Know Your "V" - Women's Vaginal and Sexual Health with Dr. Susan Boyd

How Can I Get Rid of Vaginal Odor? (I Don't Have an Infection)

2016-10-28T11:13:00.000-07:00

This week I want to address your questions about Vaginal Odor without an infection.

I am perplexed that such an important topic, such as vaginal odor and certainly one that affects so many women, has so little data and so few treatment options. Everywhere you go for answers, even medical books, it is described in the context of bacterial vaginosis (BV), being the main cause.

For the most part vaginal odor is accompanied by an increase in the pH of the vagina, normal pH usual runs lower around 4.0. It is this acidic environment that allows the 'resident' bacteria to remain higher than the yeast and infectious forms of bacteria. When the pH rises it can allow for an overgrowth and takeover by the yeast and infectious bacteria and with this comes the symptoms of malodor.

Sexual intercourse is a common cause of increased vaginal pH and is one reason women will notice strong odors after intercourse. The normal pH 7.8 for sperm allows them to live and is also very surgary in order to nourish the sperm. However, the alkaline, sugary solution can drastically affect the vagina as the 'bad' bacteria enjoy the surgary alkaline environment and begin to multiply. This, as stated above, can cause odor.

There are other changes a woman's body can go through that may change the normal vaginal odor such as pregnancy, menopause, and the taking of certain medications and vitamins. We talked about this a little bit last week, and this should not be in such a way as to create stress, irritation, foul odor or abnormal discharge. In these cases it would be best to be seen by your doctor for a check up.

The real concern are the many who battle with unwanted vaginal odor without an infection. Almost on a daily basis and no matter what treatments they have tried, it always comes back, always. This can be extremely heartbreaking and embarrassing as no matter how often creams and gels are used or how many times the area is cleansed the odor remains. One more trip to the doctor and you are given the same medications again and once again all the cultures and tests are negative, but the problem is still there.

I'm frustrated as a Doctor and I didn't know what to do until now. The one new thing I've found, most recently, has me so excited and I feel so good about getting you started with it. I stumbled on it by accident and after seeing it and getting it for the office for my patients to see and begin using, the results were amazing.

It is called WaterWorks Vaginal Cleansing System and is a simple device that resembles a douche, however, the nozzle portion is made of stainless steel and it has a reservoir for plain tap water and they connect together with a small tube. It works on the concept of a douche , using no chemicals only plain tap water, and it can be used as often as you like. It eliminates odor by the reaction of the stainless steel & water reaction with the vaginal mucosa. The same as chefs use stainless steel bars in the kitchen to remove onion and garlic odors from their hands when they are cooking.

The most wonderful part is my patients reported that their odor was eliminated the first time they used it. WOW! I was so happy for them. No more having to take medications or making the problem worse by over the counter douching or using harsh soaps. This is gentle, safe and effective vaginal cleansing device for anyone. Plus it is FDA approved. You can see for yourself. Go to WaterWorksHealth.com Oh, and most importantly, reusable that made us all smile.

Can Douching Prevent Pregnancy?

2016-09-29T10:42:00.002-07:00

When douching, a woman pours a solution of water mixed with soap, vinegar, iodine or other chemicals into a squeezable bottle with a long neck. The neck is inserted into the vagina and the fluid pushed up inside. This is usually done in the shower or tub area so as not to make a mess. Most douches today are found premixed and are sold in most grocery and drug stores.

Because of the way douching forces fluid into the vagina, it should never be used as a method of birth control. Sperm are extremely fast swimmers and most have likely made it through the cervix and into the uterus before you have even thought of sitting up to go douche. Even if you had it by the bedside and ran to the bathroom, it would probably be too late. In fact, douching can actually push sperm into the uterus and towards the fallopian tubes faster.

But in the worst case, not only can sperm be pushed further up toward the uterus, but so can all types of bacteria and viruses, including those which can cause STDs (sexually transmitted diseases). Resulting infections of the uterus and fallopian tubes, called PID(pelvic inflammatory disease), can cause scarring of the tubes and can lead to ectopic pregnancy (pregnancy in the tubes). This makes it impossible to get pregnant without assistance from a fertility center.

Some women are taught to douche to keep themselves clean down there, when in reality the vagina is one of the cleanest parts of the female's body because it cleans itself out everyday with its natural lubrication. The white/clear discharge that a woman finds in her underwear or on the toilet paper is from the vagina cleaning itself out. Once a douche is used, it can disrupt the natural environment of the vagina, removing the normal discharge and preventing the self-cleaning action.

I know that many of you douche anyway, even knowing all these facts, because I talk to the women I see in my office everyday. Many of you are concerned about odors that are impossible to get rid of. But, douching can just make it worse, as it removes the natural bacteria that clean and help keep the vagina odor-free.

Thankfully, there is a natural way to cleanse inside the vagina without traditional douches and harsh chemicals …..and which many women are now starting to use.

The new WaterWorks system is the only FDA-cleared natural way to cleanse inside your vagina. It will not remove the natural bacteria or make you more susceptible to yeast and bacterial infections. This is a reusable device that uses only plain tap water and that can be used in the privacy of your shower as many times a week as you wish.

The secret is in the medical grade stainless steel nozzle that is designed to fit easily into the vagina, while the water gently sprinkles out to rinse out semen, blood or discharge. The reaction that takes place between the water, stainless steel and vaginal mucosa effectively removes unwanted odor. Please note that, like traditional douches, WaterWorks does not prevent pregnancy.

So, dismiss the old idea that douching can prevent pregnancy. Continue to use proven birth control methods. But, leave the cleaning to WaterWorks. It's the only proven, natural, drug-free and chemical free way to rid yourself of unwanted feminine odors.

Not again! How can I stop these migraines?

2016-09-26T06:01:00.000-07:00

Dear Dr. KnowYourV,

I really hope you can help me. I have been suffering from migraines since I was 12 years old. I am now 27. I have been to several doctors, including specialists, who have helped me control the symptoms, but nothing seems to keep them from happening month after month. I know the things I have to watch like allergies, getting over-tired or dehydrated, too much chocolate and keeping regular meals so as not to over-stress my system. But no matter what I do it seems that every month with my menstrual cycle a new migraine shows up. This is so horrible for me that I have to lie in bed with the covers over my head to block out smells and light from the rest of the house. I usually wake up with the migraine and feel nauseated. I take my prescribed medication for migraines which helps for a little while, but it always comes back within a few hours. At it’s worst this can last up to 3 days of my cycle, interfering with my job and just everything in my life. There are times I have even worried that I have a brain tumor, but the tests are always negative.

Are there any new treatments or medications I haven’t heard of? Please Dr. Boyd, I hope you can help.

Thanks in advance,

Sandy

Wow Sandy, I’m sorry to hear about your pain and discomfort, and what a bummer to have to deal with it every month. This is the most common, disabling condition in women that we encounter and menstrual migraines are definitely the most frequent and hardest to treat.

Many women suffering from it feel it is just a “normal” part of the monthly routine. They continue to use the same remedies to help relieve their symptoms that were used by all the women in their family (mom, grandmother or aunts) all of which only provide a little relief. But after awhile, when work is missed month after month and the headaches begin to spill over and interfere with daily life, most will seek help from their doctors.

So what is a migraine? And why do they come with menses and are so much more debilitating than a regular headache? Menstrual migraines are more severe, last longer and are more resistant to treatment than migraines that come at other times. MM (menstrual migraines) are usually characterized by 4 criteria: Severe pain, throbbing, unilateral location and intensifies with activity. At least 2 of these must be present to be categorized as MM.

MM can also include nausea, photophobia (worsening with light) or phonophobia (worsening with sounds). They can last from 4 to 72 hours if untreated. MM are usually disabling because symptoms usually will not improve until you stop what you are doing and lay down and rest.

Migraines can have different triggers, but MM are triggered by the decline in estrogen that occurs at the end of the menstrual cycle just before your period begins. This is why most oral contraceptives do not improve the onset of MM - they are designed with 3 weeks of active pills, then one(1) week of placebo pills. The placebo pills have no active hormone in them, so every month with or without the pill your estrogen falls off just before your period triggering another MM. Some of the newer pills have added some estrogen into the placebo pills to help counteract this drop off and hopefully prevent MM from happening.

MM can be associated with neck stiffness, tension and nausea. The migraine triggers cause over dilation of the blood vessels in the brain which can slow blood flow and bring on the severe pain. Migraine medications are designed to cause vasoconstriction, which relieves the migraine. The exact mechanism of MM with estrogen drop off is not completely understood.

So what should you do to treat this monthly problem? The best way is to talk to your doctor and have the appropriate tests done to make sure that there is no other medical issue that needs treated first. If all tests are normal and you are in good health, many doctors will recommend that sufferers add low dose estrogen during the week their menstrual cycle is due. One special way to treat is to take an extended cycle oral contraceptive that cycles every 3 months and at the beginning of the placebo week add 0.9 - 1.0 mg conjugated estrogens or estradiol. This regime has helped completely eliminate MM in many women. Any other migraines that may occur can easily be treated with any regular migraine medication.

Thank you Sandy for your question, I know it has helped a lot of women today to know there is help. Also, ask your doctor about prescribing medical oxygen if you are sensitive to taking medication. Please follow your doctor’s advice.

I also wanted to let you know that many of my patients who have been using WaterWorks for several months now have not had recurrence of their vaginal odor and are experiencing less problems with discharge. WaterWorks can be used daily as part of your usual hygiene routine and to cleanse the excess semen from vagina after intercourse. My patients are reporting more confidence using WaterWorks before sexual intercourse as they are not preoccupied with worries of vaginal odor during sex which lets them relax and enjoy the time with their partners more.

WaterWorks has been FDA Cleared for elimination of vaginal odor. It is totally unlike regular douches from the store shelf. WaterWorks is known for its unique design - a stainless steel nozzle that works along with plain tap water to eliminate odors. WaterWorks uses a gentle cleansing action, not forceful pressure like disposable douches. I encourage you to check it out. I’m sure you will love how it works.

Can WaterWorks Help Prevent Yeast and Bacterial Infections?

2016-08-26T12:09:00.002-07:00

Yeast and bacterial infections come as a result of vaginal imbalance that can be caused for many reasons. Some of the more common causes are taking antibiotics, wearing a wet swimsuit or nylon/lycra clothing during long periods of time in hot weather, wearing thong underwear, douching or allowing semen to remain in your vagina.

Yeast infections can cause an abundant amount of thick, whitish discharge, vaginal swelling, and intense puritis or itching that can be unbearable. This irritation and itching may also be felt around the anus, labial area and urethra. It can also cause burning on urination. I have had many patients come in worried about a urinary tract infection, when it was really a vaginal yeast or bacterial infection.

Now, as for the men - you may have heard or boyfriends talk about 'jock-itch'. Well that is usually just external yeast or fungal infections men get from sweating in the heat. In answering the question as to whether we pass yeast or bacterial infections to our partners, the answer is no. But men can get a little itching for a few hours after sex that usually goes away quickly.

Women have found that the odor associated with their infections can really interfere with intimacy, and they have been turning to alternative solutions to help. More and more women are seeking non-pharmaceutical ways to prevent yeast and bacterial infections from coming back again and again.

Waterworks is the only vaginal cleansing system made just for this purpose. It uses only natural tap water, with it's uniquely designed stainless-steel nozzle, to clean out the vagina of unwanted discharge or left-over semen. Many women are reporting that they stopped vaginal odor the first time they used it, even after battling with vaginal odor for years. The best thing is that since WaterWorks can be used everyday they have been able to stay ahead of yeast and bacterial infections by keeping the vagina clean and rinsing out semen right away, before it has a chance to change vaginal pH.

How Do I Get Rid of Vaginal Odor?

2016-07-15T11:47:00.001-07:00

I continue to be amazed when a couple comes into my office for various health issues and, during the conversation, they are surprised to learn that odorous vaginal discharge is not normal.

One husband told me, “Well, Doc, all men know it's like deep sea diving, just take a deep breath and go in." Really? That's pretty sad to think that so many women (and the men they love) feel that pungent, strong or "fishy" vaginal odor is just normal.

So what causes vaginal odor to start in the first place? Why is it so hard to get rid of? Why does it keep coming back over and over again? Can it cause health problems?

It concerns me that so many of you, because you're worried about odor or cleanliness, continue to believe that DOUCHING is 'okay' once in a while. Right? You ask yourselves, “What can it hurt? It makes me feel clean and fresh, and it's so nice to clean out discharge or old period blood. I don’t’ want him down there if it's not fresh and clean.” But it's this obsession that causes the problem in the first place. We are not supposed to smell or taste like chemicals or perfume! It is shocking to a man to smell that, and the perfumes and chemicals in douches, mixed with the odor you are worried about, is like covering up the bathroom with freshener spray. The smell is still there, just now mixed with freshener – which can be worse.

An estimated 40% of American women between the ages of 15 and 44 continue to use a vaginal douche, even though there are no studies that have ever shown that douching has benefits at all. In fact, we know that douching can actually increase the risk of infections, cause pregnancy complications, and create other health problems.

Douching started many years ago and is practiced in Europe and many other countries. It is a method to wash out the vagina, usually with a mixture of water and vinegar. Douches that are sold in drugstores and grocery stores contain antiseptics and fragrances. A douche comes in a bottle or bag and is sprayed through a tube upward into the vagina toward the cervix, sometimes with too much pressure.

Douching is known to cause many problems for women. One of the most common is vaginal infections like yeast or bacterial vaginosis. That's because it upsets the natural balance of bacteria in the vagina (called vaginal flora) which has the purpose of maintaining a low, more acidic, pH. Changing this acidic balance makes the environment more favorable for the growth of bacteria that cause infection. We have talked before how the low pH is the vagina's defense against infection and how it is able to self-clean. If the good bacteria is constantly being washed out, how can the vagina protect itself?

We know that women who stopped douching were less likely to have bacterial vaginosis, yeast infections, and vaginal odor. Note, having bacterial vaginosis can increase the risk of preterm labor and other more serious infections:

Pelvic Inflammatory Disease (PID). PID is an infection of the uterus, fallopian tubes, and/or ovaries that can actually get inside your entire body through the tubes as they are open into your abdomen. Douching can push infection from your vagina into your uterus through your tubes and into your abdomen. Women who douche have a 73% higher risk of getting PID!
Women who douche more than once a week also have more difficulty getting pregnant than those who don't douche.
Douching also increases the risk of ectopic pregnancy – for the same reason it puts you at risk for PID. With an ectopic pregnancy, the embryo implants outside the uterus, like in the fallopian tube or ovary.
Douching at least once a week has also been linked to an increased chance of developing cervical cancer.

You can see now why you should avoid douching. Having some vaginal odor is normal. However, if you notice a very strong odor, it could be a sign of infection. The acidity of the vagina will naturally control bacteria. Simply washing the vagina with warm water is best, using mild soap is enough to keep the outside clean.

WaterWorks, which is FDA-cleared to alleviate vaginal odor, is a wonderful help to women. It has a design like a douche, but is very different. With WaterWorks, the water sprinkles outward, not upward, to gently clean the inside of your vagina. It uses only fresh, warm water (no chemicals), so it is all natural. It is used by so many women for regular feminine hygiene, like cleaning out period blood, semen after sex and excess discharge. It can be used daily as part of your normal bathing. The unique, patented design of the medical-grade stainless steel nozzle is what prevents and removes vaginal odor.

Feminine Hygiene

2016-06-17T10:38:00.001-07:00

Feminine hygiene is so important to our overall health. In addition to keeping our skin clean and free of bacteria, it can prevent odor, itching and discomfort from perspiration.

Feminine hygiene involves more than just bathing or showering. It encompasses a whole spectrum of practices women should follow to be healthy. Most of us learn these skills from our mom, sister or friends. Or we just figure it out for ourselves.

But, not every aspect of this topic is well-known. For example, whoever taught us to always wash our new jeans, panties, shorts, or other clothing bottoms before we wear them? You should, because dyes and other chemicals on new clothing can cause your vaginal area to become irritated or infected. I have noticed some clothing that will put this on label, but not often.

During your menstrual cycle, be sure to wear fabrics that allow your vaginal region to breathe. Wear loose, breathable, clothing like loose panties that allow for air circulation. Natural, breathable fabric such as cotton is preferred. Wear thigh-high pantyhose or pantyhose made with a cotton crotch to reduce the vaginal sweating caused by nylon and other synthetic fabrics.

When not on your cycle, try to sleep without wearing panties or pajama bottoms if possible, as this will provide your vagina with the air circulation needed to help prevent infection.

Tight pants, shorts, or panties made from synthetic fabrics can reduce the air circulation around your vagina and cause it to sweat, which can increase your chances for odors and infection.

Remove wet, sweaty bottom clothing as soon as possible. Wet or sweaty panties and pants can cause bacteria to multiply and increase your likelihood for getting odors and infections. Take a shower and wear fresh, clean clothing after you have gone swimming or exercised.

Of course, bathing or showering daily is the beginning of developing healthy habits. It is so important to wash the skin daily to get as much bacteria off as possible to prevent sickness and infection. Sweat is the body's way of removing waste & bacteria from the body. So it should be washed off every day. In the shower, wash the vagina externally with mild soap, then rinse with fresh water and dry off immediately with a clean towel. For internal cleansing, use WaterWorks, which is described at the bottom of this post. If you have problems with excessive sweating, abundant discharge, rashes, folliculitis, or pimply lesions on your Mons Pubis or inner thighs, be sure that you use a new sharp razor to shave and that you change the razor after 4-5 uses.

You can use a blow dryer to gently dry the external vaginal area around pubic hair, inside the creases & around the vaginal lips (Labia Majora & Minora), between your buttocks and all over the outer groin area. This can reduce irritation and infection.

Use moist baby wipes instead of toilet paper and always wipe from the front toward the back. This will help ensure that fecal matter and bacteria won't be pushed into the vaginal canal.

Never use chemical douches, deodorants, sprays or powders. We never recommend douching, as these products usually cause more infections by disrupting your natural pH, hormones and the delicate chemical balance of your vagina. Women who use these products and douche with chemicals will be battling ongoing irritation and infections on a regular basis.

Be sure to change tampons, sanitary napkins, and panty liners frequently - this means every time you use the restroom or at least every 3-4 hours. When pads and tampons are worn for long periods of time bacteria can build up. Not only can it cause foul odors, but especially with tampons, it can cause mild to very serious infections like toxic shock syndrome.

If you can, try to use menstrual products that do not contain scents or dyes. And try to find the all-cotton pads and tampons because some of the commercial products contain fiberglass. This fiberglass can find its way into your vagina or under your skin, causing non-infectious irritations.

Always wash your vaginal area after sex to rinse out the semen, bodily fluids and residue from condoms and other intimate products. All of these can cause infection, irritation, and odors if not removed. For this purpose, WaterWorks is wonderful, as it is an all-natural, FDA-cleared method for feminine cleansing. (See www.waterworkshealth.com for more details). WaterWorks is so gentle. It uses only the pressure from gravity for a gentle water flow to rinse the vagina. It can be done every day while in the shower.

I think it's important for us all to just get into a routine like we do with our hair and nails. Then it just becomes easy and we feel better.

Combating Vaginal Odor with WaterWorks

2016-05-13T12:02:00.000-07:00

A few patients I saw this week reminded me that they had been using their WaterWorks for over a year now. How exciting! I am happy to hear them report how much it has helped them. Joy was in yesterday, and she said that she uses it almost every day in the shower, after her menstrual, and after intercourse, and has felt so much more confident and comfortable during sex, because the odor and discharge she had before is gone! How awesome is that? And she has not even had to use any of the usual vaginal gels, creams or antibiotics that she used over and over again before she started using WaterWorks.

That makes me so happy for her because she is one of so many of women out there who have the same problem. I know this because for 15-19 years in my practice I have heard all of you struggling to get rid of vaginal odors and excess discharge. But the products available over-the-counter only bring temporary relief, and then it all comes back, sometimes worse than before, right? I also know there are home remedies and natural remedies that are passed around, such as Colloidal silver and lemon juice tampons, vinegar and peroxide douches and various herbal solutions.

In my opinion, these do work for a time, just like the prescription medications, but they are not helping your own vaginal defenses to “kick-in” so the cycle of healing can take place. The vagina is very good at self-cleaning because it has host of natural bacteria that reside there and problems occur when other substances enter the vagina (or we have a change in our bodies from illness, childbirth, or menopause).

The natural good vaginal bacteria is lactobacilli which is the same bacteria used to culture yogurt. Normally the smell or taste of vaginal discharge is similar to plain yogurt; a neutral, non-offensive odor. The different odor comes from the type of bacteria that are infecting at that time. Each bacterium has a unique smell. Dirt smells like dirt because of the bacteria that naturally lives in dirt. So I could blindfold you and hold a plate of dirt in front of you and you would know it was dirt by the way it smelled, or I could hold a vial of the “dirt” bacteria to your nose and you would think I had dirt in front of you.

My excitement over WaterWorks as an OB/GYN and a woman is that it is an all-natural, green product. It is meant to be reused and it is used with only tap water, no medications, no chemicals. I have a lot of you write in worried about using tap water and want to use distilled or bottled water but that is just not necessary. People brush their teeth, shower and cook with tap water. The WaterWorks system works by a reaction that takes place between the stainless steel nozzle and the water with the vaginal mucosa to extinguish unwanted odor. It’s so simple, don’t make it complicated. The water sprinkles out gently, unlike regular douching where it shoots out and can push infection up into your uterus and tubes. This makes WaterWorks much safer than traditional douching.

I hope for those of you still battling vaginal odor and discharge that this helps you understand about the WaterWorks Cleansing system and why it is so exciting to all of us.

Kegel Exercises and Incontinence

2016-04-22T11:22:00.003-07:00

This week Brenda wrote in because she was having trouble with her bowel and bladder control a year after the birth of her third child. I’m sure there are a lot of you out there who can relate to this and how embarrassing it is to bend over to pick something up and accidentally pass gas or squirt out some urine. Or maybe you may have noticed it when you exercise or burst out laughing that out comes a noisy pop (or pops) of gas that is noisy enough that everyone hears, so all the laughter starts again. Most women experience some form of incontinence at some point in their life.

Dear KnowYourV, I am writing because I have been struggling with my bladder since the birth of my 3rd child, and it’s not improving. What’s really embarrassing is my body will pass gas when it wants to. I thought it would have been better by now. I have been to my gynecologist and had a second opinion and both said my only choice was surgery. I was hoping that I would not have to have surgery, is there anything I can do?

Many women seek to avoid surgery, Brenda, and I can understand why you would rather try a more conservative approach first. It’s difficult for many of us to take a full 6 – 8 weeks off for total healing and to be relatively inactive during that time for total healing. Often the symptoms you are experiencing come from damage or relaxation to the pelvic floor muscles. This can come from weight gain, pregnancy or childbirth or can be a result of aging even if a woman has had no children. We all experience the effects of aging on the rest of our body as we see the skin and muscle changes and it’s that same force making much of the changes in the pelvic area. Unfortunately, there is no medication to help treat this, and it does continue to worsen over time without any form of treatment.

The most effective form of pelvic floor muscle strengthening is known as Kegel Exercises. These exercises are often recommended to women who are experiencing urine leakage or lack of control over gas. Consistent Kegel exercises can improve urine leakage within a few weeks. Studies have also shown that consistent Kegel exercises can affect an improvement in prolapses (when the uterus, bladder or rectum fall & push through the vaginal wall similar to a hernia). So yes, Brenda, it is worth a try to start with self-improvement. This should include weight loss through exercise, a healthy diet, and dedication to removing foods that may be affecting your bladder negatively, like caffeine and excess amount of sugar.

So what are Kegels? Kegels are a set of exercises proposed back in 1950 by Dr. Arnold H. Kegel, to help strengthen the pelvic floor muscles that support the bladder, uterus and bowel. As the muscles become stronger there will be less leaking of urine.

So for those of you who have never done Kegels, or heard of them, let’s go through step by step how it works. Start by finding the right muscles. Lie down and put your finger in your vagina. Squeeze as if you are trying to stop the flow of urine from coming out. If you feel tightening on your finger then these are the muscles of the pelvic floor. Another way to find the muscles is to stop the urine midstream when urinating on the toilet (but do not continue exercises on the toilet).

· First empty your bladder

· Tighten the muscles and hold for 10 seconds

· Relax the muscles completely for 10 seconds

· Repeat the process for 5 minutes (or 10 sets) 3 times a day.

You can do Kegel exercises lying down, standing or sitting.

Do not worry if you are not dong them right or if it takes longer to get your results, just go check with your clinician for help. Also, over doing it will not make things happen faster, if there is no improvement, there may be other therapies and devices that can help. There are some newer surgical procedures that are working very well and may only require that you be out of work a short time. Keep working at it and focus on your health and you will begin to see improvement.

Thank you so much for your question, and I hope you have a wonderful week and stay safe.

Is It Normal to Have Vaginal Discharge?

2016-04-08T10:23:00.000-07:00

Vaginal discharge is the one thing, other than the menstrual cycle, that women notice and use to judge wellness in their bodies. If your cycles are regular and on time, and your vaginal discharge is normal, you feel your body is healthy, right? But, if a woman starts skipping her cycles or having too many cycles or bleeding heavily, she knows something is not right with her body. Okay.

Still, so many of you come in (most of you for other female problems) and I find out that you are constantly dealing with abnormal vaginal discharge or odor. You and your partner feel it is just 'normal' for women to have a fishy or strong odor all the time. Isn't that what all those tuna fish and fisherman's wharf jokes are all about? Men know it, and they talk about it, and think that's just the way it is – so, just grin and bear it.

Women don't know what to do. It's embarrassing, right? Three showers a day, and you still worry if everyone else can smell you. You can't wash it away, and that SUCKS because you know he's going to smell you during sex. But feminine sprays, lotion or soap and water do not help.

It is normal to have vaginal discharge. Some women produce more vaginal discharge than other women, and this is due to hormonal fluctuations. Teenagers and pregnant women both have higher than normal hormone levels which causes an increase in vaginal discharge. Women who are dry and lack discharge may have low hormone levels, like in menopause or during breastfeeding. You may also notice changes in the amount of vaginal discharge, changes in its consistency, (thick, thin, watery, sticky), and sometimes find it necessary to wear a pad or panty liner. Birth control pills will change vaginal discharge because it balances the female hormones and is a good therapy for women who feel too 'wet' all the time.

But, no matter the amount or consistency of discharge, it should never have a foul or fishy odor. At times, discharge may have a slight odor, due to hormonal changes during the month or during the final day of your cycle – due to pH changes from the menstrual blood. Normal discharge should not be accompanied by pain, itching, burning or redness.

Vaginal discharge is very important to the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection. A change in your normal vaginal discharge may be a symptom of a vaginal infection.

Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can the odor, and the color can range from clear to a milky whitish, depending on the time of your cycle.

Important things to watch for to determine if there is an infection include the length of time you have had the abnormal discharge, the color/odor of the discharge and the presence of any itching, pain, or burning in or around the vagina. Different infections present with different types of discharge and symptoms:

Chlamydia and gonorrhea are obvious, as there is a copious amount of cloudy, yellowish discharge, sort of like having a period of discharge, with an awful odor that is so different from the normal everyday discharge that it can alarm most women. In addition, they can cause urinary incontinence, painful sex, severe pelvic pain, bleeding and irregular cycles if not treated quickly. Also, they can be the cause of PID (pelvic inflammatory disease) which can cause severe illness, fevers, blockage of fallopian tubes and eventually lead to infertility.
Trichamonas is a parasitic infection typically contracted and caused by having unprotected sex, with grayish frothy discharge.
Yeast Infections can have two kinds of discharge: either thick and clumpy like cottage cheese or thin, whitish discharge that causes intense itching and swelling.

Infections require medicated vaginal creams or antibiotic medications, but here are some tips for preventing vaginal infections that can lead to abnormal discharge:

Keep the outer vagina area clean by washing regularly with a gentle, mild soap and warm water. DO NOT WASH INSIDE THE VAGINA WITH SOAP. Never use scented soaps, feminine products or douche. Also avoid feminine sprays and bubble baths.
After using the restroom, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection. It is a good idea to have baby wipes or other 'wet' wipes near the toilet as they work much better than toilet paper for feminine cleansing.
Try to wear 100% cotton underpants; switch off wearing floss panties and regular panties; and avoid overly tight clothing all the time.

We are lucky enough to have WaterWorks, which is FDA cleared for feminine cleansing and to reduce vaginal odor problems. Everyone loves this, as it functions just like a douche, but isn't. It is made of medical grade stainless steel and uses no chemicals (only plain tap water) and it can safely remove vaginal odor with the first use.

Irregular menstrual cycles

2016-03-04T13:15:00.001-08:00

I’ve had a lot of questions from many of you about your irregular menstrual cycles. Shelly and Ciara just recently came in for a recheck because they are frustrated and searching for a solution. “I don’t understand Dr. Boyd, why my period will be normal for 2 or 3 months and then it will come so heavy that I pass clots, have cramps and soak 4 or more tampons in 30 minutes for the first couple days. Then I might skip a period or just spot for a few days, and then back to normal for a few months, then spotting or heavy it drives me crazy. Is something serious wrong with me? Will the pill help? What can I do?”

I am finding that more women than ever seem to be having problems with abnormal uterine bleeding, that presents younger as women (pre-teens) are menstruating at a younger age. Teens and young women are struggling with weight more now than ever and much of it has to do with the hormones that have been introduced into our food supply in greater and greater amounts over the past few years.

Ingesting excess hormones every day via dairy and meat products has been shown in several studies to affect growth (size, weight, and height) in children and possibly sexual development, fertility and menstrual irregularities. This becomes more of a concern as we continue to see childhood obesity increase and weight changes in women (up or down), can cause abnormal uterine bleeding and infertility. The thyroid gland is also important in menstrual regulation and can be affected by the hormone overload caused from animal sourced food products, pesticides, chemicals and plastics in our environment.

One way to gain understanding is to review the ‘normal’ menstrual cycle, then we can compare it to Shelly’s and Ciara’s problems next week and maybe see what is going on. Menstruation usually starts at about age 12 or 13. One study, however, has indicated that girls may be starting puberty earlier than in the past. By the age of eight, 48% of African-American girls and 15% of white girls were showing pubic hair and developing breasts. It had previously been thought that only 1% of girls exhibited such changes at that age. Alternatively, a study done in England found that the average age for the onset of menstruation has changed very little since the 1950s, with the median age being 13 years.

The uterus is a pear-shaped organ located between the bladder and lower intestine. It consists of two parts, the body and the cervix. When we are not pregnant the body of the uterus is about the size of a fist, with its walls collapsed and flattened against each other. During pregnancy the walls of the uterus are pushed apart as the fetus grows. The cervix is the lower third of the uterus. It has a canal opening into the vagina this opening is called the os which allows menstrual blood to flow out of the uterus into the vagina.

Leading off each side of the body of the uterus are two tubes known as the fallopian tubes. Near the end of each tube is an ovary. Ovaries are egg-producing organs that hold between 200,000 and 400,000 follicles that contain the genetic material for producing babies. The inner lining of the uterus is called the endometrium and during pregnancy it thickens and becomes enriched with blood vessels to house and support the growing fetus. If pregnancy does not occur, the endometrium is released as your period. The hypothalamus (an area in the brain) and the pituitary gland regulate the reproductive hormones. The pituitary gland is often referred to as the master gland because of its important role in many vital functions, many of which require hormones. In women, six key hormones serve as chemical messengers that regulate the reproductive system.

The hypothalamus first releases the gonadatropin-releasing hormone (GNRH)>
This chemical, in turn, stimulates the pituitary gland to produce follicular stimulating hormone (FSH) and Lutinizing Hormone (LH).

Estrogen, progesterone and testosterone are secreted by the ovaries at the command of FSH and LH and complete the hormonal group necessary for reproductive health.
The menstrual cycle reflects the changes that occur in the endometrium, the inner lining of the uterus. Layers of the endometrium are shed at the end of the cycle as part of menstrual flow. The menstrual cycle is generally divided into phases; the follicular phase, ovulation phase and the luteal (or secretory) phase.

For a clear picture of the process it is important to understand how to count days in a menstrual cycle. Day one is generally considered to be the first day of bleeding. The follicular phase includes menstrual bleeding followed by proliferation (growth and thickening) of the endometrium, uusually lasting from day 1 to day 14. The following processes occur during this time.

The menstrual flow itself lasts an average of six days. Estrogen and progesterone levels are at their lowest during this time.

At the end of the menstrual flow, the proliferative phase begins, and the endometrium starts to grow and thicken. FSH levels rise and stimulate several ovarian follicles to mature over a two-week period until their eggs nearly triple in size. During this period, FSH also signals the ovaries to produce estrogen, which, in turn, stimulates a great surge of LH around day 14.

The surge of LH at the end of the follicular phase triggers ovulation by causing the largest follicle to burst and release its egg into one of the two fallopian tubes. At ovulation (usually day 14 in a 28-day cycle), the proliferative stage ends and the luteal (secretory) phase begins. The luteal (secretory) phase lasts about 14 days.

Once ovulation has occurred, LH causes the ruptured follicle to develop into the corpus luteum, a mound of yellow tissue that produces progesterone. The corpus luteum continues to produce progesterone and estrogen. When fertilization does not occur, the corpus luteum degenerates to a form called the corpus albicans (Latin for "white body"), and estrogen and progesterone levels drop.

Finally, the endometrial lining sloughs off and is shed during menstruation. It’s amazing how complicated our cycles can be it really makes you wonder how things go right most of the time. Next week we can take a look at what goes wrong now that we know how things should function.

Understanding Vaginal Discharge

2016-02-05T10:37:00.001-08:00

Hello everyone I hope this finds you all well and healthy today.

It seems that I've been hearing from many due to your concerns over vaginal discharge. Some of you have noticed changes, and are asking whether it is normal. Some of you have been on birth control or recently delivered babies, had tubal sterilization and are now off oral contraceptives after many years. Some of you just feel that there have been changes since you have matured.

The basic function of you vagina, besides sexual pleasure, is to provide a clean, functional route from the outside of your body to your uterus and the rest of your internal reproductive system. The natural acid PH of the vagina, acts to prevent infections. The acidic nature of your vagina is caused by natural, bacteria produced by your body called lactobacilli. This is the same bacteria found in yogurt culture and that is why we always hear about women drinking or douching with yogurt to help prevent or cure infection. Unfortunately, it doesn't work well in the vagina, but can help as a 'probiotic' in the intestinal tract. When your vagina is healthy, the vagina keeps itself clean. We always joke that it is like a self-cleaning oven; it stays in a healthy state by producing the secretions of normal vaginal discharge. Many things may disrupt the natural balance of the vagina.

First it’s important to understand that all women have vaginal discharge. Glands in your vaginal and cervix produce small amounts of fluid that flows out of your vagina everyday taking with it old cells that line the vagina. Your normal vaginal discharge helps to clean the vagina, as well as keep it lubricated and free from infection and other germs. A normal vaginal discharge does not have a foul odor and usually has no odor at all. Normal vaginal discharge often appears clear or milky when it dries on your clothing; occasionally you may notice white spots or a normal vaginal discharge that is thin or stringy looking. This is all normal, and the sticky, stringy discharge indicates that you are ovulating. So if you have been on the pill for a long time you may not have seen it for awhile as you would not ovulate on the pill. The appearance may change due to sexual excitement, breastfeeding, ovulation, or diet. The consistency of your vaginal discharge or how thin or thick it is can be affected by your menstrual cycle, emotional stress, pregnancy, any prescription or OTC medications including hormones such as in the pill.

Other things that can upset the natural pH balance of your vagina and lead to vaginal infections include vaginal douches, feminine hygiene products, perfumed or deodorant soaps, antibiotics, pregnancy, diabetes, or infections. So we can all see that it is a highly sensitive area affected by many things, some obvious and some we would not expect. For example, having a head cold can cause and increase in vaginal discharge, strange huh? It is no wonder that douching with perfumed or homemade solutions can cause such recurrent or chronic odors and discharge. Although you can buy the douches at the local drug store, it this does not mean they offer help.

Your menstrual cycle has a significant affect on the type of vaginal discharge you experience throughout the month. Did you know you’re more likely to experience vaginal infections just before or during your period? This is because the pH balance of your vagina rises during your monthly cycle causing the pH of your vagina to be at its’ highest point a few days before and during your period. About halfway between your periods an increase in vaginal discharge that appears mucousy, sticky, and stretchy is normal. As stated above, this type of vaginal discharge is an indication of ovulation.

You may identify abnormal vaginal discharge and infection from the following signs:
- Changes in color, consistency, or amount
- Constant, increased vaginal discharge
- Presence of itching, discomfort, or any rash
- Vaginal burning during urination
- The presence of blood when it’s not your period time
- Cottage cheese-like vaginal discharge
- A foul odor accompanied by yellowish, greenish, or grayish white vaginal discharge

You are probably are aware of these signs or may have had them at some point. I recommend that you would go see you Ob/Gyn or family doctor when this happens and not just self-treat, unless it is something that you have had before and have already been seen for it. Vaginal discharge and infections are common and your doctor is used to seeing all types, so your doctor and the nurse may put you at ease. The anticipation of going and thinking about it is always worse.

The most common vaginal infection is bacterial vaginosis, as well as vaginal yeast infections and trichomoniasis. The most troublesome problem for some women are those who have recurrent or ongoing vaginal odor for no reason. This is a major issue and very embarrassing as they never feel clean, even though it has NOTHING to do with cleanliness. It is not from an infection and can be caused from any of the above we've already addressed.

We are lucky because if you check the WaterWorks Website you will find a wonderful device that 1000's of women are using today for daily feminine hygeine purposes, cleanliness after sex, and because of the unique FDA cleared design has cured many women of their vaginal odor problems. So no more embarrassing odors to worry about during sex, what a relief!

The Dilemma of Birth Control & Libido

2016-01-15T10:00:00.004-08:00

The question this week comes from Candace who writes:

I am twenty-nine years old and I have been on birth control since I was seventeen. The reason I was placed on it initially was to help regulate my period, which was becoming more and more of a problem. Instead of heavy flow for the first day of my cycle, I was bleeding heavy for four to five days and passing blood clots. This heavier flow also caused me to have severe cramps. When my ultrasound and blood tests came back normal I was placed on a birth control pill and, after a couple months, my symptoms went away and my periods returned to normal. Since that time, I have had no other problems. It really has been easy.

My concern now is that I have no sex drive and I feel that I am too young to be experiencing this. I read somewhere that the pill can interfere with hormone balance and cause this decreased libido or sex drive. Is that true? What can I do about it?

Unfortunately the answer is yes. The birth control pill has many side-effects. So many of them are positive (like regulating periods, decreasing of pain and cramps, controlling PMS, decreasing menstrual blood flow and clearing the complexion) that we rarely think of the negative effects.

Birth control pills combine estrogen and progesterone together in a specific way to prevent ovulation. Unfortunately, the very thing that causes this cycle control can also create a lack of sexual desire. You see, “the pill” is so effective at balancing hormones that it blocks the normal hormone fluctuations during the month which bring with them increased libido. Studies have shown that birth control pill users have a lower testosterone level than non-users because “the pill” can increase levels of sex binding globulin. This causes most of the estrogen and testosterone to be bound rather than circulating free in the blood stream, so less is available for use by the body.

So what can we do about it? First, we need to get a complete profile of lab tests, as this will give a snapshot of where hormone levels are on birth control. Once these levels are determined it is easy to see if estrogen or testosterone are low or both.

There have been several studies that show taking testosterone can improve sexual desire and function. In fact, low testosterone can not only cause hypoactive sexual desire, it can cause other diminished sense of well being, dysphoria (a mild depression), fatigue and loss of sexual pleasure.

Now, if estrogen and testosterone are low a woman can remain on her birth control with testosterone supplementation without compromising the pills' ability to prevent pregnancy. However, adding estrogen can compromise the contraceptive effectiveness.

Since sex is such an important part of a good relationship with your partner, and “the pill” is only one form of contraception, methods like the IUD (intra-uterine device) are becoming very popular, as it does not interfere with hormone balance. Most women who start using IUDs choose to stop taking “the pill” and, if the lack of sexual desire persists, then a hormone panel can be taken and re-evaluated by your doctor.

Isn't this fun? I am trying to keep it simple because it can get very complicated. Since we know low testosterone causes decreased sexual desire and pleasure, adding testosterone is the best place to start.

A healthy sexual relationship helps relieve stress and can heighten our sense of well being. This is important to understand as over 50% of office visits to health care professionals are from illness brought on or worsened by stress which can impact many aspects of our day to day life.

Is a Yeast Infection Causing The "Fishy Smell"?

2015-12-04T10:35:00.002-08:00

So many of you are concerned about vaginal odor and come in for testing worried something may be seriously wrong. Others are just frustrated because they have an odor that never really goes away.

Yeast infection is not usually the culprit of "fishy”- type odors. Yeast infection can cause a change in the normal odor of your discharge. It may smell similar to the smell of bread or beer. This kind of odor is often described as a "sour" smell, rather than "fishy". Yeast infections are also mostly known for their intense itching and white discharge that is sometimes described as “cottage cheese”-like.

"Fishy" odors are associated with bacterial infections such as Bacterial Vaginosis ('BV'). You may have had one or both of these types of infections. They are very common and are not passed sexually. They are not STD's, although partners of women with yeast infection may notice external itchiness after sex (this is uncommon and will usually go away quickly without treatment).

Your body, GI tract and vagina naturally have bacteria and yeast living in them. They are there for a purpose - to create a balance. The problems (infections/odors) come when the vaginal ecosystem gets imbalanced, which allows the 'bad' bacteria to take over. Normally the 'good' bacteria are in abundance, which is what is needed to maintain a low, acidic environment. This is the vagina's defense against infections and unpleasant odors.

I think the greatest concern is how we keep everything in balance to keep the 'bad' bacteria from taking over, and causing unwanted odors, BV and yeast infections. Sex, your menstrual cycle, medications, birth control pills, hormone changes in pregnancy or menopause and over-the-counter treatments (especially douching with over the counter (OTC) douches) can all upset the vaginal balance.

I know by the time patients come and talk to me about unpleasant fishy odor, it has become a very embarrassing problem that can interfere with intimacy. Some women worry that it is a hygiene problem and somehow they are not staying clean enough. Many women find temporary relief, but the odor returns no matter how many times they shower or try to rinse out their vagina. Most of the time this just makes it worse, because all this cleaning and douching is only destroying the 'good' bacteria with the 'bad', leaving your vagina defenseless. So everything rebounds back, over and over, causing fear and frustration.

But it is not a hygiene problem; rather the pH and normal flora balance just need to be restored. WaterWorks Feminine Cleansing System is used for so many women for odor without infection(s). WaterWorks is all-natural and you don't need to turn to pharmaceuticals to rid yourself of this recurrent odor problem. Many women are using it daily to clean their vagina and find that it is perfect for rinsing out semen after sex and residue of blood from their cycle. As I said above, it’s the semen and blood from your menstrual cycle that can create the imbalance in the vaginal ecosystem and raise the pH, causing the unpleasant odor.

WaterWorks is the only FDA cleared vaginal cleansing system that uses only tap water flowing through a stainless steel nozzle that gently rinses and cleanses the vagina. It is the reaction of running water with stainless steel contacting the vaginal walls that removes the odor. The best thing is, it is reusable and comes with a water reservoir and tubing that connects to the stainless steel nozzle for insertion. You do not have to continue to buy OTC douching products that don't work or pay co-pays on prescribed medications that only work temporarily.

WaterWorks has been the only product to work for so many women to eliminate unpleasant odor, and so many have had results the first time they used. It can help you to keep infection away, maintain a healthy vaginal ecosystem, and allow you to feel more confident. I truly hope this has answered your question and helped you this week.

Is it Safe to Douche to Remove Vaginal Discharge or Odors?

2015-11-20T09:52:00.000-08:00

This is probably one of the most confusing decisions that women make about their personal hygiene.

Just go to the corner drug store and see how many feminine hygiene products are available. You’ll find many packages of premixed, disposable douches of various types and scents. I was asked today by a patient who had just had a c-section a few weeks ago when I felt it would be OK for her to start douching again! But the majority of women won't even ask their doctor about douching because they know that most gynecologists are against it altogether.

For many girls in their early teens, douching is taught as part of their personal hygiene by their mothers or older siblings. The applicators and empty boxes are seen discarded in the wastebasket just like pads and tampon wrappers. Most girls don’t consider that douching could in any way be an unhealthy practice. They think, “Why would stores sell them if they were not safe to use?” Some women feel unfinished or unclean if they are unable to douche after their monthly cycle or intercourse. Others incorporate it into their daily bathing routine.

Unfortunately, these same women who are hoping to clean their vaginal area with douches can actually completely disrupt the natural vaginal pH and flora, setting the vagina up for odors, discharge and recurrent yeast and bacterial infections. The normal vaginal pH is about 4.0, and it is this acidic environment that prevents the overgrowth of unfriendly bacteria as seen in bacterial vaginosis or recurrent yeast infections. Changing the vaginal pH with douching can invite overgrowth and infections.

Vaginal discharge is normal, and should only cause concern if it has a very strong, unusual odor or is causing irritation, itching or burning during urination. If this happens, it is important to get examined by your doctor.

It is estimated by ACOG (American College of Obstetricians and Gynecologists) that 20 - 40 percent of women age 15 - 44 douche at least once a week to remove blood, discharge and odors. Clearly, there is much confusion among women who are struggling with recurrent infections and odors. The vagina, if left alone is usually able to maintain a low pH and clean itself. But many of you are continually struggling with unwanted vaginal odors and recurrent yeast and bacterial infections. Because of this, you are prescribed oral medications, antibiotics, and vaginal creams over and over. And the temptation to douche is still there, because the odors keep coming back.

Luckily a remarkable new product I have discovered along with my patients, called WaterWorks, has absolutely changed the lives of so many women. It is a special, reusable vaginal cleansing system that uses just plain tap water. It is used in the shower, and what makes it so special is the stainless steel nozzle that sprinkles water out gently. It is the reaction of the stainless steel with the water and vaginal mucosa that eliminates (not covers up) odor. Odor can be eliminated the first time it is used! The system does not change vaginal pH, nor does it destroy the good bacteria and natural flora.

If you haven't checked it out, now is the time. Just go to WaterWorkshealth.com and see what you're missing. Leave the old douches behind, and start on a journey of refreshment and healing.

HPV Virus and What Can be Done About It

2015-11-06T11:35:00.000-08:00

Many of you have questions about the HPV virus and what can be done if you have a pap smear with a positive result. HPV (Human Papilloma Virus) are little organisms that can infect the skin and the lining of some of the body's passageways and internal organs. There have been more than 100 types of HPV identified. Some types of HPV cause no known health problems. Others can cause warts to grow on the infected areas (skin, perineum, vocal cords and in the vagina), and a few types can cause cancer. It is because of this that we want you to have pap smears every year, as they screen for cervical cancer and HPV virus.

HPV is very common, and it is estimated that greater than 75% of people worldwide are infected. In fact, HPV is the most common STD in the U.S., especially among young people. That means that if you are sexually active, you have a very high chance of contracting it. One partner could be a virgin at the onset of the relationship, and if their partner has been with even one other person and got the virus from that person, he/she can pass it to the other. Only if both partners are virgins and truly have never been with another person sexually (in any way - anally, orally, etc.) will they remain free of the HPV.

That is why if your current partner is your first partner, but you are not his, and you suddenly have an abnormal pap smear that is positive for HPV, it does not mean he has been unfaithful. The HPV virus can lay dormant, hiding in your cervical cells for many years, never showing any symptoms, and suddenly begin to replicate and become active again.

Women who get yearly pap smears are more likely to have the virus detected and prevent any serious consequences like cancer. HPV has high and low risk types. It is the high risk types that are covered in the HPV (gardasil) vaccination which is now available for boys and girls.

We know that, with early detection, any signs of progression to cancer can be caught early and treated. HPV can affect the oral mucosa - causing mouth and throat cancer, and the anus - causing anal cancer. With a healthy immune system, most people who contract HPV when they are young will eventually destroy the virus on their own with no lasting health problems. Risk factors that can interfere with your body's ability to do this and which put a person at risk for cancer are: cigarette smoking, being infected with another STD at the same time, and a weakened immune system from having another medical illness like diabetes, HIV, or autoimmune illnesses.

Once again, safe sexual practices and using condoms seems to be very important, as well as not having multiple sexual partners at the same time. These are ways to help yourself.

I know I discussed this before, but many of my patients love the WaterWorks device for this reason. Immediately after sex, you can get up and use it to rinse out the semen. The longer the semen stays inside of you, the more likely you are to get HPV and other STDs. The guys always jump up and rinse off and pee, right? So this is a woman's way of doing the same. Get the semen out, and let WaterWorks gently cleanse your vagina. You will feel cleaner and have peace of mind. It uses only warm, clean water and no chemicals, so what could be better?

Hope you stay cool and your summer is fabulous. It is almost over, so if you haven't done something fun for yourself, it doesn't have to be expensive, but do it this week.

Causes of Vaginal Bleeding or “Spotting” Between Periods

2015-10-23T09:40:00.005-07:00

Our topic of the week, vaginal bleeding or “spotting” between periods, is just one of those common problems that women experience at different times for many reasons. What worries most of us does not know why we are bleeding or how long it will last. And let’s face it, it's just plain messy and inconvenient to have unexpected bleeding over and over.

Two patients came in this week who has been struggling with recurrent vaginal bleeding. When a woman comes into my office for vaginal bleeding that is not part of a regular menstrual cycle, it begins a whole investigative process.

Rarely would I able to discover immediately on physical exam, or by looking into your vagina with a speculum, the reason for abnormal vaginal bleeding, because the cause of most vaginal bleeding originates way up inside where I can't see. That's why we need ultrasounds and CT scans to look deep inside your body, and blood tests to make sure all your hormones are in check. We need to be sure that the other organs in your body are functioning properly.

A woman's body is so sensitively balanced and intricately put together that simple things like diet and exercise can affect and disrupt the entire system. Especially because so many of our meats and dairy products are full of growth hormones and antibiotics they give to the livestock.

So what is considered abnormal bleeding?

• When you are not expecting your menstrual period.
• When your menstrual flow is lighter or heavier than what is normal for you.
• At a time in life when it is not expected, such as before age 10, when you are pregnant, or after menopause.
• Bleeding with pregnancy is always scary, and is something that always needs to be checked out by your doctor. Spotting to minimal bleeding may be normal in pregnancy. But, heavy vaginal bleeding or bleeding that occurs before 12 weeks may mean a serious problem like possible miscarriage or ectopic pregnancy. Heavy vaginal bleeding or bleeding that occurs after 12 weeks also may mean a serious problem, such as placenta previa.

Non-pregnancy causes of bleeding:

• Ovulation can cause mid-cycle bleeding.
• PCOs (polycystic ovarian syndrome) is a hormone imbalance that interferes with normal ovulation – it can cause abnormal bleeding.
• Medicines that interfere with hormones.
• An IUD also may increase your chances of spotting or heavy bleeding.
• Infection of the vagina, cervix, uterus, fallopian tubes, or ovaries may cause vaginal bleeding, after intercourse or douching.
• Sexually transmitted infections (STIs) are often the cause of bleeding.
• Pelvic inflammatory disease (PID) causes inflammation or infection of the uterus, fallopian tubes, or ovaries, which can cause abnormal bleeding.
• Sexual Abuse or rough sex.
• An object in the vagina.
• Uterine fibroids which are a common cause of heavy periods
• Structural problems, such as uterine prolapse or polyps.
• Cancer of the vagina, cervix, or ovaries.

So, as you can see, there are so many different reasons for abnormal bleeding that it is important to check with your doctor to make sure your body is functioning properly.

I hope you all have a wonderful week and stay safe. :)

Are Oral and Hormonal Contraceptives Safe?

2015-10-16T09:42:00.003-07:00

Good Morning, I hope all is well this week.

As we all know, contraception is an important women’s health issue. It seems to be a regular part of the daily routine for many of us. A question I am frequently asked about is whether oral or hormonal contraceptives are safe, especially in women over 35 or who have medical conditions.

Besides preventing pregnancy, women gain some real non-contraceptive benefits from combined hormonal contraceptives or CHCs. Some of these could be decrease of dysmenorrhea and menorrhagia (painful periods and heavy bleeding), regulation of timing and cycle length, decrease in problems with anemia or iron deficiency or improvement of symptoms of PMS and breast tenderness.

Women with PCOS, the most common hormone imbalance in younger women, may see benefits and find improvement in their acne and weight. Pills containing progestins such as drospirenone help with antiandrogen and antimineralcorticoid activity that may reduce water retention and hirsutism (abnormal hair growth). CHCs have been found to be safe in non-smoking women with well controlled hypertension, uncomplicated diabetes, migraines without aura, uncomplicated liver disease and connective tissue disorders such as rheumatoid arthritis without antibodies and lupus erythematosus.

There are options of non-hormonal contraception like the IUD, condoms, diaphrams, cervical caps, and spermicides. If used properly they are effective to prevent pregnancy. For women who have other health issues, you may feel more comfortable using these methods.

So this should make a lot of women happy to know that birth control is safe and can be beneficial in some ways. There are lots of options, so don’t get caught pregnant, wishing you would of done something sooner.

Vaginal Discharge - What is Normal?

2015-10-02T08:38:00.003-07:00

Many of you are really struggling with an overabundance of vaginal discharge and write to me. You are concerned about whether it is normal, or perhaps due to some type of infection. It may go away for a week after the prescribed treatment, only to have it return again and again, sometimes only days later. I just want you to know, you are not alone. I see women in my office every day who struggle with this and feel that they are the only ones.

First, discharge is normal if you are a young adolescent or pre-menopausal female. It is secreted from special glands in the vagina that help keep us healthy by acidifying the vagina. This helps to fight off abnormal bacteria and yeast and provides moisture, so sex is not painful. Having no vaginal discharge would be like having no saliva in your mouth. Your teeth would decay, your tongue would stick to the top of your mouth, and you wouldn't be able to eat.

But some of you worry that you have too much discharge and actually need to use panty liners to stay dry. ‘Too much’ is not something I can determine, because what is normal for one woman may not be normal for another woman.

Vaginal discharge changes throughout our cycle, in both consistency (from thin and runny, to sticky and gooey, to thick and creamy). During ovulation it even has the consistency of mucous and a texture that is stretchy in nature. The changes correlate with hormone changes in our bodies. That's why the amount can change from woman to woman, as some women naturally have higher estrogen than others. We see this in pregnancy, and any woman who has been pregnant knows she had more discharge then, due to the higher hormone levels.

Besides making us feel 'wet' all the time when there is too much discharge, what you need to look for as abnormal is a sour or fishy odor, or itching that is uncontrollable. The first can be a sign of a bacterial infection (BV), and the second can be a sign of a yeast infection. Both are easily treated with prescription vaginal gels or tablets.

The odor can be exceptionally upsetting, as it lingers, and no amount of showers or baths will cure it because it is not from being unclean. Persistent discharge can also cause rashes and irritation, sort of like diaper rash in infants.

Recurrent yeast (candida) infections need to be checked out, as sometimes it can be a sign of a compromised immune system, like we see with diabetes, lupus, thyroid disorders, and HIV patients.

If you are struggling with constant yeast and bacterial infections, and feel you have way too much discharge, your gynecologist may prescribe Metrogel and Diflucan tablets to clear the infection. But for those of you who use the medications, only to find they return within a few days or a week, the best treatment is often to repeat the treatment 3-4 times back to back.

If you have an IUD, yeast and bacterial infections can happen more often, and it may take longer to normalize the vaginal pH to prevent recurrent infections.

I would also recommend purchasing and using a WaterWorks, as it is FDA cleared for vaginal cleansing and odor, and is all natural – with no harsh chemicals or perfumes.

As for surgery, like cryotherapy of the cervix for chronic cervicitis, or endometrial ablation, if you have no intentions of future pregnancy, it may help. But these need to be discussed with your gynecologist.

Should I Use an IUD to Regulate My Periods?

2015-09-17T20:07:00.000-07:00

“Dear KnowYourV, I’m 17 years old and I am active in many different sports like track, La Cross, biking and water sports. Every month my period comes very regular but it lasts for 6-8 days and it is very heavy and I pass clots for at least 3-4 days. I’ve heard birth control can help regulate periods and decrease bleeding. I have also seen commercials on TV that talk about the Mirena IUD and that it can do the same. The thing is I just don’t know if I am too young for an IUD or if I should use some other kind of birth control? I’ve heard if you are young, and have never had children, you should never use an IUD. Is that true?"

Thank you for your question Mimi. I know so many women of child-bearing age that have questions regarding birth control and IUDs (Intrauterine Devices). There are a lot of things to consider when deciding to start taking birth control. Things like; bleeding patterns, how much bleeding with each cycle, PMS, menstrual migraines, pain with periods, whether you have tried birth control before and had undesirable side effects, whether you want permanent or reversible birth control, etc. etc.

The trend today with so many women is to try to use more natural products and steer clear of products that artificially alter the body’s natural chemistry. That is why we are seeing a renewed interest in IUDs.

These 2nd generation IUDs are designed a little different than the IUDs of old, and these changes have really made all the difference. Let’s remember that “the pill” and other hormonal birth control have only been around for about 35-40 years for extensive use by the public. Prior to that, couples had few choices (such as condoms, spermicidal jellies, and IUDs). We’ve come a long way. So what are our choices for birth control today? Reversible types include; temperature chart or rhythm method, condoms, spermicidal jellies/ovules, several types of hormonal birth control ("the pill", the ring, the patch, the injection), IUDs (Mirena or Paragard). You can also choose from two permanent types: tubal ligation (laparoscopic or at time of cesarean section) or hysteroscopic tubal blockage like the ‘Essure’.

So let’s take a look at how IUDs work because there is a lot of misunderstanding about this. Today’s IUDs are shaped like a capital letter ‘T’ with a string attached to the bottom of the ‘T’. It is placed during the menstrual cycle for two reasons; first, during the menstrual cycle the cervix is slightly open so the IUD can slide up into the uterus easier and second, because the cycle is a confirmation that there is not an early pregnancy. The string is there for easy removal, to monitor correct placement and insure that it is still in place and has not fallen out or migrated out of the uterus and up into the abdomen (which is extremely rare). The string is only seen on speculum exam by your doctor and does not hang out through the vagina like a tampon string.

Currently there are two types of IUDs, the Mirena and the Paragard. The Paragard is can be placed in the uterus for about 10 years and has been around longer than the Mirena. It is known as the “copper T” because the copper in the stem is what causes the cervical mucus to thicken, creating a barrier and preventing the sperm from passing through into the uterus and on to fertilize the egg. The Mirena IUD can be placed in the uterus for about 5 years. It releases progesterone from the stem to thicken the cervical mucus and thin the uterine lining. The abnormally thick mucus prevents the sperm from swimming through to reach the egg. The progesterone can also work to thin the uterine lining, which will prevent abnormal uterine bleeding and irregular menstrual periods. That is why sometimes the IUD is used instead of surgery to help treat irregular bleeding.

The main problem with the IUDs of the past was that they used a soft cotton string. This type of string acted like a wick to absorb the vaginal moisture and bacteria from the vagina and allowed it to travel up into the uterus. The use of these typed of IUDs caused many women to become infertile as the infections caused severe scaring of the fallopian tubes. The strings on the IUDs today feel like fishing line and are a monofilament type of substance which prevent bacteria from attaching and traveling up inside the uterus where the IUD is. The new IUDs are safe, and with the new type of string we no longer see these types of super infections.

So, Mimi, that is where the rumor started long ago that IUDs were not the best birth control for someone who has not had children. But now that is no longer the case. In fact, the Mirena would be a good choice for you as it lessens menstrual bleeding and cramping, and you don’t need to remember to take it. More women are choosing it as it doesn't artificially introduce hormones into our bodies to regulate menstrual cycles and it allows you to remain on a regular cycle and to ovulate, it just blocks the sperm from meeting the egg. So give your Gynecologist a call, this may be the right choice for you.

I hope you all have a wonderful week, and please keep writing in with your questions as we love to hear from you.

Can Thongs Cause Infections?

2015-09-03T19:22:00.002-07:00

There have been many articles in women's magazines, fashion magazines, and medical journals concerning this very question. But most women don’t even think about it being the cause of vaginal infection, irritation or urinary tract infections. Thong panties may look sexy, but they can bring health risks that don't feel too sexy. It is important that women are conscious about the health risks related to wearing thong panties, so here's what you need to know before you slip on another pair.

The way a thong is constructed makes it a perfect set-up for infection. This is because that thin band of material that fits so snuggly against your delicate areas works like a sponge for bacteria. This is especially concerning as fecal material from the anal area can make its way to the vagina and urethra creating ideal conditions for urinary tract or vaginal infections.

All it takes is for the thong to slide a little when you walk to send fecal bacteria like E. Coli and Beta-Strep where it's not supposed to be. Most non-thong panties don't cause this type of problem because they're looser and allow better air flow. They also don't slide in between the delicate tissues back and forth like a see-saw.

Another problem associated with thongs is the irritating effect of the tight material against the skin. When a woman walks around all day wearing thong panties, the material rubs against the urethra and outer vaginal area creating small tears which create a risk for infection. Thongs can also irritate hemorrhoids and even cause anal lacerations. Even more risky is wearing a thong during exercise, especially in hot weather. This is a set-up for vaginal yeast and bacterial infections.

Women’s urinary pain and/or vaginal irritation often lead women to worry whether they 'caught' something from their partner like an STD/STI. By the time I see them in my office, they have often tried over-the-counter medications and douching to clean the vaginal area.

I have had my patients worry so much about cleaning the vaginal area that they will use disposable douches 3-4xs a day. They will reuse the disposable douche bottles and refill them with their own recipes like vinegar solutions, soap and water, shampoo, mouthwash, lemon juice, or plain water. I’ve even had women who have used a shower nozzle inserted into their vaginal area to clean out the discharge and infection. I have had other women tell me they simply use their fingers to reach up and clean inside their vagina with soap and water. All of these methods can be very harmful and can lead to more infections by continually removing all the 'good' vaginal bacterial or flora that is there to balance and fight infection.

That is why, if you haven't already looked into purchasing the WaterWorks Vaginal Cleansing System, you should.

It is a wonderful way to feel clean, and be able to safely clean inside your vagina without destroying the 'good' bacteria and vaginal flora that is supposed to be there. It is FDA approved and reusable so you never have to re-buy anything. It is made of medical grade stainless steel and is sturdy and well-made.

WaterWorks uses no chemicals - only plain tap water for cleansing. It is the reaction of the stainless steel with the water and the vaginal mucosa that creates the natural chemical reaction to remove unwanted odors. And unlike a traditional douche, the soft downward sprinkling action completely and safely removes unwanted discharge. What a wonderful combination for women today to have to ensure personal hygiene without the worry of creating more infection.

What Causes Vaginal Odor?

2015-08-12T19:58:00.001-07:00

This week’s question comes from quite a few of you, like Sandy and Joanie, who asked: "I’m so frustrated, because I don’t understand how I can shower (sometimes four or five times a day) but am still so embarrassed because I feel like others can smell me if they get too close. Am I doing something wrong? I feel like I’ve always been a clean person. Can you help me, or tell me what I’m doing wrong?"

Thank you for your question. This is such a common problem for so many women, so let’s talk about what this odor means and what can be done to help. Vaginal odor, no matter the cause, is a distressing thing to try to deal with. There can be many causes. Most of you have heard of BV, or bacterial vaginosis, and know about the odor that can accompany it. It is the most common vaginal infection and is caused by an imbalance of the normal bacterial environment. This is found most commonly in women of childbearing age that are sexually active, but all women are at risk. Normally the vagina maintains a healthy balance of good and bad bacteria but BV happens when the bad bacteria outgrow the good bacteria. This imbalance interferes with the vagina’s ability to “self-clean”, as the predominant bacteria is smothered out and over taken by the bad species of bacteria not normally found in the vagina.

A healthy vagina normally contains many microorganisms. The most common are from the Lactobacilli family, commonly found in yogurt and beneficial to the vagina as it is a hydrogen peroxide-producing species, which helps prevent other vaginal microorganisms from multiplying to a level where they cause symptoms. The microorganisms involved in BV are very diverse, but include Gardnarella Vaginalis, Mobiluncus, Bacteroides and Mycoplasma.

The bad bacteria can cause symptoms like itching, burning, pain, and can even give you a bladder infection. In pregnant women, it can cause preterm birth and low birth weight babies. There can be a noticeable thin, grey-white discharge with an unpleasant fishy odor that accompanies it. This discharge coats and clings to the vaginal walls, preventing the release of normal discharge that is used to clear the vagina of unwanted bacteria.

However, you should note that vaginal odor does not necessarily mean you have a BV infection. Yeast, trichomoniasis, and other STDs can also be a cause. And, sometime vaginal odor occurs without any infection at all. Anything that would disrupt the normal vaginal pH can cause vaginal odor and, if left untreated, can reach the level of a BV infection. Many things can disrupt this vaginal environment: menstrual cycles (blood is neutral pH), sexual activity (semen is a sugary, alkaline fluid), hormone imbalance, antibiotics and douching, which can sterilize the normal vaginal environment and create recurrent vaginal infections.

Most often when vaginal odor occurs, we seek out medical help and are prescribed antibiotics that destroy the bad bacteria only. This can help until it returns again, at which point the treatment will need to be repeated. Some feel that eating yogurt or taking herbal preparations with lactobacilli will cure and prevent BV. What do I think? I think yogurt is good, and eating it will help your digestion and intestinal tract, but you would have to put it in your vagina for it to help there (not recommended).

So, this is a long explanation to show you why a simple shower (no matter how many you take!) cannot eliminate vaginal odor problems. The one product I have found to be of most value in removing vaginal odor and keeping it away is the WaterWorks vaginal cleansing system. It is FDA cleared for the removal of unpleasant vaginal odor.

How does it work? It is a reusable system that looks a lot like a douching device, but it uses only tap water. The reusable nozzle of the device is made a medical grade stainless steel. It is the reaction of the stainless steel with the vaginal mucosa as the water gently sprinkles out, that creates a chemical reaction that removes odor. Many of you have seen this same thing done by chefs when they rub their hands under running water with stainless steel bars to remove the unwanted onion and garlic smell after cooking.

The best part is you don’t have to take pills or use vaginal gels. WaterWorks can be safely and effectively used every time you bathe or shower. Many of my patients use it right after sexual intercourse to rinse out the semen, which can help eliminate odor.

I hope this helped you understand just a little more about how our bodies function as women. I hope your week is productive and you stay safe.

What Can I Do About Heavy Menstrual Bleeding?

2015-08-07T10:22:00.000-07:00

I always enjoy sharing these important issues with all of you. It is so healing for us, as women, to realize that we do not suffer alone and that many others may share the same problems. It is helpful to know that there is an answer or a way to get better. If nothing else, these conversations bring understanding and validation.

Many of you are trying to deal with heavy cycles every month. There are an estimated 10 million new cases of Heavy Menstrual Bleeding (HMB) in the United States every year! So don't even think that you are alone.

This has become such a problem, as it affects overall health and ability to just feel good and function at home and work. It changes how women feel physically, and that affects emotions - so their husbands and children are also impacted. "Mom is always tired. She doesn't act happy anymore and I think she is mad at me all the time."

For some women the bleeding comes only with your menstrual cycles, but it comes with such force and terrible cramping that it brings on nausea and vomiting - causing many of you to lose days from work every month. Others of you just bleed heavily with little to no cramping, but the first 3 days of your cycle you don't dare leave the house and hope your work will be understanding AGAIN!

As women, we are used to having our cycles every month and actually are very sensitive to changes. That's why things can get pretty horrible and out-of-control before some of you actually come in to seek help. Our periods are like a fifth vital sign. There's temperature, heart rate, blood pressure, respirations and, for women, our menstrual cycle. Women come in all the time for 'emergency' appointments due to a missed cycle or because they had a double cycle. The lucky ones have a one-time or occasional irregular cycle, immediately returning to normal. Others of you are not so lucky and come in because the crazy, heavy cycle just got worse, and now you have been bleeding for 3 weeks straight (others even longer, like 3 months).

A THREE MONTH long period? A three month long period with cramps and heavy, heavy bleeding with passage of strawberry- and cherry-sized blood clots? Indeed. The bleeding can get so strong that you use both tampons and pads, but the blood clots just push the tampons back out. So off you go to sit on the toilet and let the clots and blood drip out, while you change your pad again for the 6^th or 8^th time that hour.

This is 6-8 pads an hour for hours on end, with only a few hours of relief between bleeding episodes before it starts up again! This can be how the first 2-3 days go. It is no way to live, and over the past century treatment has come a long way. Many women aren't interested in trying hormones or birth control pills, as they have tried them in the past without success. Other forms of pharmacotherapy, which is what it is called, like non-steroidal anti-inflammatory drugs (such as Motrin, Advil and Aleve) or tranexamic acid are still considered first line treatment before a D & C or other forms of surgical treatment can be considered. Unfortunately, insurance companies make most of the medical decisions, and women have to "fail" hormone therapy before they can be approved for a surgical cure.

Until the 1980s, the primary alternative to pharmacotherapy was a hysterectomy. It is still a viable option and, for some, still the best decision. Hysterectomy is a major operation, and if bleeding and pain are the only problem, endometrial ablation has become a preferred option. So many women work and do not have the financial luxury of taking weeks off from work to recover. The first ablations were attempted in 1930 with radio-frequency, but were not successful until 1981, when the Nd-Yag laser was used. With endometrial ablation, a hysteroscopy can be performed beforehand to evaluate the inside of the uterus. Also, a D & C can be performed after the hysteroscopy (and before the ablation) so a tissue sample can be sent to pathology for evaluation and inspection. Pictures are taken for documentation, which give the doctor and the patient an opportunity to go over the findings together.

The type of ablation performed is your choice. Most will cause periods and the bleeding to go away, or at least return to a normal cycle. Only 15% of women proceed to a hysterectomy after having an ablation, so this speaks for the success of the procedure.

It’s important to note that excessive bleeding can also bring imbalance to the vaginal flora, so it is common to notice more vaginal odor and trouble with excess discharge. I encourage all my patients to buy the WaterWorks system, as I have never found a better, natural, non-pharmacologic cure for these vaginal odor/discharge problems that are not due to infection.

Can Natural Remedies Really Help A Bladder Or Urinary Tract Infection?

2015-07-31T04:15:00.002-07:00

I have more and more patients that are turning to natural remedies when they become sick or have a medical problem such as urinary tract infections (bladder infections).

Some of you may experience bladder infections regularly to the extent that you have been placed on a daily antibiotic by your doctor to help prevent recurrence. It is common for some women to experience symptoms after sex as the bladder is partially attached to the uterus, so it can take quite a beating. Another reason for recurrent bladder infections after sex is the way we as women are made. Our vagina, urethra (opening where we pee from), and anus are so close to each other that during sex bacteria from the anus can accidentally be dragged up to the urethra or vagina.

The anal area, even if we are very clean, can harbor E.coli and other types of bacteria that live in our intestines. E.coli, outside of the intestines, can make us sick and cause infections and the closest target is the urethra and bladder. Let’s be real, we all know that during sex sometimes he can have trouble finding the vagina and for a few seconds he might be too low, right? Well, that is usually when the bacteria gets transferred from the anus up to the urethra, during that moment.

One way to prevent a bladder infection is to urinate before and after sex. Urinating before helps as it prevents the bladder from getting bumped around during sex. And urinating afterwards helps push bacteria out of the way that may be sitting at the opening of your urethra. I find that wet wipes, like the ones used on babies bottoms, are nice to have by the toilet to wipe with rather than toilet paper as they clean so much better.

If you enjoy anal sex, the rule is to never return to the vagina after or go back and forth as again, it will drag that .E.coli bacteria right into the vagina and cause an infection.

Some bladder infections come even without having sex. There are many reasons why this happens and if you have more than 6-8 episodes a year (not after sex) it should be evaluated by a urologist.

So what about natural remedies for this? Prevention is very important, but do cranberry juice and pro-biotics really help? Absolutely, and many of you know this by experience. Of course, being a trained physician it’s nice to know that controlled scientific studies have verified its efficacy. So how does it work? Well, one important property of cranberry juice is that it acidifies the urine. Why is this important? For the same reason that it is important for the vagina to maintain a slightly acidic environment - most bacteria that infect our bodies (like E.coli) cannot grow in an acidic environment. Our bodies, blood, etc. have a physiologic pH of around 7.4 which is compatible with life. The acidity of the urine, vagina and mouth are a natural barrier created by God to protect against bacterial invasion from the outside. If there is a breakdown in the defense that changes that pH, it creates a way for the bad bacteria to flourish.

So, if you feel like you are getting a bladder infection, get some cranberry in juice or pill form and take often. It is also important to drink lots and lots of water to flush out your bladder. That is a good way to prevent recurring infections too, as drinking too much soda and coffee can irritate the bladder. We also know cranberries contain certain components that adhere to the bladder wall that block bacteria from invading. Fortunately they are finding some natural probiotic remedies that are helping to naturally fight infection.

WaterWorks is a natural remedy to help you feel fresh and clean and it fits into the “green” protocol. It provides a natural way for you to cleanse the vagina and labial area to help eliminate odor. Try WaterWorks after sex to rinse out the semen. It works better than just the shower spray that some of you use to clean with because it is designed with a light weight stainless steel nozzle that inserts into the vagina and releases water to gently cleanse. The stainless steel reacts with our vaginal mucosa to remove unwanted odors. WaterWorks is a safe and effective way to clean vagina out naturally.

Vaginal Discharge and Odor Relief

2015-07-24T08:33:00.000-07:00

This week the question that has been asked is: what should you do if your discharge has an odor with it that doesn’t go away after bathing and douching for a week. This is one of the most common benign problems that I hear about from my patients. But for some, the problem is so persistent and bothersome that they become desperate to try ANYTHING that will make it stop so that they can return to normal. Here is what Sarah wrote:

Dear KnowYourV, I’ve hesitated to write to you as I have been having trouble with vaginal discharge for awhile now and no matter what I do it keeps coming back. At times there is a foul odor that comes and goes. I saw where you talked about the WaterWorks device and how it may help with discharge and odor. Can you please help me? I am frustrated. I feel that I am a clean person but don’t understand why I keep having discharge.

Well, Sarah, your first inclination may be to douche so lets talk about that. Douching means to soak or rinse out the vagina. Usually water, vinegar, lemon juice, baking soda or iodine is used, but other mixtures have been used as well. This practice has been shown in recent years to cause more harm than good because it can destroy the normal vaginal flora that is present to maintain a normal healthy environment. The vagina is effective at self-cleaning due to the fact that it maintains an acidic pH. It is this that keeps the yeast and abnormal (smelly) bacteria from over growing. But there are ways that the pH can be thrown off, such as from normal period blood or from semen, because they are physiologic pH and disrupt the normal vaginal flora.

There are many reasons we as women would want to reach for a douche: to clean the vagina, to rinse out period blood after the cycle is over, to clean out a foul odor, to clean out sexually transmitted diseases or wash out semen. But douching can cause more harm than good. If you have a true bacterial or yeast infection you may need a prescription to help get rid of it. Douching can also make an STD worse by forcing the infection up through your cervix and causing infection in your fallopian tubes. This can cause infertility. Douching is also not a good way to prevent pregnancy because the forcefulness of the stream of fluid again can force the semen through your cervix and carry the sperm closer to the egg.

Your discharge could well be caused by a bacterial infection. Bacterial infections are not dangerous and they are treatable. Your doctor can prescribe an antibiotic pill or gel to eliminate the infection. If the odor remains, which it may, after the infection has cleared up DON’T DOUCHE!!! As we've seen, over the counter douches are dangerous. However, there is a product out there now that goes a step farther: WaterWorks Feminine Cleansing System. The reason it is so awesome is that it is FDA cleared for eliminating vaginal odor and it is chemical free. And it uses plain tap water from your shower and doesn't use soaps or harsh chemicals of any kind. WaterWorks is the only feminine cleansing system with the patented stainless steel nozzle that reacts with the water and eliminates odor from your vagina.

The best part is that it’s completely reusable and can be used every day (or less, it can be used as often as needed) to clean the vagina. All parts are made of sturdy materials that are easily cleaned for the next use. When I first learned about it I could hardly believe it, but many of my patients, personal friends and even I have used it and can testify that it truly works. I know so many of you who have struggled for years trying everything over and over, and I want you to know WaterWorks is what you’ve been looking for.

Relieving Vaginal Discharge Issues

2015-07-09T17:55:00.002-07:00

Hello everyone, it’s been a great week and I trust all of you feel the same. I have had many of you writing in because you are struggling with an increase in vaginal discharge that sometimes itches but mostly has an odor that won’t go away no matter how often you shower.

Mandy wrote in worried about just that problem:

“Dear KnowYourV, I really don’t know if you can help me or not. I am 26 years old and I have had a discharge for about 6 months now that comes and goes. I know having some discharge is normal, but this is so much more than what I normally have that when it’s there I have to use a tampon or a pad all the time. Then when I take the tampon out there is a terrible odor. I’m so worried because it never gets better no matter how many times I bathe or shower. I’m concerned I have something really serious like a cyst or cancer or a serious STD that could make me infertile. I have been to my primary care doctor who gave me some pills that only helped for a week or so. I hope you can help me, I’m really worried. Thank you, in advance, for your help.”

Vaginal odor can be a very difficult thing to deal with, especially when it keeps reoccurring for no known reason. It is a good idea to make an appointment with a gynecologist when you have an ongoing problem like this. Your doctor can send you for an ultrasound to make sure your uterus and ovaries are normal and that there are no polyps or cysts present that could be causing abnormal discharge. At the same visit vaginal cultures can be done to insure that you do not have an STD or other infection.

Cancer is very rare in someone as young as you; if you have an updated pap smear that is negative and the ultrasound was also negative, you can breathe a sigh of relief.

Most of the time women end up trying many different products, including douching, to try to get rid of the odor. Some of these products may help for a few days (just as the “pills” you were prescribed by your Gynecologist) but the odor always returns. The vagina is self-cleaning and should maintain a healthy pH level on its own. A healthy pH level prevents the growth of yeast and unwanted bacteria. But anything that disrupts this pH can disrupt the self-cleaning. Semen and menstrual period blood can cause a rise in the vaginal pH, resulting in recurrent bacterial infections and ODOR. This cycle can go on and on. Uuugh!! It makes you feel like everyone else can smell what you smell as you walk by them. Not to mention sex, who wants him down there when it smells like that?

Well, lucky for all of us, bacterial infections are not dangerous and they are treatable, and have never been shown to cause problems with infertility (other than avoiding sex because of odor problem - LOL). But seriously, your doctor can prescribe an antibiotic pill or gel to eliminate the infection.

If the odor remains, which it may, after the infection has cleared up DON’T DOUCHE!!! Over the counter douches are dangerous. However, there is a product out there now that goes a step farther: WaterWorks Feminine Cleansing System. The reason it is so awesome is that it is FDA cleared for eliminating vaginal odor and it is chemical free. And it uses plain tap water from your shower and doesn't use soaps or harsh chemicals of any kind. WaterWorks is the only feminine cleansing system with the patented stainless steel nozzle that reacts with the water and eliminates odor from your vagina.

The best part is that it’s completely reusable and can be used every day (or less, it can be used as often as needed) to clean the vagina. All parts are made of sturdy materials that are easily cleaned for the next use. When I first learned about it I could hardly believe it, but many of my patients, personal friends and even I have used it and can testify that it truly works. I know so many of you who have struggled for years (or maybe only 6 months like Mandy) trying everything over and over, and I want you to know WaterWorks is what you’ve been looking for.