Reproductive Health Facts You Didn’t Learn In Sex Ed
The sex ed class you deserved, about 20 years late.
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The one-day sexual education class I took in 8th grade is barely memorable. We saw an anatomical model of the female reproductive system. We didn’t see one for males because the class was segregated. The boys went into a different room. For the girls, abstinence was the main talking point—and, as I’d hear later over a giggly lunch, it was for the boys, too. We were told that, if we weren’t going to abstain from sex, be sure to use a condom. We were shown how to put it on properly, so we’d know if a guy had done so. (Speaking as an adult, many of them do not.) Birth control was mentioned, reluctantly, as a third option. Still, the instructor immediately pivoted back to: Don’t have sex at all, then you won’t have to worry about getting pregnant. Abortion wasn’t discussed, which isn’t at all shocking in the Bible Belt.
Accurate and comprehensive sex education is not easy to access. Only 29 states and D.C. require public school students to take a sex ed course, and, of those, only 20 require the information taught to be medically accurate, according to a 2025 factsheet by the Guttmacher Institute. Forty-three states plus D.C. require programs to stress abstinence, despite a slew of evidence that the method is ineffective and harmful to adolescents. There’s also no cohesion on how to discuss gender identity or sexual orientation, which means 10 states either ban talking about it or restrict the conversation based on age. The hodgepodge landscape leaves teens with inconsistent and often inaccurate information. They’re also ill-equipped to make informed decisions about their bodies and well-being—an attribute that continues into adulthood.
The things you weren’t taught at 13 become the things you’re left to figure out when you’re in your 20s and 30s, usually when something goes wrong. Black women are three times as likely to develop uterine fibroids, and most of us aren’t told to screen for them until the symptoms are already severe. Perimenopause can start in your 30s, but because the earliest signs are anxiety and brain fog rather than hot flashes, many women and their providers chalk it up to stress. Endometriosis operates with a biological severity that researchers are now comparing to cancer at the molecular level—and the average wait for diagnosis is still 7 to 10 years. The system that was supposed to teach us about our bodies never started, and nothing since has caught up.
The March Living A Better Life Resources is an attempt to close some of that distance. Everything below is focused on reproductive health—the science, the context, and the practical information that should have been part of the conversation a long time ago.
Let’s get into it.
Sexual health isn’t just about having sex
It includes understanding your anatomy, maintaining reproductive wellness, navigating contraception, managing menstruation, getting screened for cancers and infections, and having the language to communicate about your body with partners and providers. The World Health Organization defines sexual health as “a state of physical, emotional, mental, and social well-being in relation to sexuality”—not merely the absence of disease or dysfunction. When sex ed reduces the conversation to pregnancy prevention and STI avoidance, it leaves out a chunk of what people actually need to know to take care of themselves.
Your period is a vital sign
In 2006, the American College of Obstetricians and Gynecologists formally recommended that clinicians treat the menstrual cycle as a vital sign—on par with blood pressure, heart rate, and respiratory rate—when evaluating adolescent health. The logic was that abnormal menstrual patterns in adolescence could flag conditions like PCOS, thyroid disease, eating disorders, and even early indicators of liver failure. That was nearly 20 years ago, and the recommendation, reaffirmed in 2025, still only applies to adolescents.
A 2025 comprehensive research review argues that this is a mistake, since the menstrual cycle functions like any other vital sign. It can signal when something is wrong, track how a condition is progressing, guide treatment decisions, and confirm when things are working as they should.
Ongoing issues with your cycle could be an indicator that you have a health problem that needs to be addressed. Long and irregular cycles are associated with increased risk of premature mortality. A 2024 study investigating the association between PCOS and cardiometabolic conditions found that, regardless of a PCOS diagnosis, irregular menstrual cycles were associated with higher rates of obesity, prediabetes, type 2 diabetes, high cholesterol, hypertension, metabolic syndrome, and other cardiovascular issues.
Think of your period like a monthly briefing from your body. When things are going smoothly, it usually arrives in a predictable rhythm—not necessarily every 28 days, but in a pattern you recognize. When your cycle starts to show up late, disappear for months, or brings heavier bleeding or new pain, it’s often a signal that something in your body or environment needs attention.
Contracting an STI doesn’t mean you’re dirty
Sexually transmitted infections are extraordinarily common health conditions, not character assessments. The CDC estimates that roughly 1 in 5 people in the U.S. has an STI at any given time, according to the most recent data available. The moral stigma attached to STIs—which is this idea that they reflect carelessness or promiscuity—is a cultural issue that stands in the way of improving public health by discouraging people from getting tested, seeking treatment, or disclosing their status to partners.
Further reading: It Might Not Be Too Late to Protect Yourself From Cervical Cancer
There are only about six days per cycle when pregnancy is possible
The fertile window refers to the five days before ovulation and the day of ovulation itself. Sperm can survive in the reproductive tract for up to five days, while an egg is viable for about 12 to 24 hours after release. Outside of this window, conception is biologically unlikely.
The female reproductive tract actively selects sperm
The idea that fertilization is a race where the fastest sperm wins is one of the most persistent oversimplifications in reproductive biology. Recent research has found that eggs aren’t passive participants in fertilization. The fluid around the egg releases chemical signals that preferentially attract sperm from certain men over others—meaning your egg has its own preferences about which sperm gets chosen. It’s an evolutionary advantage science is only beginning to understand, but it’s so fascinating!
You can have a safe pregnancy after 40
The panic around “advanced maternal age”—a clinical term applied at 35—deserves context. Fertility does decline with age, and specific risks (chromosomal abnormalities, gestational diabetes, preeclampsia, and miscarriage) do increase. But more birthing persons are having babies in their late 30s and into their 40s due to meaningful advances in medical care, such as prenatal screenings for genetic disorders and scheduling more ultrasounds to look for congenital disabilities.
Further reading: Thinking About Having a Baby in Your Late 30s or 40s? Here’s What I Tell My Patients.
Your medical history determines which birth control is best for you
Birth control is not one-size-fits-all, and the conversations from our adolescent years don’t go far beyond “condoms and the pill.” In practice, your health history significantly shapes which methods are safest. Take combination birth control, for instance. If you’re a smoker, over the age of 35, have migraines with aura, or a history of blood clots, this form of birth control—which contains estrogen and progestin—could increase your risk of having an adverse medical event. Plus, there’s the bloating, which sucks.
Thankfully, other forms of birth control exist, including progestin-only and non-hormonal options.
Non-hormonal birth control for men is on the way
For decades, male contraception has been limited to condoms and vasectomy. But, as of February 2026, multiple non-hormonal male contraceptive candidates are in Phase II clinical trials, and men are actively enrolling with many citing the 2022 Dobbs decision as a motivating factor. Phase II trials evaluate efficacy and safety, and regulatory approval, so public availability is still years away, but the pipeline is more active and closer to market than ever.
If you want to nerd out for a second …
NEXT Life Sciences has two: a long-acting reversible hydrogel injected into the vas deferens called Plan A (lol), and a daily pill designed to provide 24 hours of protection. Contraline’s ADAM hydrogel reached a 24-month efficacy milestone in 2025, with trial participants achieving azoospermia (zero sperm count), and received Phase II approval in Australia. YourChoice Therapeutics is also advancing YCT-529, a non-hormonal pill that blocks a vitamin-A-dependent protein involved in sperm production.
Uterine fibroids disproportionately affect Black women, and most of us aren’t told about them
Black women are three times as likely to be diagnosed with these noncancerous growths in the uterus that can cause heavy bleeding, pelvic pain, and pregnancy complications. Almost 25 percent of Black women ages 18–30 have fibroids, compared to about 6 percent of their white counterparts. By age 35, the rate among Black women reaches 60 percent. By age 50, it hits 90 percent.
In addition to developing fibroids at younger ages, Black women experience larger and more numerous growths, report more severe symptoms, and wait longer before seeking treatment. We are also two to three times more likely to undergo a hysterectomy as a first-line treatment. Research emphasizes that these disparities are due to structural racism, provider bias, higher levels of chronic stress, environmental exposures, and barriers to healthcare access.
Perimenopause can start in your 30s, and the first symptoms aren’t what you’d expect
This transitional phase, when hormone levels begin shifting, can start as early as the mid-30s and last four to eight years before menopause. A 2025 study found that more than half of women in their 30s experience moderate to severe perimenopause symptoms. Many don’t seek treatment, most likely because they don’t even consider that they could be perimenopausal.
The earliest symptoms are often anxiety, depression, irritability, and brain fog, not the hot flashes and night sweats people expect. These psychological symptoms tend to emerge before physical ones and peak between ages 41 and 45.
Because the symptoms don’t match the popular image of menopause, many women and their providers dismiss what’s happening as stress, aging, or mental illness. Understanding that perimenopause can begin much earlier, and that its first signals are often emotional, could change how millions of women interpret their own experience.
Further reading: I Didn’t Expect Perimenopause to Start With My Teeth
Endometriosis is a cancer-mimicking disease
Keyword: mimicking!
Endometriosis is usually talked about in terms of pain and diagnostic delay. That framing isn’t wrong, but it could be underselling the biology. A 2025 review documents how endometriosis mimics cancers at the molecular, imaging, and biomarker levels. The paper catalogs 35 cases where endo was clinically mistaken for malignancy, which include elevated tumor markers triggering oncology workups, imaging findings indistinguishable from tumors, and more. The researchers also investigated symptom overlap between endo and cancers—such as bleeding or bowel obstruction—as another way endo mimics. The parallel to cancer has resulted in women undergoing major surgeries or other aggressive medical interventions that weren’t necessary, and could lead to morbidity, due to the imitation.
None of this means endometriosis is cancer. It isn’t. It means the condition operates in a way that the current clinical framework isn’t well equipped to address. For the 190-plus million people living with it, the language we use to describe what it actually does to the body matters—and “benign gynecologic disorder” ain’t cutting it.
Further reading: My Disease Is Not Benign In Any Sense of the Word
Your pelvic floor is a muscle group that needs care like any other in your body
The pelvic floor is a group of muscles at the base of the pelvis that support the bladder, uterus, and rectum and play a role in controlling bladder and bowel function, sexual sensation, and core stability. When those muscles are weakened, tightened, or injured—from pregnancy, childbirth, chronic straining, high-impact exercise, or simply aging—the result can be urinary incontinence, pelvic organ prolapse, chronic pelvic pain, or pain during sex. And yet, a systematic review of the research found that the majority of women have significant knowledge gaps about pelvic floor health.
Some good strengthening exercises include bird dogs, squats, kegels, and hip extension movements—like a bridge pose, pelvic tilts, or a hip thrust.
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