By Jeanne Novas, MD 
Your sexual health is important in all times of your life.
Young women in their late teens and early twenties are delaying intercourse compared to years ago. In pursuit of careers/education, they may not feel the drive for sexual relations. Nothing is wrong with those choices. We, of course, encourage condom use with a new partner to prevent STDS and encourage a monogamy/love relationship. Chlamydia is a common STD amongst this age group. Don't mix alcohol, drugs and sex. Young women should start a sexual relationship because they want to and not in order to please the partner or feel pressured – EVER!
Many women enjoy sex more in their thirties, and/or before childbearing. Once they have children, stress can interfere with sex life. It is important to "find time" to have date nights/get babysitting to spend time with spouse/partner. Vaginal delivery can "weaken" the pelvic floor, so be sure to discuss at your exam and consider pelvic floor exercises. Watching your weight, sleep, nutrition and exercise can help sex drive at all ages.
Some women do have an increase in sex drive once they cannot get pregnant and are near menopause. The rule, though, is a drop in libido during this time. Medications that help are estrogens – vaginal and systemic, and testosterone. Exercise, nutrition, healthy weight, sleep all help. Male partners can start to have impotence from medications for depression, diabetes, high blood pressure, prostate issues. They too can seek help so keep an open dialogue. Women can be prone to bladder infections, vaginitis due to sensitive tissue from intercourse, especially in the perimenopause years. Things that can help are proper lubrication such as coconut oil (has anti-inflammatory properties), position with you on top with more control, voiding before and after intercourse, wiping perineum off front to back before and after intercourse. Sex can release ‘endorphins’ and give a feeling of well-being!!
Women of all ages may have lack of desire or enjoyment of intercourse. Always keep open communication with your partner and keep a healthy mutually beneficial relationship. Treat depression and anxiety – seek professional counseling, do not resort to alcohol and drugs. Prescription antidepressants are safe and effective, under a doctor's supervision.
Some women may experience narrowing of the vagina. If so, consider dilators - try soulsource.com. This can occur in menopause, and may be more common in women who have not had a vaginal delivery, or have abstained from intercourse and have a new partner. Vibrators/masturbation can be done by yourself or with a partner. Check out trojanvibrations.com for info on vibrators. Always bring up with your gyne exam to rule out any medical issues such as vaginal atrophy of menopause, vaginal prolapse/relaxation, pelvic masses, vaginitis or lesions.
Sex is a healthy practice and can be important for your relationship as well as for yourself. Your OBGYN is the person to talk to regarding this private issue.
Jeanne Novas, MD, FACOG