of your cycle, and more lethargic or emotional during others.
When to Seek Help
If you start noticing symptoms that seem out of the ordinary—such as persistent acne, irregular periods, unexplained weight gain or loss, or excessive hair growth—these could be signs of a hormonal imbalance. Conditions like PCOS, thyroid disorders, or other endocrine issues often manifest in your 20s and can have a significant impact on your overall health if left unaddressed.
Seeking help from a healthcare provider is essential if you experience these symptoms. They can perform tests to check your hormone levels and help you understand what’s going on in your body. Early intervention can make a big difference in managing these conditions and maintaining your overall health.
Tracking your hormonal health, understanding the changes your body is going through, and seeking help when needed are all key steps in taking charge of your health in your 20s. By paying attention to these factors now, you can set the stage for a healthier, more balanced future.
Navigating Your Body in Your 30s
Overall Health
In your 30s, you might find that your health needs become more specific and nuanced. This decade often brings a heightened awareness of long-term health, with many people beginning to think about the future more intentionally—whether that means considering family planning, maintaining peak physical health, or addressing early signs of aging.
Your 30s are a good time to focus on preventive care. This includes regular health screenings that become more relevant in your 30s, like thyroid function or metabolic health. If you’re considering pregnancy now or in the future, it might be time to discuss fertility health with your provider.
This decade is key for maintaining and refining those habits you began in your 20s. Balancing career, family, and personal time can also make stress management more critical. Continue prioritizing sustainable movement, balanced nutrition, and effective stress management to support your physical, mental, and sexual health. Your body may start to show subtle signs of aging or shift in response to new life stages—pay attention to these cues and adjust your care routines as needed.
Your 30s can be a time of significant hormonal shifts, and these changes can affect various aspects of your health, from your menstrual cycle to your mood, energy levels, and even your fertility. Understanding these hormonal changes can help you navigate this decade with more confidence and control over your health.
Menstrual Cycle and Fertility
In your 30s, you may notice that your menstrual cycle starts to change. For some, cycles may become shorter, lighter, or more irregular. Others might experience heavier periods or more pronounced premenstrual symptoms. These changes are often a natural part of the aging process as your body gradually prepares for the transition to perimenopause, which can start as early as your late 30s.
Fertility is also a key consideration during this decade, if conceiving a child using your own body (like carrying a pregnancy in your uterus) or your own genetics (your eggs) is something that might be important to you. While many people in their 30s can and do conceive without difficulty, it’s important to be aware that fertility naturally begins to decline, especially from about 35 on for most people. This decline is primarily due to a decrease in the number and quality of eggs in the ovaries. If you’re planning to have children, you might want to consider discussing your fertility health with a healthcare provider, especially if you’re thinking about delaying pregnancy. Options like fertility preservation (e.g., egg or embryo freezing) can be explored to give you more flexibility in your family planning.
Perimenopausal Symptoms
For some, the late 30s mark the beginning of perimenopause—the transitional phase leading up to menopause. During this time, hormonal fluctuations can become more pronounced, leading to symptoms like irregular periods, hot flashes, night sweats, mood swings, and changes in sexual desire. These symptoms are caused by fluctuating levels of estrogen and progesterone, which can vary widely from one cycle to the next.
Even if you’re not yet in perimenopause, it’s helpful to be aware of these potential changes so you can recognize them early. Tracking your cycle and symptoms can provide valuable insights into how your body is changing and help you and your healthcare provider make informed decisions about managing any discomfort or disruptions.
Impact on Mood and Mental Health
Hormonal changes in your 30s can also have a significant impact on your mood and mental health. As estrogen levels fluctuate, you may experience mood swings, increased anxiety, or changes in how you respond to stress. This can be particularly challenging if you’re balancing new demands of work, family, and personal life, all of which can add to your stress levels.
To support your mental health during these shifts, it’s important to prioritize stress management and self-care. Regular physical activity, a balanced diet, adequate sleep, and mindfulness practices like meditation or yoga can all help stabilize your mood and reduce the impact of hormonal fluctuations. If you’re struggling with mood changes or anxiety, especially for more than two weeks, it’s always a good idea to seek support from a healthcare provider or mental health professional.
Skin and Hair Changes
The hormonal shifts in your 30s can also affect your skin and hair. Some people may experience adult acne, which is often linked to fluctuations in hormones like estrogen, progesterone, and androgens. Conversely, you might also notice changes in skin texture or increased dryness as estrogen levels begin to decrease.
Hair thinning or shedding can also occur as a result of hormonal changes, particularly if you’re experiencing stress or have an underlying thyroid condition. Maintaining a balanced diet rich in vitamins and minerals, managing stress, and using gentle skincare and haircare products can help mitigate these effects. If you notice significant changes, it’s worth discussing them with your healthcare provider to rule out any underlying conditions.
Metabolic and Energy Levels
Your 30s may also bring changes in metabolism and energy levels. Some people notice that it becomes harder to maintain their weight, or that they feel more fatigued than they did in their 20s. These changes can be partially attributed to shifts in hormone levels, particularly those related to thyroid function, insulin sensitivity, and cortisol—the body’s primary stress hormone.
To support your metabolism and energy levels, it’s helpful to maintain a regular exercise routine that includes both cardio and strength training, which can help counteract the natural decline in muscle mass and metabolic rate. Eating a balanced diet with plenty of whole foods, staying hydrated, and getting enough sleep are also key factors in maintaining your energy and overall health.
Supporting Your Hormonal Health
Maintaining a healthy lifestyle can help support your hormonal balance, no matter how old you are. This includes eating a balanced diet rich in whole foods, getting regular physical activity, and managing stress effectively. Stress and sleep, in particular, can have a significant impact on your hormones, leading to imbalances that affect everything from your menstrual cycle to your skin.
Consider incorporating mindfulness practices, which can be anything from dance to guided meditations, to help keep stress levels in check. Additionally, make sure you’re getting enough sleep, as rest is crucial for your body’s ability to regulate hormones effectively.
Comprehensive Sexual Health Care
In addition to the simple-but-not-easy tasks of sleep, exercise, nutrition, and stress management you’re working on with yourself, you’ll want a trusted provider supporting your sexual health. Staying on top of your sexual health involves regular check-ups with a clinician you can trust and talk openly with about your symptoms, needs, and goals. Ideally you have someone you don’t just go to when things start to itch or ache, but you have a relationship with a clinician who helps you proactively care for any needs.
Regular Check-Ups
Sexual health is intimately connected to your whole body wellness, so getting an annual exam to check on your overall health is key to your sexual wellness care. Any issues with your hormones, such as thyroid, or your metabolic conditions, or other physical health concerns can be addressed there.
On top of that, if you have a cervix, uterus, ovaries, or all of the above, routine gynecological exams, including Pap smears, HPV testing, and STI screenings, are essential for keeping your reproductive health up to date. Regular check-ups allow you to catch potential issues early, manage changes in your body, and stay informed about your health.
STI Testing
Everyone who is sexually active with a partner(s) should consider regular STI testing. Most people with an STI do not know it. Your clinician can help guide you about how frequently to test, what to test for, and what parts (e.g. vagina, mouth, rectum) to test, depending on your sexual practices.
The CDC guidelines do not speak to the experiences or bodies of queer and gender diverse people very well, so really recommend working with your clinicians on this. There is little downside to getting tested and lots of potential risk to not!
But so you know, the CDC recommends:
- All adults should be tested at least once for HIV.
- All sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year. Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STI should also be tested for gonorrhea and chlamydia every year.
- All sexually active gay, bisexual, and other men who have sex with men should be tested:
- At least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently (e.g., every 3 to 6 months).
- At least once a year for HIV and may benefit from more frequent HIV testing (e.g., every 3 to 6 months).
- Anyone who engages in sexual behaviors that could place them at risk for infection or shares injection drug equipment should get tested for HIV at least once a year.
Bottom line - discuss this with a doctor, but if you’re sexually active you should get tested regularly, even if you are monogamous, and more frequently if/when you have new partners.
On-Demand Care for When Symptoms Arise
Even with regular check-ups and proactive health practices, symptoms can sometimes appear unexpectedly. It’s important to have access to on-demand or “as needed” care for those times when your body requires immediate attention. Whether it’s an unusual discharge, unexpected pain, or changes in your menstrual cycle, being able to quickly consult with a healthcare provider can prevent small issues from becoming larger concerns.
On-demand care is especially valuable for addressing sudden or new symptoms that might not warrant an emergency room visit but still require timely medical advice. This could include anything from a flare-up of period pain to concerns about a potential STI exposure. Many providers now offer telehealth services, allowing you to get care without having to wait for an in-person appointment. This can be a convenient way to get peace of mind, prescriptions, or referrals for further testing.
When to Get Immediate Care
It’s also important to recognize when symptoms might indicate a need for more immediate attention. For instance, severe pelvic pain, heavy or unusual bleeding, or signs of an infection (such as fever or foul-smelling discharge) should prompt you to seek care quickly. Having a provider you trust who is familiar with your health history can make these situations less stressful, as they can offer informed advice and a swift path to treatment.
Remember, taking care of your sexual health is not just about routine maintenance—it’s also about being responsive to your body’s signals and seeking care whenever something feels off. Being proactive and getting the care you need when symptoms arise helps ensure that you stay in control of your health, no matter what comes up.
Mental Health and Sexual Health
Sexual health and mental health are deeply interconnected. Chronic stress, anxiety, or other mental health concerns can impact your libido and overall sexual satisfaction. Taking care of your sexual health might mean utilizing mental health resources like treatment for anxiety, depression, or insomnia, therapy, mindfulness practices, or exercise to help manage stress or mental health conditions, which, in turn, can improve your sexual health.
Sexual and Reproductive Health Choices
When it comes to sexual and reproductive health, there’s no one-size-fits-all approach. Whether your goal is preventing pregnancy or planning for it, protecting against STIs, or managing your period, it’s about choosing what works best for you and your body.
Contraceptives and STI Protection Options
First off, there are many ways to be intimate or have sex that are no or low risk for pregnancy or STIs. Much of the sexual health information out there assumes that if you have a vagina you are having sex with a person with a penis and are concerned about pregnancy. Not here! We know this might not be true for you at all. Depending on the kinds of sex you have and the bodies of the people you have sex with, some of these methods may be more or less relevant to you.
Know that you have a variety of contraceptive (birth control and cycle control) options and STI protection choices depending on your needs. Some do double duty if pregnancy and STIs are both a concern, and you’re a uterus/ovary/vagina-having person partnering with someone with sperm, others are best suited for either preventing pregnancy or STIs, but not both.
Barrier methods like condoms and dental dams offer STI protection for many types of sexual activity, from vaginal to oral and anal. If pregnancy prevention is important to you, options like birth control pills, patches, or IUDs, either on their own or layered with STI protection, can be effective. For those not focused on pregnancy but more on protection against HIV, PrEP is another vital tool to consider.
It’s important to remember that not everyone you get intimate with is thinking about the same sexual health things you are. For example, you might not generally have sex with people who can get you pregnant, but your sexual partner might. Open conversations about practices and risks are the only way to know. Tailor your choices based on your unique circumstances, and if you’re unsure, consult a healthcare provider to discuss your options.
Fertility Awareness
Fertility naturally shifts as you age, and some people start to think more about pregnancy (or avoiding it) in their 30s. Understanding your cycle can give you insight into your fertility, whether you’re actively trying to conceive or just want to track your body’s patterns. Tools like fertility trackers and apps can help you keep tabs on your cycle.
If you’re LGBTQIA+, you might want to learn more about LGBTQ fertility options available to help you start a family, which is something a provider can support you with as well.
Managing Pain and Period Symptoms
For many, menstruation comes with the added struggle of period pain or PMS. If you experience painful cramps or other disruptive symptoms, it’s essential to explore different management strategies.
Period Pain Management
Lifestyle changes like exercise, a balanced diet, and stress management can help lessen symptoms. Over-the-counter pain relievers can also be helpful, and some people find alternative treatments like acupuncture or heat therapy to be effective.
However, if your period pain is intense or you suspect something more serious, such as endometriosis or fibroids, it’s important to seek medical guidance. Heavy or irregular bleeding shouldn’t be ignored, as these can be signs of underlying conditions that might need attention.
Addressing Sexual Dysfunction and Other Concerns
Sexual health is also about taking care of your body, understanding your needs and your desires, and feeling good in your body, alone, or in connection with other people. Your sexual well-being is just as important as your physical health, and it's not uncommon to experience sexual dysfunction at some point in your life. This can include issues like decreased libido, discomfort during sex, or difficulty experiencing pleasure.
Sexual Dysfunction
Sexual dysfunction can stem from many factors, including hormonal changes, stress, or anxiety. If you’re experiencing these concerns, know that you're not alone—and more importantly, there’s help available. Talking with a healthcare provider or a therapist can provide insight into solutions, whether that means adjusting medications, exploring different types of sexual activity, or incorporating lubricants or pelvic floor exercises.
Body and Pleasure
Equally important is ensuring that sexual health includes conversations about pleasure, consent, and communication with partners. Navigating sexual health isn't just about addressing dysfunction—it's about taking the time to understand your body, learn what feels good, and make room for sexual self-care.
Empowering Yourself Through Knowledge and Resources
The more you understand about your body, the more empowered you’ll feel in making informed choices.
Educational Resources
Utilize trusted resources like FOLX Health to stay informed about sexual and reproductive health. Whether it’s learning more about contraception options, STI prevention, or how to manage changes in your body, having access to accurate, compassionate information is key.
Community and Support Networks
You don’t have to navigate sexual health alone. Finding community—whether online or in person—can offer support, validation, and the chance to learn from others with shared experiences. Surround yourself with people and resources that uplift and empower you.
LGBTQIA+ Inclusive Care
Finding a healthcare provider who respects your identity and understands the nuances of LGBTQIA+ health is crucial. Seek out inclusive, affirming care where your concerns and needs are acknowledged and addressed without judgment. This can significantly improve your healthcare experience and overall health outcomes.
In summary
Taking charge of your sexual health in your 20s and 30s is an act of self-love and empowerment. Understanding your body, embracing your needs, and seeking affirming care will allow you to live a healthier, more informed, and more fulfilling life. Don’t hesitate to ask questions, seek care, and advocate for yourself—your body deserves it.
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FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, nonbinary, or another identity, you can find LGBTQ-specialized health care that helps you meet your wellness goals. Get all the benefits of becoming a FOLX member and sign up today!
