Can Thongs Cause Infections?

>> Thursday, September 3, 2015

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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.

Dr. Susan


What Causes Vaginal Odor?

>> Wednesday, August 12, 2015

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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.

My Best,

Dr. Susan Boyd, MD


What Can I Do About Heavy Menstrual Bleeding?

>> Friday, August 7, 2015

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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 6th or 8th 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.

I hope you all have a safe week and enjoy this hot summer air.  My partner, Dr. Liu, will be back from Taiwan on Monday with his family, since he had to abandon me emergently when his mom became ill.  :'(   So HOPEFULLY, yours truly will get a day off, a night’s sleep and a sit-down dinner after 27 days straight on call by myself.  Phewww!!

Keep hangin' on and just keep goin'.  Things are going to be okay. Okay?

                                                                            Dr. Susan Boyd, MD  


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

>> Friday, July 31, 2015

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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.

I hope you have a happy, productive week and stay safe and healthy.

Dr. Susan Boyd, MD


Vaginal Discharge and Odor Relief

>> Friday, July 24, 2015

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Good afternoon, I hope you all had a good week.

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 Dr. Boyd, 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.

Until next week,

Dr. Susan Boyd


Relieving Vaginal Discharge Issues

>> Thursday, July 9, 2015

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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:

“Dr. Boyd 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.

Until next week,

Dr. Susan Boyd


Vaginal Odor and WaterWorks

>> Friday, July 3, 2015

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Vaginal odor is an embarrassing problem and can interfere with intimacy because, well who wants him down there with that problem, right? Most everything we are taught to do can actually worsen vaginal odor, like douching or washing with harsh soaps and/or cleansers. They even make feminine hygiene sprays to cover up the odor like perfume or deodorant we use on other parts of our body. Of course that's just silly & desperate really.

As a gynecologist my best recommendation to you when you take your shower is to be sure to allow the soap suds to gently run over and lather the pubic and groin area but don't scrub or allow the soap to get inside the vagina. Never douche. Not even with medicated solutions, diluted lemon juice or vinegar solutions. Daily soap usage inside the vagina or douching will cause an imbalance of the normal flora (bacterial environment) which is there to fight off the unwanted smelly bacteria that can also be associated with infections.

You may know this but let's just go over it to refresh your memory, ok? The normal bacterial flora in the vagina is predominantly lactobacilli which keeps the vagina slightly acidic to prevent the overgrowth of unwanted, smelly bacteria & yeast. It is also the main bacteria used to culture milk into yogurt. Wow! So that is why the vagina usually has a very pleasant smell or taste, or often no smell or taste.

So what causes the imbalances that bring on the odors? Mostly things like our period or sex, and also the many hormone imbalances we go through with childbirth, menopause or our monthly cycles. Blood is normal pH & this rise in pH encourages the abnormal bacterial & yeast growth.
Semen is sugary & normal pH to keep those sperm alive for their long journey.

But recently, within the past few years, a new product called WaterWorks has been out that is FDA approved for the treatment of chronic vaginal odor. I personally saw it first on a daytime tv show called "The Doctors". I was so excited that I made an order cause I wanted to see for myself if it worked. It did.

WaterWorks is a reusable vaginal cleansing system. It has a sturdy bag that is filled with warm shower water with durable tubing and a stainless steel tip that is inserted into the vagina. During your shower you release the warm water and let it flow into your vagina. The stainless steel reacts with the vaginal mucosa in such a way that it removes odor immediately. Chefs in restaurants do the same, in that they have stainless steel bars they use to strong odors like onion & garlic off their hands.

The amazing thing is that WaterWorks can be used everyday, or to rinse period blood out and many women use it right after sex to rinse semen out right away which prevents odor. The water gently sprinkles out so you never have to worry about pushing bacteria upward into your uterus & tubes.

I love WaterWorks because it really works for my patients and they aren't using medication over and over again. Many of them have struggled for years with no hope & now after one use their odor is gone.

I hope this helps you so you can finally get some relief & feel good & confident. It's always a good idea to see your doctor to make sure you don't have an infection or other problem. Then go to our website; or & check out WaterWorks. Let me know if u have any other questions, be safe, and have a wonderful week.


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