Yeast and bacterial infections come as a result of vaginal imbalance that can be caused for many reasons. Some of the more common causes are taking antibiotics, wearing a wet swimsuit or nylon/lycra clothing during long periods of time in hot weather, wearing thong underwear, douching or allowing semen to remain in your vagina.
Yeast infections can cause an abundant amount of thick, whitish discharge, vaginal swelling, and intense puritis or itching that can be unbearable. This irritation and itching may also be felt around the anus, labial area and urethra. It can also cause burning on urination. I have had many patients come in worried about a urinary tract infection, when it was really a vaginal yeast or bacterial infection.
Now, as for the men - you may have heard or boyfriends talk about 'jock-itch'. Well that is usually just external yeast or fungal infections men get from sweating in the heat. In answering the question as to whether we pass yeast or bacterial infections to our partners, the answer is no. But men can get a little itching for a few hours after sex that usually goes away quickly.
Women have found that the odor associated with their infections can really interfere with intimacy, and they have been turning to alternative solutions to help. More and more women are seeking non-pharmaceutical ways to prevent yeast and bacterial infections from coming back again and again.
Waterworks is the only vaginal cleansing system made just for this purpose. It uses only natural tap water, with it's uniquely designed stainless-steel nozzle, to clean out the vagina of unwanted discharge or left-over semen. Many women are reporting that they stopped vaginal odor the first time they used it, even after battling with vaginal odor for years. The best thing is that since WaterWorks can be used everyday they have been able to stay ahead of yeast and bacterial infections by keeping the vagina clean and rinsing out semen right away, before it has a chance to change vaginal pH.
I hope that helped with your question this week. Please write if you have any questions. I'd be happy to answer any that you have.
Have a safe week,
I continue to be amazed when a couple comes into my office for various health issues and, during the conversation, they are surprised to learn that odorous vaginal discharge is not normal.
One husband told me, “Well, Doc, all men know it's like deep sea diving, just take a deep breath and go in." Really? That's pretty sad to think that so many women (and the men they love) feel that pungent, strong or "fishy" vaginal odor is just normal.
So what causes vaginal odor to start in the first place? Why is it so hard to get rid of? Why does it keep coming back over and over again? Can it cause health problems?
It concerns me that so many of you, because you're worried about odor or cleanliness, continue to believe that DOUCHING is 'okay' once in a while. Right? You ask yourselves, “What can it hurt? It makes me feel clean and fresh, and it's so nice to clean out discharge or old period blood. I don’t’ want him down there if it's not fresh and clean.” But it's this obsession that causes the problem in the first place. We are not supposed to smell or taste like chemicals or perfume! It is shocking to a man to smell that, and the perfumes and chemicals in douches, mixed with the odor you are worried about, is like covering up the bathroom with freshener spray. The smell is still there, just now mixed with freshener – which can be worse.
An estimated 40% of American women between the ages of 15 and 44 continue to use a vaginal douche, even though there are no studies that have ever shown that douching has benefits at all. In fact, we know that douching can actually increase the risk of infections, cause pregnancy complications, and create other health problems.
Douching started many years ago and is practiced in Europe and many other countries. It is a method to wash out the vagina, usually with a mixture of water and vinegar. Douches that are sold in drugstores and grocery stores contain antiseptics and fragrances. A douche comes in a bottle or bag and is sprayed through a tube upward into the vagina toward the cervix, sometimes with too much pressure.
Douching is known to cause many problems for women. One of the most common is vaginal infections like yeast or bacterial vaginosis. That's because it upsets the natural balance of bacteria in the vagina (called vaginal flora) which has the purpose of maintaining a low, more acidic, pH. Changing this acidic balance makes the environment more favorable for the growth of bacteria that cause infection. We have talked before how the low pH is the vagina's defense against infection and how it is able to self-clean. If the good bacteria is constantly being washed out, how can the vagina protect itself?
We know that women who stopped douching were less likely to have bacterial vaginosis, yeast infections, and vaginal odor. Note, having bacterial vaginosis can increase the risk of preterm labor and other more serious infections:
- Pelvic Inflammatory Disease (PID). PID is an infection of the uterus, fallopian tubes, and/or ovaries that can actually get inside your entire body through the tubes as they are open into your abdomen. Douching can push infection from your vagina into your uterus through your tubes and into your abdomen. Women who douche have a 73% higher risk of getting PID!
- Women who douche more than once a week also have more difficulty getting pregnant than those who don't douche.
- Douching also increases the risk of ectopic pregnancy – for the same reason it puts you at risk for PID. With an ectopic pregnancy, the embryo implants outside the uterus, like in the fallopian tube or ovary.
- Douching at least once a week has also been linked to an increased chance of developing cervical cancer.
WaterWorks, which is FDA-cleared to alleviate vaginal odor, is a wonderful help to women. It has a design like a douche, but is very different. With WaterWorks, the water sprinkles outward, not upward, to gently clean the inside of your vagina. It uses only fresh, warm water (no chemicals), so it is all natural. It is used by so many women for regular feminine hygiene, like cleaning out period blood, semen after sex and excess discharge. It can be used daily as part of your normal bathing. The unique, patented design of the medical-grade stainless steel nozzle is what prevents and removes vaginal odor.
Have a safe and wonderful week,
Dr. Susan Boyd, MD
Feminine hygiene is so important to our overall health. In addition
to keeping our skin clean and free of bacteria, it can prevent odor,
itching and discomfort from perspiration.
Feminine hygiene involves more than just bathing or showering. It encompasses a whole spectrum of practices women should follow to be healthy. Most of us learn these skills from our mom, sister or friends. Or we just figure it out for ourselves.
But, not every aspect of this topic is well-known. For example, whoever taught us to always wash our new jeans, panties, shorts, or other clothing bottoms before we wear them? You should, because dyes and other chemicals on new clothing can cause your vaginal area to become irritated or infected. I have noticed some clothing that will put this on label, but not often.
During your menstrual cycle, be sure to wear fabrics that allow your vaginal region to breathe. Wear loose, breathable, clothing like loose panties that allow for air circulation. Natural, breathable fabric such as cotton is preferred. Wear thigh-high pantyhose or pantyhose made with a cotton crotch to reduce the vaginal sweating caused by nylon and other synthetic fabrics.
When not on your cycle, try to sleep without wearing panties or pajama bottoms if possible, as this will provide your vagina with the air circulation needed to help prevent infection.
Tight pants, shorts, or panties made from synthetic fabrics can reduce the air circulation around your vagina and cause it to sweat, which can increase your chances for odors and infection.
Remove wet, sweaty bottom clothing as soon as possible. Wet or sweaty panties and pants can cause bacteria to multiply and increase your likelihood for getting odors and infections. Take a shower and wear fresh, clean clothing after you have gone swimming or exercised.
Of course, bathing or showering daily is the beginning of developing healthy habits. It is so important to wash the skin daily to get as much bacteria off as possible to prevent sickness and infection. Sweat is the body's way of removing waste & bacteria from the body. So it should be washed off every day. In the shower, wash the vagina externally with mild soap, then rinse with fresh water and dry off immediately with a clean towel. For internal cleansing, use WaterWorks, which is described at the bottom of this post. If you have problems with excessive sweating, abundant discharge, rashes, folliculitis, or pimply lesions on your Mons Pubis or inner thighs, be sure that you use a new sharp razor to shave and that you change the razor after 4-5 uses.
You can use a blow dryer to gently dry the external vaginal area around pubic hair, inside the creases & around the vaginal lips (Labia Majora & Minora), between your buttocks and all over the outer groin area. This can reduce irritation and infection.
Use moist baby wipes instead of toilet paper and always wipe from the front toward the back. This will help ensure that fecal matter and bacteria won't be pushed into the vaginal canal.
Never use chemical douches, deodorants, sprays or powders. We never recommend douching, as these products usually cause more infections by disrupting your natural pH, hormones and the delicate chemical balance of your vagina. Women who use these products and douche with chemicals will be battling ongoing irritation and infections on a regular basis.
Be sure to change tampons, sanitary napkins, and panty liners frequently - this means every time you use the restroom or at least every 3-4 hours. When pads and tampons are worn for long periods of time bacteria can build up. Not only can it cause foul odors, but especially with tampons, it can cause mild to very serious infections like toxic shock syndrome.
If you can, try to use menstrual products that do not contain scents or dyes. And try to find the all-cotton pads and tampons because some of the commercial products contain fiberglass. This fiberglass can find its way into your vagina or under your skin, causing non-infectious irritations.
Always wash your vaginal area after sex to rinse out the semen, bodily fluids and residue from condoms and other intimate products. All of these can cause infection, irritation, and odors if not removed. For this purpose, WaterWorks is wonderful, as it is an all-natural, FDA-cleared method for feminine cleansing. (See www.waterworkshealth.com for more details). WaterWorks is so gentle. It uses only the pressure from gravity for a gentle water flow to rinse the vagina. It can be done every day while in the shower.
I think it's important for us all to just get into a routine like we do with our hair and nails. Then it just becomes easy and we feel better.
Hope you all have a great week and stay safe.
Dr. Susan L. Boyd, MD
Vaginal discharge is the one thing, other than the menstrual cycle, that women
notice and use to judge wellness in their bodies. If your cycles are
regular and on time, and your vaginal discharge is normal, you feel your
body is healthy, right? But, if a woman starts skipping her cycles or
having too many cycles or bleeding heavily, she knows something is not
right with her body. Okay.
Still, so many of you come in (most of you for other female problems) and I find out that you are constantly dealing with abnormal vaginal discharge or odor. You and your partner feel it is just 'normal' for women to have a fishy or strong odor all the time. Isn't that what all those tuna fish and fisherman's wharf jokes are all about? Men know it, and they talk about it, and think that's just the way it is – so, just grin and bear it.
Women don't know what to do. It's embarrassing, right? Three showers a day, and you still worry if everyone else can smell you. You can't wash it away, and that SUCKS because you know he's going to smell you during sex. But feminine sprays, lotion or soap and water do not help.
It is normal to have vaginal discharge. Some women produce more vaginal discharge than other women, and this is due to hormonal fluctuations. Teenagers and pregnant women both have higher than normal hormone levels which causes an increase in vaginal discharge. Women who are dry and lack discharge may have low hormone levels, like in menopause or during breastfeeding. You may also notice changes in the amount of vaginal discharge, changes in its consistency, (thick, thin, watery, sticky), and sometimes find it necessary to wear a pad or panty liner. Birth control pills will change vaginal discharge because it balances the female hormones and is a good therapy for women who feel too 'wet' all the time.
But, no matter the amount or consistency of discharge, it should never have a foul or fishy odor. At times, discharge may have a slight odor, due to hormonal changes during the month or during the final day of your cycle – due to pH changes from the menstrual blood. Normal discharge should not be accompanied by pain, itching, burning or redness.
Vaginal discharge is very important to the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection. A change in your normal vaginal discharge may be a symptom of a vaginal infection.
Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can the odor, and the color can range from clear to a milky whitish, depending on the time of your cycle.
Important things to watch for to determine if there is an infection include the length of time you have had the abnormal discharge, the color/odor of the discharge and the presence of any itching, pain, or burning in or around the vagina. Different infections present with different types of discharge and symptoms:
- Chlamydia and gonorrhea are obvious, as there is a copious amount of cloudy, yellowish discharge, sort of like having a period of discharge, with an awful odor that is so different from the normal everyday discharge that it can alarm most women. In addition, they can cause urinary incontinence, painful sex, severe pelvic pain, bleeding and irregular cycles if not treated quickly. Also, they can be the cause of PID (pelvic inflammatory disease) which can cause severe illness, fevers, blockage of fallopian tubes and eventually lead to infertility.
- Trichamonas is a parasitic infection typically contracted and caused by having unprotected sex, with grayish frothy discharge.
- Yeast Infections can have two kinds of discharge: either thick and clumpy like cottage cheese or thin, whitish discharge that causes intense itching and swelling.
- Keep the outer vagina area clean by washing regularly with a gentle, mild soap and warm water. DO NOT WASH INSIDE THE VAGINA WITH SOAP. Never use scented soaps, feminine products or douche. Also avoid feminine sprays and bubble baths.
- After using the restroom, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection. It is a good idea to have baby wipes or other 'wet' wipes near the toilet as they work much better than toilet paper for feminine cleansing.
- Try to wear 100% cotton underpants; switch off wearing floss panties and regular panties; and avoid overly tight clothing all the time.
Have a safe and happy week,
Susan Boyd, MD
I’ve had a lot of questions from many of you about your irregular menstrual cycles. Shelly and Ciara just recently came in for a recheck because they are frustrated and searching for a solution. “I don’t understand Dr. Boyd, why my period will be normal for 2 or 3 months and then it will come so heavy that I pass clots, have cramps and soak 4 or more tampons in 30 minutes for the first couple days. Then I might skip a period or just spot for a few days, and then back to normal for a few months, then spotting or heavy it drives me crazy. Is something serious wrong with me? Will the pill help? What can I do?”
I am finding that more women than ever seem to be having problems with abnormal uterine bleeding, that presents younger as women (pre-teens) are menstruating at a younger age. Teens and young women are struggling with weight more now than ever and much of it has to do with the hormones that have been introduced into our food supply in greater and greater amounts over the past few years.
Ingesting excess hormones every day via dairy and meat products has been shown in several studies to affect growth (size, weight, and height) in children and possibly sexual development, fertility and menstrual irregularities. This becomes more of a concern as we continue to see childhood obesity increase and weight changes in women (up or down), can cause abnormal uterine bleeding and infertility. The thyroid gland is also important in menstrual regulation and can be affected by the hormone overload caused from animal sourced food products, pesticides, chemicals and plastics in our environment.
One way to gain understanding is to review the ‘normal’ menstrual cycle, then we can compare it to Shelly’s and Ciara’s problems next week and maybe see what is going on. Menstruation usually starts at about age 12 or 13. One study, however, has indicated that girls may be starting puberty earlier than in the past. By the age of eight, 48% of African-American girls and 15% of white girls were showing pubic hair and developing breasts. It had previously been thought that only 1% of girls exhibited such changes at that age. Alternatively, a study done in England found that the average age for the onset of menstruation has changed very little since the 1950s, with the median age being 13 years.
The uterus is a pear-shaped organ located between the bladder and lower intestine. It consists of two parts, the body and the cervix. When we are not pregnant the body of the uterus is about the size of a fist, with its walls collapsed and flattened against each other. During pregnancy the walls of the uterus are pushed apart as the fetus grows. The cervix is the lower third of the uterus. It has a canal opening into the vagina this opening is called the os which allows menstrual blood to flow out of the uterus into the vagina.
Leading off each side of the body of the uterus are two tubes known as the fallopian tubes. Near the end of each tube is an ovary. Ovaries are egg-producing organs that hold between 200,000 and 400,000 follicles that contain the genetic material for producing babies. The inner lining of the uterus is called the endometrium and during pregnancy it thickens and becomes enriched with blood vessels to house and support the growing fetus. If pregnancy does not occur, the endometrium is released as your period. The hypothalamus (an area in the brain) and the pituitary gland regulate the reproductive hormones. The pituitary gland is often referred to as the master gland because of its important role in many vital functions, many of which require hormones. In women, six key hormones serve as chemical messengers that regulate the reproductive system.
The hypothalamus first releases the gonadatropin-releasing hormone (GNRH)>
This chemical, in turn, stimulates the pituitary gland to produce follicular stimulating hormone (FSH) and Lutinizing Hormone (LH).
Estrogen, progesterone and testosterone are secreted by the ovaries at the command of FSH and LH and complete the hormonal group necessary for reproductive health.
The menstrual cycle reflects the changes that occur in the endometrium, the inner lining of the uterus. Layers of the endometrium are shed at the end of the cycle as part of menstrual flow. The menstrual cycle is generally divided into phases; the follicular phase, ovulation phase and the luteal (or secretory) phase.
For a clear picture of the process it is important to understand how to count days in a menstrual cycle. Day one is generally considered to be the first day of bleeding. The follicular phase includes menstrual bleeding followed by proliferation (growth and thickening) of the endometrium, uusually lasting from day 1 to day 14. The following processes occur during this time.
At the end of the menstrual flow, the proliferative phase begins, and the endometrium starts to grow and thicken. FSH levels rise and stimulate several ovarian follicles to mature over a two-week period until their eggs nearly triple in size. During this period, FSH also signals the ovaries to produce estrogen, which, in turn, stimulates a great surge of LH around day 14.
The surge of LH at the end of the follicular phase triggers ovulation by causing the largest follicle to burst and release its egg into one of the two fallopian tubes. At ovulation (usually day 14 in a 28-day cycle), the proliferative stage ends and the luteal (secretory) phase begins. The luteal (secretory) phase lasts about 14 days.
Finally, the endometrial lining sloughs off and is shed during menstruation. It’s amazing how complicated our cycles can be it really makes you wonder how things go right most of the time. Next week we can take a look at what goes wrong now that we know how things should function.