Dr. Alyssa Dweck,author of V is for Vagina, shares everything you need to know to keep your vagina healthy.
Dr. Dweck explains the markers of a healthy vagina, as well as when it's time to see your gynecologist. She also shares nutritional and hygiene tips.
RadioMD Presents: Wellness for Life Radio | Original Air Date: May 8, 2015
Host: Susanne Bennett, DC
Guest: Alyssa Dweck, MS, MD
You are listening to Radio MD. She is a chiropractic, holistic physician, bestselling author, international speaker, entrepreneur and talk show host. She is Dr. Susanne Bennett. It is time now for Wellness for Life radio. Here is Dr. Susanne.
DR. SUSANNE: Every year, once a year, women are recommended to go to our gynecologist so that we can make sure that everything is doing really well within our female organs, the vagina, ovaries, uterus. All of that and the majority of the time, and I mean, majority of the time, the doctors will say, “Oh. Everything is looking really good. Your vagina and the health of your female organs are wonderful.” Now, I’m asking about this for women out there. Is it really 100% healthy? Because we only go there, to the doctors, once a year. So, my next guest is a full-time practicing gynecologist and also the author of, “V is for Vagina: Your A to Z Guide to Periods, Piercings, Pleasures and so much more.” So, she’s here to share with us how to keep your vagina healthy and how to know when it’s time to see your doctor.
Welcome, Dr. Alyssa Dweck.
DR. DWECK: Thank you for having me.
DR. SUSANNE: Oh, absolutely. You know, how often should we get our vaginal area examined? Our female organs examined?
DR. DWECK: I’m so glad you’re asking this question. We always recommend that women come in once a year to have a regular exam. However, there’s been some confusion out there because the frequency of the actual test called PAP smear, which is a screening for cervical cancer, has actually decreased over the last couple of years and, in many cases, could be ever 3-5 years. So, just because the PAP smear is every 3-5 years as a recommendation doesn’t mean women shouldn’t still come in to see their gynecologist once a year.
DR. SUSANNE: Well, once a year, you know, if women are sexually active. Now, often, when…and some women are on birth control. You know, we actually have more discharge than the average individual and so how do we know? If it’s just once a year, maybe we’re actually having an infection and you don’t even know it.
DR. DWECK: Right. This is so true. I think it’s so important that women get to know their own bodies so that if there’s a real change that occurs, that would be a signal to perhaps give you gynecologist a call. In general, a mucousy, clear, non-malodorous discharge from the vagina is physiologic and typically normal and for women not on the birth control pill, for example, they’ll notice a heavier discharge during the mid-cycle with ovulation. But, for example, if there’s a bloody discharge or a discolored discharge or something that has a foul odor or is causing pain or irritation, this really should be checked out.
DR. SUSANNE: Right. Right. Also, there’s other symptoms such as itching and burning and even when you’re having sex, you might have pain. That’s also indicated, isn’t it?
DR. DWECK: Yes. And that’s something that should be checked. For example, now that a lot of the yeast medications are over the counter, women often try to self-treat and, many times, that’s successful, but many times they’re really self-diagnosing a yeast infection when something else might be going on. For example, a bacterial imbalance or an irritation from a product that they might be using. So, at times, it really is helpful to get checked out thoroughly.
DR. SUSANNE: Right. Right. Often, I know. Women do take it upon themselves to help clean their own body and some people use douches. I don’t recommend them. I’d really like to know what your recommendation is.
DR. DWECK: Well, you and I are on the same page. I really don’t recommend douching either, although some women really feel comfortable cleansing out the vagina with a mild fluid maybe once a month after their period and if they feel that this is so urgent that something very simple, a pH balance, like a vinegar and water douche would be reasonable but I don’t recommend douching. The vagina is an amazing organ that actually cleans itself and it has plenty of mechanisms to keep itself healthy without the need to douche or use any feminine washing products other than just mild soap and water.
DR. SUSANNE: Right. Right. A lot of my patients come in and they’re on birth control and it’s a lot easier for sexual activity, but also the man can ejaculate inside the vagina and, of course, the pill is to prevent any unwanted pregnancies. What I find thought, is that the semen itself can actually be food for more yeast infections so I ask my patient to just go in and use their fingers and go in there after ejaculate is inside and just scoop it out. Do you think that would be okay for women to do?
DR. DWECK: I don’t think there would be any harm in that. I typically recommend that, especially for women who get uncomfortable after intercourse or who might be prone to infections to just use the restroom after intercourse, urinate. That tends to flush things out a little bit. Or, even shower quickly if they feel that that’s necessary. But, it’s really kind of an individual basis.
DR. SUSANNE: Right. That’s a great point about showering. Showering quickly. And, also urinating, right?
DR. DWECK: Yes.
DR. SUSANNE: Urination. So that…Yes.
DR. DWECK: I have so many women who are prone to urinary tract infections and sexual activity seems to bring them on and really instigate this symptom so in those particular cases, I’ll often recommend urinating both before and after intercourse just to lessen the chance of getting an infection.
DR. SUSANNE: Oh, I like what you just said. Before having intercourse. That sounds great, too. Absolutely. So, what’s the best method for good vaginal hygiene.
DR. DWECK: The best method is probably the least intrusive method which is just warm water and a mild soap and, in fact, you don’t need to be particularly vigorous about cleaning inside the vagina but, certainly, a mild soap and water on the vulva is very reasonable and patting dry and, really, you should not need a whole lot of fragrant products or sprays or anything along that line, although I know that this is a very popular practice for lots of women.
DR. SUSANNE: Oh, I know it is only because they want to make sure that, you know, when…That they want to make sure that they don’t have any odor as well as they want to make sure they’re clean, too, but know that some of those chemicals have a lot of fragrances which are very irritating and allergic. I’m an allergy expert, so for me, I want to make sure that you’re not using anything that’s irritating. But, how about those lubricants? What do you think about those lubricants that are out there these days?
DR. DWECK: Well, I’m a fan of as natural a lubricant as possible but, on the other side of that are the women who really are having discomfort during intercourse as a result of dryness. So, it’s very reasonable to consider various lubricants. So, certain water-based lubricants such as KY Jelly or Astroglide are easily available over the counter and, typically, very well-received and well tolerated. For some women, that doesn’t seem to be enough and I’ll often recommend a silicone lubricant but, again, this is not for everybody. What’s really been popular lately is coconut oil, if you can imagine. Wonderful. An organic coconut oil has been helpful and really, really well-received by women who are having a little dryness and they find that it’s enjoyable and fun and natural and so, I often will recommend that as well.
DR. SUSANNE: Oh, I love what you’re saying about coconut oil because I know of a company that’s made these little suppositories that you can actually put in and so, for women, not just for sexual activity but to keep it more moist and I’m talking about perimenopausal/menopausal symptoms.
DR. DWECK: I’m so glad you brought that up because that thought came to my mind as well. So, of course, some women do rely on estrogen for really notable dryness and discomfort during intercourse in their perimenopausal and menopausal years, if necessary and if they are candidates for that but otherwise, the lubricants I mentioned are really helpful and vaginal moisturizers are also helpful on a chronic basis so that dryness is not a problem.
I will always make one caveat note and that is that oil should not be used with condoms. If you’re relying on condoms for protection against pregnancy because they could ruin the integrity of that.
DR. SUSANNE: Good point because oils…I mean, I know that different kinds of condoms…How about like the natural skin ones? There are natural condoms out there, right?
DR. DWECK: Yes, there are and those are very helpful for prevention of pregnancy but not all would prevent sexually transmitted infection.
DR. SUSANNE: That’s such a great point because, you know, I know that it may be most comfortable for women. I find that a lot of women do really well with the natural forms but, gosh I’m so happy that we got to talk all about the vagina and I really want everyone to go get Dr. Dweck’s book. It’s called V for vagina. Your A to Z Guide to Periods, Piercing, Pleasures and So Much More. Thank you so much. For more information and vaginal health, you can visit Dr. Dweck’s blog on DrDweck.com and also on my page.
Alright. This is Dr. Susanne Bennett.