Yvonne Orji

Not My Baby: A Gynecologist’s Guide to Raising Sexually Responsible Teens and Young Adults

I have a healthy obsession (is that an oxymoron) with HBO’s Insecure. I think that it’s because I have been black and awkward for my entire life. Minus the potty-mouths, I relate to these characters. The show isn’t just for African American viewers. This show is crossing over. I love you Issa Rae, but Yvonne Orji, this one is for you! #Molly

Recently, I encountered a patient scenario that also has significant cross-over appeal. I saw a teenager who was beginning to explore her sexuality and had started having sex. She was trying to be responsible and safe by discussing safer practices with me, but was reluctant to have STD testing or start taking birth control for fear that her mother would find out what she was doing. This is the inspiration for this post, a plea to mothers.

I care for women of all ages, ethnicities and religious backgrounds. Here is how a new patient virgin talk usually goes:

Me: “Are you sexually active?”

Her: “No”

Me: “Have you ever been?”

Her: “No, never.” … Enter small talk and subject change, but the inevitable circle back:

ME: “What led you to that decision, if you don’t mind me asking?”

Ladies have many reasons, the majority being religious. Generally, it is a decision they made within themselves that was a result of faith and belief. Wait, mothers. Hold on. Before you high-five yourselves for teaching these young ladies the right way, you need to know that the numbers of young ladies who I see who are virgins are far outnumbered by women who are not, many of whom were taught the same values and principles of those still wearing their chastity belts. I often find that most mothers of non-virgins don’t know that their daughters have gone “there”. and some talk like they don’t want to know.

I am not challenging the value in teaching children and adolescents how to be sexually “pure”. I am, however challenging the practice of teaching virginity by denying information. Many of my patients who are virgins are not such because they don’t know what sex is. On the contrary, they almost unanimously know what it is and how to be safe while doing it. They have just decided not to do it for the time being.


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Photo: Andrew Michael Casey

Re-enter Yvonne Orji. In Season 1 of HBO’s Insecure, her character, Molly, is a very sexually liberated character. She gets down frequently. Ironically, in real life, she is a 33-year-old comedian, actress, and virgin. Here is this beautiful, successful woman who has had countless on-screen romps, and no off-screen ones. She isn’t not doing it because she doesn’t know what it is. She is actually driven by her religious convictions to keep her real-life legs closed. The point is, it’s not because of a lack of knowledge.

I wrote an article years ago for Jet Magazine that was a letter from me to the teens. It was a short list of reasons to not have sex, or at least not have a lot of sex. I called on my favorite thing, logic. As a doctor, informed consent means that you have explained the risks, benefits, and alternatives of whatever you are about to do. I wanted my teens to not just walk into having sex for the “benefits” without understanding those risks, benefits, AND alternatives.

Misinformation is so prevalent. I can’t tell you how many people don’t know how STDs are transmitted, which ones are dangerous, pull-out is an unreliable form of birth control, the clap is not chlamydia (it is actually gonorrhea), and that a person doesn’t need to have a lot of sex to get pregnant. It just takes once.


If you gave your kids a car and some keys but didn’t give them driving lessons or education on the rules of the road, eventually they may learn how to start the car (or their friends will teach them), put it in gear and drive. They will probably run into some things, blow through some traffic signals and get some tickets. Let’s pray they don’t hurt themselves or anyone else. If instead you teach them about the car but give them reasons why they might not want to drive yet (rush hour, etc), they may be a little safer with their actions. If they choose not to drive, it could be because they are fine using another form of transportation (no innuendo there, I promise).

I posed the following question to my teen at the beginning of this post: “Which do you think your mother would dislike more: Finding out that you are having sex, but knowing that you are trying to be as safe as possible, or not knowing that you are having sex and as a result, you contract an undiagnosed STD or unplanned pregnancy?” I have a daughter. I would prefer for her to not have sex until she is either married or at least mentally prepared for the emotional weight that it carries. Damn a hookup! Trust and believe, though, that she will know what’s what, AND know that she can always talk to me or ask me questions, regardless of whether I agree with her decision. For the record, the same thing goes for my sons. #headsoutofthesandmoms

Click here to read my 2015 throwback Jet article for teens about sexual choices. This was the very beginning of my writing journey. (Sniff sniff)



Insecure Issa Rae Lawrence Tasha Sex

Sex, Lies and HBO Insecure-ities: The Untold Story About Sex And Lady Parts

I still remember that the first movie sex scene I ever saw was when Terri’s husband bumped and grinded his cousin-in-law up against a wall in Soul Food. This was such pivotal scene that almost got Miles from Fake After Seven killed! It also felt so “hard-core” to me back then. I mean, I was born and RAISED in the church. Who knew that exactly 20 years later Lawrence and Tasha would be doing a butt-naked side bang and it would be just a regular day?

Some of you are shocked that I, little sweet Wendy, am writing an article about sex. Others are wondering how I made it 8 months in this blog as a blunt and real gynecologist without yet writing an article about sex. Well, Issa Rae Diop, I have you to thank. I have now seen the Season 2 Insecure Premiere about 6 times because it is so complex and layered and I want to catch every message and innuendo. I also love being put-on, or Woke to music. HBO’s Insecure is solely responsible for my underground-ish music exposure. I’m V103 all day so SZA is new to me. #betterlatethannever

The point is, sex is a topic rarely pontificated in any scientific way in the mainstream. I recently had a woman in her late 30’s ask me, as I had my hand on the doorknob on my way out the exam room (a clear marker for the conclusion of our visit), about how she could remedy the fact that she had never had an orgasm. She went on to ask where her G-spot was because her Internal Medicine doctor told her that I could show it to her. Needless to say, I sat back down.

So far in one episode alone, Lawrence has busted a cashew, a pecan and a pistachio, while his female leading ladies have moaned, stunned, and “Zaddy”-ed during the process, not showing any signs of on screen climax-ery. It made me ask the question, “are all hookups created equally?” The answer is, no. The following stats are compiled from a number of research studies and data.

Fact #1: Only 25- 50% of women have or have ever had AN orgasm, let alone multiple during penetrative intercourse. Said differently, penetrative intercourse alone is unlikely to lead to orgasm in more than half of all women!

Fact #2: Some studies say up to 10% of women have never had an orgasm. Ever.

Independence Day Orgasm
If you have never had an orgasm, do you remember the alien’s primary weapon in Independence Day? The way it formed and grew before it shot down and everything exploded? Well…

Fact #3: Some women can have multiple orgasms from multiple sources, positions, and a cornucopia of styles and efforts. A blessing or a curse? You be the judge.

The Point: If penile-vaginal penetration alone doesn’t take you there, you’re not broken. or alone.

Consider the following G-spot excerpt a pre-screening for my book It Smells Just Like Popcorn. It is two-thirds of the way finished and I am so amped. Anyway, back to the subject:

Regarding the elusive G spot- get your tear-ready facial tissues out for this one- there is no proven anatomic location that is definite for the existence of the G-spot. I am imagining a bunch of sex therapists and karma sutra experts chasing me with S&M whips and chains (not that I think that is something those groups would have, but what better to chase someone with), because I am denying the existence of the infamous place. I am not. I am only denying the anatomic location in our study of anatomy in both text and cadaver alike.

To those of you who KNOW it exists, good for you. There are women who have never and will never experience this level of sensation. These women are not missing something that anatomically they are supposed to have. They just aren’t. Sorry and RIP Dr. Gräfenberg- This is the dude who coined the term and theorized the location and function. Even sex therapist have been known to deny the existence in all women. Women who have not experienced G-spot pleasure should not consider themselves dysfunctional. And no, I cannot show it to you.

The text that we studied in medical school for anatomy was called Netters. There are over 60 pages dedicated to the pelvis and perineum, 9 specifically for the nerves. It’s not in there. I even pulled out my William’s Gynecology, another text that is comprehensive and factual. There is a whole chapter dedicated to teaching the intricacies of Female anatomy. Again…

Wait, there is hope. Women are known for sexual individuality. What makes a woman’s lady parts smile may not be limited to our textbooks or technical medical study. New subject.

CNN recently released an article about why Americans are having less sex. The article proposed multiple reasons, not limited to the increased phone and social media distraction. I once wrote a riveting article about how we spend our time that tackles this very subject and proposes solutions to feeling like we are lacking time. That was a shameless plug. Back to CNN, one of my favorite quotes from the article, (because it is interesting, not because I can relate in any way, fyi, btw, ijs, tmi), is from psychologist Margie Nichols:

“Compared with earlier generations, women might be viewing sex as less of a duty to their husbands and more of a personal choice. “It makes sense that women in relationships might be losing their sex drive and saying ‘no’ more, as opposed to my mother’s generation that just spread their legs and composed a shopping list in their heads during sex,” she said. “If that’s true, then the decline in frequency is a good thing.””

A middle aged patient recently told me, “There is a big difference between doing it and enjoying it.” She gave me permission to quote her, as do all of my ladies whose examples I’ve used today and every day. She was speaking in reference to her recent decision to not have sex anymore because of pain/discomfort for which I am helping to treat her. I encounter this female perspective of discrepancies between “doing it and enjoying it” regularly.

Sometimes the disconnect between her desire and his is related to pain or discomfort. Sometimes it is an issue of interest due to issues external to the relationship. Sometimes the issues are within the relationship. Sometimes they are both perfectly happy with one another, but the disconnect arises between how often he wants to and how often SHE WANTS to. Once a month, once a week, or once a day can ALL be considered too often or too infrequent depending on who I’m talking to.

My job is to help the woman understand if her feelings are reasonable by normalizing them when they are common. I also encourage her to communicate said feelings with her significant other rather than just with me. Sex therapy is also a “thing” and there are even meds now available to help women increase interest.

Then there is a common scenario where the precedence in sexual frequency and enthusiasm set in the “courting” stage falls off of a cliff when marriage and KIDS come into the picture. I personally know of a number of couples who didn’t have sex at all before they got married, so the aftermath was, by my calculations, the come up (no pun intended). If two people start off getting “it in” (or getting “it on” depending on how cool you are with your phraseology) every day, then over time go to once per week or once per month, I could see one or both partners feeling some kind of way about that. Remedy? I don’t know. Don’t set the bar so high? Talk to the Lord? The latter always works well for me.

Last question, from me this time: Is it next Sunday night yet? #InsecureHBO


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What? It’s cherry season. Get to Bing-in’


 Roksolana Zasiadko

What The Hair?

What the HAIR! Take THAT Netflix

Hair today, gone tomorrow… or at least we would hope, in certain places. Even the three little pigs said, “Not by the hair of my chiny chin chin.” The big bad wolf could have made a different kind of “killing” if he knew how to thread.

Women generally have 2 types of problems with hair. This is aside from style and color choices. Women either complain about too much hair that is not on their head or too little hair on top of their head. If you think you are losing hair or have thinning hair, that is definitely a reason to see an Internal Medicine doctor or a Dermatologist to search for underlying causes.

Possible causes range from destructive styles or coloring, to endocrine or autoimmune problems. Don’t trust the diagnosis provided to you by the internet, or Dr. Google as I like to refer to him. That dude never even went to Medical School. I don’t mind if someone tries skin, hair and nail vitamins, but if the changes are abrupt or dramatic, medical investigation by an actual doctor is warranted.

Too much hair is a much more common issue for my patient population. Not too much on top of the head either. We’re talking new and more abundant hair on the chin, abdomen, nipple, buttocks, underarm, and many other places. If this subject is searched, hormonal imbalances such as polycystic ovarian syndrome will come up.

Hairy man that could be a woman
This could be ANY ONE of us behind closed doors… or before our appointment…

Photo By Ishan @seefromthesky

While hormonal problems can affect hair growth, more commonly, age is a factor in leading to a normal amount of increased hair growth. I’ll repeat that one: It is normal for women as we age to grow more hair in unwelcome places. Now it is time to do one of my favorite things: Dispell myths:

  1. Shaving hair does not make more hair grow, per multiple sources including Scientific America. There is nothing about a razor that creates new hair follicles. My very novice, brown thumb understanding of bush pruning is that if you trim down dying or overgrown bushes, the growth efforts of the remaining branches will be fuller and more abundant. Razors aren’t like that. There is no follicle fertilizer. What a person may notice is that the hair appears darker.
  2. The new hair that results from waxing or plucking grows back fine and tapered. This is in contrast to hair that is cut mid shaft with a razor or shaver. The full diameter of the remaining hair is what remains, which is wider and broader than the new hair. Take home message, plucking or waxing will leave less noticeable hair, but shaving won’t increase hair volume.
  3. People with coarse hair who are prone to ingrown hairs may need to not cut hair below the skin. I am referring to my ladies who shave or wax the bikini zone and immediately have to answer to ingrown hairs and scars. Those coarse or curly hairs can more easily get trapped under the skin surface when you shave with a razor or when you wax. For those who don’t need to get to the beach regularly, a better alternative may be to use an electric razor. That way the length and volume of hair can be kept at bay without the individual hairs having to fight their way through the skin.

Regarding grays:

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All hair turns gray eventually. Even the hair on your… pets.

Photo By Dmitriy Karfagenskiy

In short, scientists are beginning to gather clues that support the theory that stress can hasten the graying process. There is no proven scientific evidence demonstrating a cause-and-effect relationship. Scientific America has more on that subject.

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I can’t leave my sistas out

Photo By Tanja Heffner

I would be remiss if I didn’t tackle hair loss related to hair products and styling practices. An article that I read about the physical stress imposed on the hair and scalps of African American women by many chemical and styling techniques was stirring enough to make anyone go natural. Forget being scared straight- you’ll be scared curly! The take home message there is that repetitive tight styles and chemical treatments can cause inflammation of the scalp that can be difficult to treat. If you find yourself with hair loss or itching and irritation, be aware that these can be a cause.

I wrote an article earlier this year about heightening awareness to some of the dangers of some commercial skin and hair products. You would be surprised what types of products are sold in stores and used every day that have known side effects that can be detrimental to overall health. Click here for more about how to keep yourself and your family safe from unnecessary risky exposure. 

Do you have something to add, Dr. Shelly?

Dr. Shelly: Ahhh. the relationship with hair in a women’s life. It is definitely a love/ hate relationship. As a woman of Indian descent, my forays into the hair world started early. There are two types of hair struggles. One is the hair on my head, the second is the hair on my face and body. We want the hair on our head to be long, thick, and luscious. The hair on our body, however, should be thin, light and barely there. What a conundrum!

From childhood, my girl cousins, sister and I have compared notes on all the latest trends and products to remove, bleach, pluck, wax, thread, and shave our hairs. We have gone through laser treatments, epilators, and Nair, all while massaging coconut oil and almond oil into our heads to coax the hair to fill in and grow thicker and thicker.

What The Hair
Chad Madden

I still remember the envy of my classmates in school with their long and straight hair- no frizz, no curls. I remember as a college student going to a salon where the hair dresser just changed my life. She said “You don’t have white girl straight hair. Embrace your curls! Embrace your wave!” Since then my quest has been about finding a hairdresser that knows how to cut my hair. It includes using products designed for my wave and texture, realizing that everyone has their own issues with their hair, and like most things in life, it’s all about just embracing it, and owning it. Here’s to good hair days, and cute hats on the other ones.

Dr. Wendy:  Shells, you had hair issues growing up too? I feel so much closer to you right now. I’m glad we both love our tresses now!

The point is, follicles work in mysterious ways. If you think you are alone, you’re probably not. If you think it is problem, talk with a doctor. Otherwise, know that there are people who are trained to keep us all LOOKING like hair only grows in designated places that have obtained our written consent. Hair is like children: It can only do what you allow. Obedience is mandatory in my household.

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These Lashes Though!

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pregnant mom and dad holding onsie

How to Help Your Partner During (and After) Pregnancy: A List of Do’s and Don’ts for Dads

I hated smells when I was pregnant.

As I write this post, my husband is reminding of my 9-month ban of sardines anywhere in a 5 block radius of our house. He also reminded me of a time when I made him go upstairs to our mortgage paying neighbor’s apartment and tell THEM not to fry anything else in THEIR KITCHEN. That nose was sensitive. He couldn’t even utter the words Truffle Oil without the threat of bodily harm (he is a chef).

This post is for the fellas.

During an initial prenatal visit, a dad asked me what he could do to help his pregnant wife in the first trimester. I yelled, “NOTHING!” But I was just kidding. There are plenty of things for the dads-to-be to do during the pregnancy and delivery. Let this OB break it down so that you can shine during the gestation and delivery of your child. After that, you’re on your own.

First Trimester (Weeks 4 – 12-ish):

Pregnant Woman in 1st Trimester Holding Ultrasound over Belly
Photo by Bich Ngoc Le on Unsplash
  1. Let her sleep and feed her whatever sounds good as long as it isn’t too unhealthy.
  2. In early or mid-pregnancy, your sexual thunder ain’t gonna hurt that baby. Mom may be a little more sensitive though. This pearl, by the way, was a quote from one of my favorite dads in my practice. He gave me permission to share.
  3. More vaginal discharge is normal, usually. If it doesn’t itch or have a foul odor, I wouldn’t worry. Recommend that she ask her doctor about it if she’s concerned.
  4. Google, mom groups, and (specifically) chat rooms are not good for her. She may think they are, that they will prevent her from having some untoward fate. They will just encourage paranoia about experiencing every red herring that could possibly happen because those are the majority of the stories you see posted on the internet. People with normal pregnancies generally don’t post, but they have a substantially greater piece of the pie. Mmm, pie. Don’t stress. Remind yourself everything will be fine, as often as you remind her that everything will be fine.
  5. Regarding her breasts: Look, don’t touch, or touch carefully. Her mountains, or in my case, hills, will be a little or very sensitive. Oh and her breasts will likely deflate later and her nipples will change, but that is life. Your baby is worth it.

Second Trimester (Weeks 12-ish – 28):

Pregnant woman in second trimester
Photo by Janko Ferlic on Unsplash
  1. Recommend that she keep a list of questions for the doctor, or keep it for her. Pregnant ladies forget. Don’t say that though. She may not appreciate hearing you say that she is getting more forgetful, but pregnancy brain is real.
  2. Rub anything she asks you too, or pay someone else too. Get your minds out of the gutter. I’m talking about a massage. Heads up though, a lot of prenatal massage places want a doctor’s note for safety clearance before they will do the massage. A little mother-baby safety mixed with C.Y.A. I’m sure. Another one of my favorite dads surprised his wife with a massage and got a note from me in the sly a couple of visits prior.
  3. Be present at as many appointments as you can – get your questions answered and be present for scheduled or impromptu ultrasounds. If schedules prohibit this, ask her to record the heartbeat for you. It is a wonderful sound and a gesture that you care.
  4. She may be a little mean sometimes. Give her a little pass. Be like a freshly waxed car and let some of her momentary lapses in basic human respect roll off of you like water. if she isn’t letting up,  try peaceful communication tactics. Example: I am trying to help my doing x, is that helping? How can I help more? Ladies, try to be nice. He really is trying and is only concerned about you and baby well being. If he suggests healthy snacks, say thank you. Don’t smack them out of his hand.
  5. If she hasn’t thought of it, offer to book her a maternity photo shoot. Be ready to be in the pics. If she already booked one, go willingly. The late-second trimester is a good time for this because she is not yet so big that she gets uncomfortable and grumpy.

Third Trimester (Weeks 28-40 or delivery):

Pregnant Woman in third trimester with tattoo on leg
Photo by Leandro Cesar Santana on Unsplash
  1. Don’t be afraid to take classes with her, especially if it is your first baby. CPR, and what-to-expect type classes are usually pretty helpful. They are available for a small fee at my hospital. Can’t swipe that insurance card for those.
  2. Offer to go for a walk or to the gym. remind her it will help her get through the end of pregnancy and delivery to be strong and conditioned offer to buy her a support belt if she complains of pain in her back or pelvic pressure
  3. You are on car seat duty! You guys can buy it together – she will likely have strong opinions about which one you should have. It is very important to the both of you that it is installed properly and checked. This is one place to have your car seat checked for proper installation. There are others I am sure. I am told firehouses Do NOT check them anymore. My hospital has patient attendants who are certified but check with your hospital before you assume that.
  4. Back to sex, but now in reference to the term (no longer early) pregnancy. Sex is okay and can help encourage labor at the end of pregnancy. The exact mechanism is very technical, involving prostaglandins and cervical stimulation, but in the moment, none of that matters. Make her feel sexy and appreciated. Do not give her anything or let her give herself anything that will induce or start labor without talking to her doctor. Women get desperate at the end sometimes. Just because it is natural, doesn’t make it safe. Protect her and your baby by keeping her from being her own worst enemy.
  5. Try to do something for her that you don’t normally do – clean something that you wouldn’t normally tackle. Organize something that she has been meaning to get to – hang up her clothes she has been meaning to put on hangers. Buy something she has been saying she needs – a new shoe rack, perhaps. Am I the only one who has things I’ve “been meaning to do?”

Delivery Day – Early Labor and Hospital Labor:

Father and Baby, Photo by Andrew Branch
Photo by Andrew Branch on Unsplash
  1. She won’t look up with a glimmer in her eyes and say “It’s Time” like in the movies. Labor starts slowly and contractions often take hours to days to get to 5 minutes apart. Feed her and hydrate her before it is time to go to the hospital and have her doctor’s number programmed into your phone to check in when you’ve reached that 5-minute mark or have any concerns.
  2. Tell her that she is amazing and you love her. Only say that last part if it’s true. This is not a time for false or pretend feelings just because you want to be involved with the baby. That’s my opinion.
  3. A “Push Present” is a thing. No matter how she delivers this baby, she carried it for almost a year and she felt every moment. Half of these little crumb snatchers don’t even look like their mom. Get her a charm, a massage, a clean house (it’s okay to hire someone), or any small token of love to let her know you appreciate what she allowed to happen to her body and mind for your collective human. As an adjunct, and this one may seem obvious: Do NOT complain about how long labor or pushing is taking. I had a husband once flop down in a chair next to his pushing wife, and fix his mouth to say the words: Uhh, I am so tired of pushing. He’s lucky his child didn’t lose her father in that moment. Don’t do it. Oh, and do not eat your delicious smelling food in her room or come back with the breath of onion and garlic when she is unable to eat.
  4. Don’t let her leave the house without pants or a skirt. Don’t leave your other child/children alone to take her to the hospital. I wouldn’t be giving this advice if these things hadn’t happened under my watch. Also, help her with her shoes because she likely can’t reach her feet easily.
  5. In the delivery room, there might be a lot of healthcare providers in the room, or there might not be. Take as many pictures as she will allow without being annoying. You can delete them later but you can’t go back to get them. Rules: no vagina or nipples in the picture, try to avoid flash photos because they are annoying (take advantage of the delivery bright lights), and ask the nurses about recording rules. My hospital doesn’t allow the actual delivery to be photographed or recorded. That’s okay though because it would break my No Vagina rule anyway.

Postpartum – You’re back home.

Newborn Baby Chien Pham
Photo by Chiến Phạm on Unsplash

Protect her postpartum: Protect her from your parents, her parents, anyone with too much advice. Being helpful is great and their tips are welcome. At the end of the day, though, it’s your baby. Schedule visits to allow for at least 3-hour naps, and put that phone on silent periodically.

Also, since $150,000 baby gifts are not common place (#kanye #kim #beyonce) there are a few things that are good to have in the house when your baby comes home.

  • Aquaphor and/or coconut oil for diaper changes. Coconut oil has some skin conditioning and antifungal properties that can help prevent diaper rash, and Aquaphor is the best skin protectant ever for extra sensitive skin. We don’t use baby powder anymore because of some health concerns so these are a good alternative.
  • Vitamin D Drops. If she is breastfeeding, babies often need a little more vitamin D to keep their nutrition balanced. Even though breastmilk is liquid gold, that D is often a little lacking. Sunbathing isn’t a thing in infancy so your pediatrician will likely recommend supplementation. I liked Dr. Carlson’s brand because it was just one drop per day, rather than the multiple required by some other brands.
  • Lots and lots of baby socks of different sizes from infant to 1 year. My kids ran through socks like diapers. You loose them, you drop them, you don’t put away laundry and can’t find the matches in the bag of clean clothes. Keep some spares on hand.
  • Babyproofing: Socket protectors, cabinet locks, etc. You won’t need them right away, but there is no harm in being prepared.

I will end this post with another story my husband just reminded me of. First baby, January, Chicago, flashers on, he pulls up to the hospital exit to pick us up. He comes up to the room and helps get us packed up. We are a family of 3, happy and ready for the world. We get in, car seat secure, strapped in, go to start the car. It. Won’t. Start. The battery is dead. Welcome to our world little baby! Lesson: Just park the car or as least turn off the flashers, or know your battery status. #mcdonaldchronicles

Newborn baby Gui Vicente
Photo by Giu Vicente on Unsplash

Disclaimer: I got no kickbacks or associate fees for any products recommended in this post and am not responsible for how they work for you. I just like them.

orange tulips in forest

The Truth about Douching, Boric Acid, and D-Mannose

I still remember my third day as an attending. It was the first time I had more than 2 people on my schedule. I also remember that a significant number of these women were add on patients for vaginal discharge. Throughout the last few years, complaints of vaginal itching, irritation, discharge, discomfort, burning, etc etc etc, has become a mainstay as a general gynecologist. Although there is some overlap, for the most part, there are different reasons for external complaints vs internal complaints.

This article will focus on some of the internal remedies that are out there: vaginal douching, boric acid, and D-Mannose.

To be clear, natural remedies can be very effective and a good way to avoid taking medicine. We recently had written an article on some of the health benefits of turmeric. I often joke that I have to be very sick to take any sort of prescription medicine. However, just because something is natural or over the counter does absolutely NOT mean it is without risk, nor does it mean it is effective.

Vaginal Douching

One of the worst things to do for the vagina is to douche.

I have had women tell me they use a variety of things as suppositories, including vinegar, yogurt, peroxide (yes. I know), soap, garlic and tea bags.

I’m going to say it again. DO NOT DOUCHE.


The vagina is virtually a self-cleaning oven. If you feel the need to clean the inside or want some relief, take a plastic cup into the shower- not glass, #safetyfirst – and use it to rinse the area with warm water while gently spreading the external lips. That’s it!

Boric Acid

Boric acid can be used to treat both yeast infections of the vagina and bacterial vaginosis. It is administered in a capsule placed in the VAGINA overnight. Even though I really don’t feel like I need an explanation to capitalize the word VAGINA, I capitalized VAGINA (okay, that one was unnecessary) to highlight the fact that this treatment is NOT oral. If an adult, or child swallows boric acid, it can be toxic, and even possibly fatal. This treatment is not ever to be used orally- don’t swallow it, chew it, or sniff it (too far?). When used vaginally, it is safe for adults who are not pregnant. It is not to be used in pregnant women or children.

The regimen for treatment of yeast and/or bacterial vaginosis is a nightly vaginal dose for 7-14 days. Then it can be used as a maintenance regimen two times per week. I like because it is an alternative to oral therapy for women who experience multiple episodes of vaginitis per year. There is also data to suggest that there are more and more evolving fungi that won’t die as easily in response to the little pink pill or other classic treatment. This resets the vaginal pH and makes it a conducive environment for normal bacteria to grow.

If used as a maintenance, or therapy, please abstain from intercourse for at least 2-3 days from the final suppository used just to let the remaining medication come out of the vagina. That is not a recommendation based on evidence, but it just makes sense to me. It can be purchased online or your doctor can prescribed it to a compounding pharmacy. Disclaimer: External skin irritation around the vagina can occur during use. Think of it like a facial that is uncomfortable during, but makes you feel rejuvenated afterward.

Boric acid is like a vag-acial.

A little A&D ointment or Aquaphor can help keep that under control. Apply to clean, dry skin and the barrier for when the boric acid starts coming out. One more time: Do NOT, eat, drink or otherwise ingest Boric Acid. It ONLY belongs in your vagina, and is NOT to be used in pregnant women or children.

Where can I get boric acid? Click the pic to be taken to Amazon


D-Mannose is a supplement used to prevent and treat urinary tract infections. I don’t recommend this to treat a UTI, primarily because if it doesn’t work, a kidney infection could develop and kidney infections are real. By real, I mean REAL DANGEROUS. Anyway, D-mannose was brought to my attention by one of my patients because she suffered from recurrent UTIs. She wiped from front to back, urinated after sex, drank a lot of water, and still had to deal with UTIs every 1-2 months. Since trying D-mannose, she said the frequency dropped substantially.

bacteria under microscope

D-mannose is a natural molecule that is found in cranberries, apples and some other fruits. It is the active ingredient in cranberries, minus the sugar that usually accompanies cranberry products like juice. Sugar is the not an infection’s best friend, so being able to consume the active ingredient without the sugar is best. Drinking water is also very important. The molecule has been found to reduce the ability of bacteria to adhere to the urinary tract, which is why I think that it is most useful for prevention rather than treatment. The bacteria don’t even make it in the door, let alone have an opportunity to trash the place. Risks are relatively low with this product, especially if used as directed.

A Quick Fun Fact

Another fun fact to remember when considering self-treating vaginal irritation: ACOG states that only 5% of women can accurately tell when they have bacterial infection and 30% can tell when they have a yeast infection. And this stat is only true if a woman has had this problem before. So you potentially could be treating the wrong problem with a natural treatment that may not even work. Not an ideal situation.

Your Takeaway on Natural Remedies for Vaginal Health

Vaginal health is greatly influenced by overall and general health. Drinking plenty of water, maintaining a good weight, eating a well-balanced diet, taking a daily probiotic to keep the vaginal environment healthy, using condoms, all of these things can be extremely important to reducing the number of infections in a year. Although natural remedies in general are not harmful, they are not routinely tested or regulated by the FDA. It may take some trial and error to find one that works well for your lady bits.

Also, if you try something that has worked in the past and it isn’t working anymore then it is a good idea to have a doc check it out. Remember these are just guidelines and it’s always best to review all questions with your physician.