Stop, The Love You Save May Be Your Own: Birth control and other options for preventing pregnancy until you’re ready

Beginning with fundamentals, the basic principle that must be dealt with first is

Sex in Man + Woman = Egg + Sperm = Baby.

I have to break down the basics because I often hear statements like this:

“I only did it  once.”

“We weren’t trying.”

“How did this happen?”

What’s more is that I ask every patient if there are sexually active. If they say yes, I ask if they are using condoms or any other form of birth control. If they say no, then I say, “do you want to get pregnant?” The question is not a sarcastic one, nor is it meant to embarrass the patient. The answer is almost always an emphatic, NO.

Then the pause… because if you aren’t trying to get pregnant, what are you don’t to prevent it? When I hear, “well, I don’t have sex that much,” I can’t help but think, do you think you only produce a baby after having a certain amount of sex? Sure couples can try for a long time to get pregnant, but it only takes one time to actually conceive. If you remember the movie, Look Who’s Talking, the classic ’80’s movie with John Travolta and Kirstie (I thought her name was Kristie for the longest) Alley, the sperm swims and swims and gains admission to the egg to make the hilarious talking baby who we all fell in love with. That conception scene was amazing, timeless, and still available for viewing on YouTube. Did you know Bruce Willis was the voice of Mikey? Summary of this point: If you aren’t preventing pregnancy, you ARE “trying.” Oh and the pull-out method doesn’t count.*

Early pregnancy, early ultrasound, pregnancy confirmationOn average, not adjusting for age or risk factors, after one year of unprotected intercourse, 86 out of 100 women will get pregnant. Pull-out decreases chances of conception, but enough semen is released prior to ejaculation to leave a substantial chance of conceiving. To be specific, in 1 year of regular unprotected sex using the pull-out method, 22 women out of 100 will be pregnant. The Rhythm method will leave 24 out of 100 women pregnant, and a startling 18 women will be pregnant who use the traditional male condom (sorry rubbers). Part of that risk comes from improper or inconsistent use, while part of it comes from failure of the method itself (a hole for example). I still believe wholeheartedly in condoms for reducing STD transmission, but condoms are not the best at pregnancy prevention. The most comprehensive and accurate contraceptive statistics can be found on the Center for Disease Control (CDC) website. My highlight real includes implants, and IUDs. Less than 1 pregnancy per 100 women in 1 year. These methods aren’t for everyone, but they will bring your Oops chances down substantially.

nss2erzqwgw-freestocks-orgAnyway, if you don’t want to get pregnant, but you do want to have sex, birth control is a must-have EVERY TIME. The only absolute 100% effective form of contraception is abstinence, which I believe in, support, and practiced myself in my pre-marital days, (fyi, tmi). Now that I’ve made that statement, let’s tackle types of contraception: barrier, pill, patch, ring, shot, IUD, implant and permanent sterilization. Barrier methods include condoms and diaphragms with spermicide. Yes, some women still use diaphragms. They are fit to a woman’s uniquely sized vagina by us gynecologists in the office and ordered at the pharmacy. Proper diaphragm use entails filling the rubber cup with spermicide and placing it in the vagina. A diaphragm can be inserted as many as 6 hours before intercourse and SHOULD stay in place for 6 hours after intercourse. The reason for t is that the spermicide-diaphragm combo has to remain in place long enough to kill the sperm. If that isn’t sexy enough for you, pills can possibly do the trick.

There are different kinds of birth control pills. The term the pill can include combined estrogen-progesterone pills (COCs) or progesterone only pill. 9 women out of 100 will become pregnant over the course of a year on a pill. COCs stop you from ovulating, or releasing an egg, and they regulate the menstrual cycle. They need to be used with caution in smokers, women over the age of 35, and shouldn’t be used in women with certain types of migraines or blood clotting disorders. Blood clotting disorders are not to be confused with blood clots that may come out of your body during a heavy period. The clotting disorders that preclude COC or estrogen use are the ones that develop deep clots within the legs or lungs. These clots can be life threatening and increased estrogen levels can make them more likely to form. Progesterone only pills, implants or IUDs, or even hormone free IUDs may be options for women with clotting disorders. For the sake of perspective, the risk of developing a blood clot off of birth control is about 4 in 10,000, or 0.04%. On an estrogen containing birth control, the risk is about 10-14 in 10,000, or about 0.1%. In pregnancy the risk is about 5 times that of the no birth control group (the NBCs), which is 0.2% (1 in 500). The risk is about 20 times higher in the postpartum period than the NBCs, or about 1% (1 in 100).iuds-various

Permanent options like tubal ligation during c-section, laparoscopic tubal ligation, or hysteroscopic tubal occlusion are all extremely effective methods of birth control. You MUST be ABSOLUTELY SURE you don’t want to have any more babies when you choose this method. There is no consistently successful reversal of a tubal ligation and the risks are not small in attempting to restore fertility. When I ask my patients if they want their tubes tied, say in the setting of a scheduled c-section, if they say “I think I do” with the pensive, unsure emoji hovering over their head, I generally respond with “you didn’t say it right.” You need to know that you know that you know that you don’t want to have any more children EVER. If you aren’t 100% certain, a LARC (long acting REVERSIBLE contraceptive) can offer you the same effectiveness with the reversibility in case you really do lose your mind and want more.

tom-hanks-tooth-removalI know you didn’t think I was going to make my way through the contraceptive topic without talking about vasectomy. Sure, this is not my organ of specialty, but vasectomy is a very reasonable method of contraception. It is one of the least invasive methods of permanent contraception. You just need to make sure that the significant other goes for that confirmatory test ensuring no sperm remain in the ejaculate. Initially, the situation is like that of pipes after you turn the water off. You have to get the remaining water out of the pluming before you start disconnecting pipes. Tell him I said its okay. Manly men get “snipped” too.  He can crush a beer can on his forehead and go mow the lawn bare chested after it’s all done.

g8xdo1q1kig-rachael-walkerA common question that is posed is how will birth control impact a woman’s long-term fertility. You shouldn’t worry significantly about fertility after birth control, any more than you would worry about fertility not having been on birth control. The modifiable factor that matters most for fertility is not the length of time you have been on birth control, it is the age that you try to conceive. Fertility changes every year. There is not a magic change that occurs at 35 as many women believe. Every year from when we start menstruating until we become menopausal, our fertility is decreasing and our risks of complications increase. This is a gradual change that becomes slightly more rapid at 35, but a 22-year-old is more fertile than a 27-year-old, who is more fertile than a 32-year-old. While some women have menstrual cycle irregularities that may take a small amount of time to normalize after stopping birth control, some women get pregnant while on birth control, meaning there isn’t a purge period that every woman automatically needs to resume fertility.

The take home point: Use whatever method suites you best for as long as you don’t want to conceive, but never take fertility for granted because you don’t know what hand you’ll be dealt when you are “ready.” Oh and being 40-plus is NOT considered birth control. Surprise babies can occur all of the way up to menopause. The little miracles!

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*Dr. McDonald PRETENDS she is a singer sometimes. Her cover of My Boo will have you second guessing some less-than-effective birth control methods.

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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.

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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

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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!

Subscribe to The Gyneco-bLogic to not miss any of the latest updates. I also just started building my musical YouTube channel about many women’s health and parenting topics. Check out the latest addition, Dr. Everykah Badu sings my rendition of Erykah Badu’s, Didn’t Cha Know. Subscribe so this movement can grow. Thanks all!

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.

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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

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.

Gynecologic Cancer Symptoms: Is this normal? Or is WebMD right??

It is very common to be fearful that any new or different symptom we experience is cancer. Because female organs tend not to be discussed or highlighted as often, I wanted to review some of the common signs or symptoms that can be associated with gynecologic cancers. This is by no means an inclusive list, and it is always important to discuss any concerns with your physician. It may help to review basic anatomy before jumping into this post: Lady Bits Exposed: Why Knowing Your Anatomy Matters

Gynecologic Cancer Symptoms for the Ovaries, Endometrium, Cervix, and Vulva

Ovarian: Ovarian cancer is one of the most elusive. The ovaries are small, almond sized organs that sit deep in the pelvis. After menopause, they shrink and become virtually nonexistent. However, they can still become cancerous. Women that have a change in juan-jose-valencia-antia-16138.jpgtheir weight, abdominal circumference, problems with eating, or other GI changes, especially when these changes occur abruptly (think: within 2-3 weeks) should not only see their primary care physician but also their gynecologist. One of the common questions I ask is, “Do you feel like your pants aren’t fitting the way they used to last month?”

Endometrial: The endometrium is the lining of the uterus or womb. Any woman who is experiencing post-menopausal bleeding should have an evaluation of her lining because there is a 10% chance that the bleeding is due to cancerous or precancerous cells. Before menopause, endometrial cancer can cause abhorrent or irregular cycles. If your cycles have become unpredictable then it is important to see your physician.

Cervical: The cervix is the area between the uterus and the vagina. This is the area that gets tested when having a pap smear performed in the office. What’s Pap-pening? What You Should Know About HPV and Abnormal Pap Tests. HPV, or human papilloma virus, is a sexually transmitted virus. Because cervical cancer is slow growing and can be treated in its early and precancerous stages, it is important to get routine exams and also use condoms to protect infection with the virus. It is very rare to have any symptoms from cervical dysplasia, however bleeding after sex that didn’t occur in the past should warrant an exam from your gynecologist.

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Vulvar: The vulva is the area also referred to as “the lips” outside of the vagina. Vulvar cancers are very rare, however they do occur. Symptoms associated with vulvar cancers are intense itching, skin discoloration, and cysts or abscesses that form in the glands.

This is not an inclusive list of the different cancers that can arise from the gynecological organs. It is important to be cognizant of your body and discuss any changes with your physician. Early detection is extremely important when it comes to any form of cancer.