Sexually transmitted diseases, such as chlamydia, HIV infection, herpes, syphilis, gonorrhea, and hepatitis B, are passed easily from one person to another during sex.

Sexually transmitted diseases may cause serious health problems. For example, HIV causes AIDS. Hepatitis B can cause liver damage, including liver cancer. Many STDs can harm a pregnancy and the health of the baby. Some, such as chlamydia, can lead to infertility.

If you have sex, you may be at risk for a sexually transmitted disease. Your risk is increased if:

• You or your partner has or had other sexual partners.
• You do not always use condoms consistently and correctly.
• Your partner has a sexually transmitted disease.
• You use injection drugs.
• You exchange sex for money or drugs.
• You live in an area where a particular sexually transmitted disease is common.
• You are a man and have sex with other men.

If you are at increased risk for sexually transmitted diseases, talk to your doctor about whether you should be tested. This is especially important because some diseases, such as chlamydia, may have no symptoms. Serious health problems may develop before you realize you have a disease.

You can greatly lower your risk for sexually transmitted diseases by using a male latex condom every time you have sex. If you are allergic to latex, use a polyurethane (soft plastic) or synthetic condom.

If you have sex and are not ready to have a child, you and your partner may want to use some form of birth control. Many birth control methods are available for men and women. Each has advantages and disadvantages.

The condom is the only birth control method that protects against most STDs, including HIV/AIDS. Use a latex condom. If you are allergic to latex, use a polyurethane (soft plastic) or synthetic condom.

Whichever birth control method you choose, remember that, for it to work, you must use it all the time and use it correctly.

Folic Acid During Childbearing Years

If you are a woman who can become pregnant, you should take at least 400 micrograms (or 0.4 mg) of folic acid every day. Folic acid, also known as folate, is a B-vitamin that can be found in some enriched foods and in vitamin pills.

If you have enough folic acid in your body when you become pregnant, this vitamin can lower the risk for birth defects of your baby's brain or spine. You need to be taking the vitamin before you become pregnant because, by the time you know you are pregnant, birth defects may already have formed in your child.

To get the folic acid you need:

• Take a vitamin with 400 micrograms (or 0.4 mg) of folic acid (folate) every day. Both folic acid pills and multivitamins can be bought at grocery stores, pharmacies, or discount stores.
• OR, every day, eat a bowl of cereal that has 100% of the daily requirement of folic acid per serving. (The nutrition information on the cereal box will tell you how much folic acid is in each serving.)
• AND eat folate-rich fruits and vegetables and foods fortified with folic acid. Fruits, orange juice, green leafy vegetables, and dried beans, peas, lentils, and peanuts all have folate. Enriched pasta, rice, bread, and flour have added folic acid.

Menopause and Beyond

The time when your menstrual cycle stops for good is called menopause. Most women reach menopause in their late 40s or early 50s.

During the years leading up to menopause, levels of two female hormones, estrogen and progesterone, begin to change. These changes signal that your body is getting ready to stop menstruating. This time leading up to menopause is called perimenopause.

Most women begin perimenopause between ages 35 and 50. Perimenopause usually lasts around 5 to 7 years. You can still get pregnant during this time, so you may want to use some method of birth control.

For many women, the shifting levels of hormones during perimenopause cause physical and emotional changes. Some of these changes may be uncomfortable, but there are many ways to relieve the discomfort.

The changes could include any of the following:

• Skipped periods.
• Irregular bleeding.
• Hot flashes.
• Mood swings.
• Sleep problems.
• Painful intercourse from vaginal dryness.

If you have not had a period for at least a year, you are likely to be in menopause. At this point, your hormone levels drop, so you are no longer producing eggs. Once this happens, there is no chance of becoming pregnant.

What happens after menopause?

Hormone Therapy. Hormone therapy increases the levels of the hormones estrogen, progesterone, or both in your body. If you are approaching menopause or have gone through menopause, you may be considering hormone therapy to relieve symptoms of menopause or to reduce your risk for diseases such as osteoporosis.

Hormone therapy may reduce your risk for fracture, bone thinning, and colorectal cancer. On the other hand, there is evidence that some hormone therapies may increase your risk for breast cancer, heart disease, blood clots, stroke, and gall bladder disease. For women with mild or no symptoms of menopause, the potential harms of hormone therapy may outweigh the benefits.

If you are considering hormone therapy, it is important to be well informed about these benefits and harms and how they apply to you specifically. Your doctor can help you decide.