Sex education really shouldn't end after those uncomfortable elementary-school classes you blushed through as a kid. With the pace of sexual health research moving along at a fast clip, a refresher course may be overdue for many of us. What's more, researchers are getting better at explaining, and there's never been more information about women's sexual health, on issues ranging from libido to birth control. How up to date are you? Take our true/false quiz to find out.

1. It's easier than ever to get pregnant in your 40s.

False. With tabloids boasting happily fertile 40-something celebs on one hand, and doctors warning us about the difficulties of getting pregnant on the other, one thing is for sure: The decade is a tricky time for fertility. If you want to get pregnant in your 40s, be aware that we don't know how often those celeb pregnancies involve intervention—and even a donor egg. On the flip side, if you don't want to get pregnant, don't be too cavalier about your method of birth control. "This should be discussed with your doctor, but most women can expect to cease being fertile between the ages of 50 and 52," says Kristen Gilbert, director of education at Options for Sexual Health in Vancouver. While some women continue to take hormonal birth control through their perimenopausal years (it can help with symptoms such as irregular bleeding and heavy periods), doing so can mask the timing of menopause, so speak to your health-care professional about your best options.

2. You need to have a pap smear once a year.

False. The guidelines set by The Society of Obstetricians and Gynaecologists
of Canada differ from province to province, but generally, women who are sexually active (even if they haven't had intercourse) should have Pap smears (which test for abnormal—possibly precancerous—cells on the cervix) every three years starting at age 21. And you'll typically be hitting the stirrups until around age 70, as long as your last decade of Paps were normal. And, of course, if you're sexually active with new, multiple or nonmonogamous partners, talk to your health-care provider about regular screening for sexually transmitted infections as well.

3. Frequent urinary tract infections can be a sign of low estrogen.

True. We know that these uncomfortable bacterial infections—marked by the frequent need to urinate and pain when doing so—usually occur after sex, when bacteria enter the urinary tract. But they can also be among the symptoms of genitourinary syndrome of menopause (GSM), a new term referring to the many changes that can take place in and around our reproductive organs, including vaginal burning, irritation and dryness, as well as urinary symptoms. In GSM, many symptoms are caused or exacerbated by lowered levels of the hormone estrogen. "The loss of estrogen can make the bladder more prone to urinary-tract infections," says Dr. Marla Shapiro, family physician in Toronto and president-elect of the North American Menopause Society. Vaginal estrogen therapies can help—ask your doctor.

4. If you never initiate sex, you must have a low sex drive.

False. We may have the idea that a healthy or normal sex drive means wanting to pounce on our partners at every opportunity. But new research is showing that women can have a healthy sex drive yet rarely initiate sexual encounters with their partners. What's also perfectly healthy and normal is to be receptive when your partner makes the first move. "You may not have the background hum of desire, that thought of, Gee, I'm feeling horny," says Meredith Chivers, a leading investigator in female sexuality research. "But desire can emerge from a partner making a sexual advance and you thinking, Maybe I am interested in having sex."

5. Men and women have similar sexual fantasies.

False. A 2014 study by researchers from Université du Québec à Trois-Rivières polled more than 1,500 Quebecers to discover what they fantasized about. More women than men reported fantasies involving submission (including being tied up and spanked), while more men imagined sex with someone other than their partner. Another difference? About half of the women wanted their submissive fantasies to remain just that, but the majority of men said they would love for their fantasy to come true.

6. Pain during intercourse usually goes away once you get going.

False. Sure, some pain (like from pelvic-muscle tightness) can go away during sex, but a chronic pain condition called vulvodynia actually worsens during intercourse, and its burning sensation can last for hours. We now know that vulvodynia affects 15 to 20 percent of women and is frequently misdiagnosed or dismissed by doctors. An effective drug-treatment option remains elusive. Instead, researchers are finding that cognitive behavioural therapy (CBT) and mindfulness meditation can help. Dr. Rosemary Basson, clinical professor and director of The University of British Columbia's sexual medicine program, is running programs based on CBT and mindfulness based cognitive therapy (MBCT). "Both programs use the traditional CBT approach, looking at thoughts that are exaggerated or maladaptive," she says. "Women learn how to change them (CBT) or how to take those thoughts and just let them be (MBCT)." While, ideally, this therapy may one day be available online, if you're currently experiencing vulvodynia, see your physician and speak to a therapist or psychologist trained in treating issues around chronic pain. "They don't have to be specific to vulvodynia," says Dr. Basson. "It would be the same approach if the pain was anywhere in the body."

7. No one uses a diaphragm anymore.

False. It may have fallen out of favour as a contraceptive, making room for increasingly popular IUDs, but there is a new diaphragm on the market called Caya. It fits most cervixes, so there's no special fitting or prescription required, and it can be purchased online or at some clinics for about $100. "It's made of silicone and nylon and should be used with a contraceptive gel," says Gilbert. "Caya is safe to use and hormone-free, but about 15 percent of those who use it will get pregnant in a year." Still, Caya may be a good option for those looking for nonhormonal birth control.  

Have you got low desire? Check out everything you need to know about female viagra: The new drug for female desire.

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This story was originally part of "A Sexual Health Quiz For Grown-Ups" in the February 2016 issue. Subscribe to Canadian Living today and never miss an issue!