Is It Normal to Have Vaginal Discharge?

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.

Infections require medicated vaginal creams or antibiotic medications, but here are some tips for preventing vaginal infections that can lead to abnormal discharge:

• 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.

We are lucky enough to have WaterWorks, which is FDA cleared for feminine cleansing and to reduce vaginal odor problems. Everyone loves this, as it functions just like a douche, but isn't. It is made of medical grade stainless steel and uses no chemicals (only plain tap water) and it can safely remove vaginal odor with the first use.

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Understanding Vaginal Discharge

Hello everyone I hope this finds you all well and healthy today.

It seems that I've been hearing from many due to your concerns over vaginal discharge. Some of you have noticed changes, and are asking whether it is normal. Some of you have been on birth control or recently delivered babies, had tubal sterilization and are now off oral contraceptives after many years. Some of you just feel that there have been changes since you have matured.

The basic function of you vagina, besides sexual pleasure, is to provide a clean, functional route from the outside of your body to your uterus and the rest of your internal reproductive system. The natural acid PH of the vagina, acts to prevent infections. The acidic nature of your vagina is caused by natural, bacteria produced by your body called lactobacilli. This is the same bacteria found in yogurt culture and that is why we always hear about women drinking or douching with yogurt to help prevent or cure infection. Unfortunately, it doesn't work well in the vagina, but can help as a 'probiotic' in the intestinal tract. When your vagina is healthy, the vagina keeps itself clean. We always joke that it is like a self-cleaning oven; it stays in a healthy state by producing the secretions of normal vaginal discharge. Many things may disrupt the natural balance of the vagina.

First it’s important to understand that all women have vaginal discharge. Glands in your vaginal and cervix produce small amounts of fluid that flows out of your vagina everyday taking with it old cells that line the vagina. Your normal vaginal discharge helps to clean the vagina, as well as keep it lubricated and free from infection and other germs. A normal vaginal discharge does not have a foul odor and usually has no odor at all. Normal vaginal discharge often appears clear or milky when it dries on your clothing; occasionally you may notice white spots or a normal vaginal discharge that is thin or stringy looking. This is all normal, and the sticky, stringy discharge indicates that you are ovulating. So if you have been on the pill for a long time you may not have seen it for awhile as you would not ovulate on the pill. The appearance may change due to sexual excitement, breastfeeding, ovulation, or diet. The consistency of your vaginal discharge or how thin or thick it is can be affected by your menstrual cycle, emotional stress, pregnancy, any prescription or OTC medications including hormones such as in the pill.

Other things that can upset the natural pH balance of your vagina and lead to vaginal infections include vaginal douches, feminine hygiene products, perfumed or deodorant soaps, antibiotics, pregnancy, diabetes, or infections. So we can all see that it is a highly sensitive area affected by many things, some obvious and some we would not expect. For example, having a head cold can cause and increase in vaginal discharge, strange huh? It is no wonder that douching with perfumed or homemade solutions can cause such recurrent or chronic odors and discharge. Although you can buy the douches at the local drug store, it this does not mean they offer help.

Your menstrual cycle has a significant affect on the type of vaginal discharge you experience throughout the month. Did you know you’re more likely to experience vaginal infections just before or during your period? This is because the pH balance of your vagina rises during your monthly cycle causing the pH of your vagina to be at its’ highest point a few days before and during your period. About halfway between your periods an increase in vaginal discharge that appears mucousy, sticky, and stretchy is normal. As stated above, this type of vaginal discharge is an indication of ovulation.

You may identify abnormal vaginal discharge and infection from the following signs:
- Changes in color, consistency, or amount
- Constant, increased vaginal discharge
- Presence of itching, discomfort, or any rash
- Vaginal burning during urination
- The presence of blood when it’s not your period time
- Cottage cheese-like vaginal discharge
- A foul odor accompanied by yellowish, greenish, or grayish white vaginal discharge

You are probably are aware of these signs or may have had them at some point. I recommend that you would go see you Ob/Gyn or family doctor when this happens and not just self-treat, unless it is something that you have had before and have already been seen for it. Vaginal discharge and infections are common and your doctor is used to seeing all types, so your doctor and the nurse may put you at ease. The anticipation of going and thinking about it is always worse.

The most common vaginal infection is bacterial vaginosis, as well as vaginal yeast infections and trichomoniasis. The most troublesome problem for some women are those who have recurrent or ongoing vaginal odor for no reason. This is a major issue and very embarrassing as they never feel clean, even though it has NOTHING to do with cleanliness. It is not from an infection and can be caused from any of the above we've already addressed.

We are lucky because if you check the WaterWorks Website you will find a wonderful device that 1000's of women are using today for daily feminine hygeine purposes, cleanliness after sex, and because of the unique FDA cleared design has cured many women of their vaginal odor problems. So no more embarrassing odors to worry about during sex, what a relief!

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Vaginal Odor and WaterWorks

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; www.KnowYourV.com or WaterWorksHealth.com & check out WaterWorks. Let me know if u have any other questions, be safe, and have a wonderful week.

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Everything You Need to Know About Feminine Odor

Today, I want to help those of you that are concerned about the type of vaginal odor that seems to get better and then, for no reason, will show up again and again. It is so frustrating because you know you haven't changed your hygiene habits, so why does it keep coming back?

The thing is, women have always struggled with vaginal odor, rashes and irritation. Why? Because period blood, sex and many medicines can disrupt the normally-low vaginal pH and create an environment for odor, bacterial and yeast infections to return over and over.

Many women struggle with how to clean up inside the vagina and have only learned what our mothers and grandmothers told us. The truth is, most of us over clean, and grab every product we can, in an effort to help - whether it is douches, sprays, special soap for "down there", creams, lubricants or inserts. We even read on the Internet about "natural" ways to cleanse and heal the vagina. For some reason, we think natural is better, and we use douches with vinegar or lemon juice, or soak tampons with vinegar, lemon juice, yogurt, lactobacillus, colloidal Silver, and an unending number of herbal products.

But, unfortunately, the odor and irritation does not get better and returns anyway, which makes us work even harder to clean up inside. This goes on and on.

The vagina was made in such a way that it does not need help from us to heal or cleanse itself. Yet, we feel the need to intervene. Many women do not "feel" clean unless they can clean up inside their vagina. Especially with the change of vaginal discharge throughout the month, a change of your sexual partner (or finding out that he cheated on you or if he gave you an STD). The natural vaginal environment is acidic (lower pH) than the rest of our body. Semen, period blood, douches, soap, vaginal creams and lubricants can raise the pH and completely hinder the vagina from healing and cleaning itself.

It is a healthy feminine hygiene practice to use soap to cleanse the outside of your body, around the vagina, anus and labia. But up inside, if you feel the need to rinse out your vagina to clean out semen, blood or excess discharge, you should only use warm water.

A lot of women are using WaterWorks now because it has been FDA cleared for vaginal cleansing to remove odor. WaterWorks is very different from store bought douches. It is made to be reusable. Therefore, you can save money and the environment by using it. It is designed with a refillable bag to fill with warm shower water connected to tubing with a medical grade stainless steel nozzle. The nozzle is placed inside the vagina and sprinkles out the warm water. It is the reaction of the stainless steel, water and vaginal mucosa that removes vaginal odor. It is a wonderful, useful discovery to help women with excessive discharge and odor. It can be used daily or as often as needed.

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How to Smell Fresh Down There?

This week I bunched together the questions or worries I hear from many of my readers out there and lots of you who come into my office each week for appointments. This week a patient came in and asked a common question: “I don’t know what is wrong with me, but I shower several times a day, and I still do not smell fresh down there! What can I do? I am so worried that people next to me can smell me.”

This is such a common and distressing problem. Not only does it destroy a woman’s confidence, but it can also put a real strain on her sexual intimacy.

Before you attempt any type of self-treatment, you should first visit your gynecologist to be sure you do not have an STD or vaginal infection. Any type of vaginal infection can cause unwanted odor and irritation with discharge.

The most common infections with odors are caused from imbalances of the normal bacterial environment (or flora) in the vagina. Most of the time this is corrected by using an oral or vaginal form of a certain antibiotic. This can be very effective, but because vaginal odors are often caused by bacterial imbalances of the natural vaginal flora, it is often only a temporary fix.

I think because odors are usually (and often erroneously) linked with poor hygiene, many woman become so distressed that they may resort to using over-the-counter douches, feminine hygiene sprays or other products that just cover up the odor and can actually worsen the problem.

The best product on the market today to help with vaginal odor is WaterWorks. It has been FDA cleared for this purpose, and unlike douching, WaterWorks does not use any chemicals which can disrupt the normal vaginal ecosystem. The gentle downward sprinkling action of WaterWorks does not irritate the vagina nor push bad bacteria further up into your cervix Its unique design allows you to use it in the privacy of your own shower, and it is reusable, so you don’t have to spend money repeatedly for products that do not work.

WaterWorks destroys odor causing bacteria through its unique design, using gently flowing water and a medical-grade stainless-steel nozzle to naturally eliminate feminine odor.

This product is safe enough to be used every day for feminine hygiene purposes, for rinsing out semen after sex or to wash away old blood after your period. No wonder women love it! You will too. You may have struggled with odor for years, but find it is gone after just the first use of WaterWorks.

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Protect Yourself Against Cervical Cancer

"Dear KnowYourV, how can I protect myself and reduce my chances of getting cervical cancer?"

With the rise of HPV infections & lesions showing up in places like the tongue, throat and anal and labial areas, everyone is becoming concerned. HPV (Human Papilloma Virus), is in the condyloma (genital wart) family. But unlike other genital warts, HPV warts are flat and cannot be detected without placing a special solution on the area. The solution reacts in such a way that the HPV lesions turn a whitish color, and this helps in diagnosis and treatment.

Since HPV is transmitted sexually, the best way to protect yourself from infection is to ensure safe sexual practices. Condoms are the best way to prevent most STD's, but it is thought that the HPV virus is so small that it can escape through a condom’s tiny pores. The addition of spermicidal foams and jellies can help.

The biggest breakthrough in the past few years has been the introduction of a vaccine initially approved for females age 8 to 27. Now the vaccines approval has been extended to males of the same age. This will hopefully be the #1 way to prevent transmission.

Women are typically at higher risk for acquiring these types of STDs as we are the semen recepors. Men, on the other hand, are depositors. Because we are the receptors of the semen, if the semen is infected, we serve as little incubators.

That is why it is so nice to use the WaterWorks cleansing system. WaterWorks can be used immediately after sex to rinse out semen quicklyreducing the time HPV can sit in vagina. Not only does WaterWorks function to reduce vaginal odors, it can also be used for daily feminine cleansing.

If you have not spoken to your healthcare provider about getting the HPV vaccine, it is a good idea to at least get information to read about it.

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Advice For Dealing With Chronic Vaginitis

Most women gauge their health by their menstrual regularity and their vaginal health. As a gynecologist, I experience this through my patients on a daily basis. Any signs of abnormal bleeding or discharge, missed periods (or too many periods) or unexpected pain during sex, sets off an internal alarm to seek medical help. Women are sensitive and intuitive, and because changes in our periods or discharge can signal pregnancy, cancer, metabolic diseases or infection, it's no wonder they are concerned.

Chronic vaginitis can cause vaginal redness, itching or irritation, bleeding between periods or after sex and abnormal amounts of discharge. Sometimes there can also be a sensation of a mass or bulge in your vagina, accompanied by a sensation of pressure or heaviness in your vagina.

Sexually transmitted infections can affect the vagina, including genital warts, syphilis and genital herpes. These require specific medications for healing. The vagina can also form cysts and abscesses which will cause pain during sex or make it difficult to insert a tampon.

Chronic vaginitis can affect our fertility, desire and ability to enjoy sex and reach orgasm. Ongoing vaginitis causing odor and inflammation brings stress that interferes with healing and can result in relationship problems. Chronic stress often leads to anxiety and depression, but even slight mood changes can contribute to a lack of sexual desire. This causes hormone changes resulting in discomfort and pain during sex. So we see how it becomes a cycle circling back again and again.

Of course, we are taught about the importance of hygiene when we are young. Bathing, brushing our teeth, dental checkups, washing our hands before we eat, etc., but somehow vaginal hygiene is over-looked or just assumed. If we are lucky, we are taught not to douche, use perfumed soaps, feminine sprays or scented pads and tampons.

WaterWorks is a wonderful way of maintaining vaginal hygiene naturally, without disturbing your natural vaginal flora. Regular use of WaterWorks has been reported by users to help prevent vaginitis and its recurrence. It is an easy way to maintain vaginal health and cleanliness. It is reusable and is considered a "green" product. Check out the WaterWorks website to see how it works!!

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Do I Need to Cleanse Inside My Vagina Before My Yearly Exam?

The yearly gyn exam can be very stressful for most women. We can worry about our health, the outcome of tests, how to ask uncomfortable questions and sometimes worry about having the most private parts of our bodies examined. The purpose of the yearly exam, as we've discussed previously, is to do an annual pap test to check for cancer and HPV virus, do the breast exam (and schedule a mammogram if needed), do a pelvic exam to check for any ovarian, uterine or pelvic masses, answer questions and do lab tests.

Your doctor will examine the external genitalia and inside the vagina, inspect the cervix and perform a pap smear. This makes many women wonder whether they need to clean inside their vagina before the exam, and if so, how to do so in order to assure the best exam results. The best answer to this from a gynecologist viewpoint (and as a woman myself) is: of course....but do it properly! We all want to feel clean and be ready for the best exam, but it’s important not to clean so much that there is nothing left to be examined and sent to the lab.

For the best exam, prepare starting 48 hours ahead of time abstain from vaginal sex, use of lubricants, gels, foams, feminine deodorant sprays, or using soap internally. Cleansing externally is fine as is shaving or waxing excess pubic hair. It is best to shave or wax a few days before your exam is to reduce sensitivity or irritation during the exam. Just do what makes you feel comfortable.

All of you by now have heard about WaterWorks Vaginal Cleansing System, which is a wonderful way to clean your vagina naturally without the use of drugs or chemicals that can cause more irritation and more infection. The chemical cleansers can cause a cycle that never ends, where you think the odor is gone for a day or two, and then it coms right back and harmful to the vaginal eco-system! With WaterWorks, getting ready for your annual exam is easy. WaterWorks can be used every day or even two to three times a day if you shower that many times. It can be used after vaginal sex to rinse out semen and prevent odor and persistent discharge afterwards. Unlike the 48 hours restriction we place on other vaginal products or activities, but with WaterWorks you only need to abstain for 24 hours prior to your exam.

The reason for this is that WaterWorks uses only tap water and medical grade stainless steel nozzle to cleanse the vagina. Women who have struggled for years with vaginal discharge and odor have had results the first time they use it! No more spending money on pills, medication, vaginal gels, or douches. WaterWorks can be used again and again and you never need to buy any extra parts or solutions because it uses only tap water. How wonderful. As a physician, this made me so happy for my patients.

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Tips For a Healthy Vagina

When our vagina is healthy, we feel healthy. But when we notice abnormal discharge or odor or abnormal periods, we worry about our overall health. That's because vaginal problems can affect our fertility, desire for sex and ability to reach orgasm. Ongoing vaginal health issues can also affect other areas of our life, causing stress or relationship problems.

First it is good to know some details about our bodies. For example, the vagina is a closed muscular canal that extends from the vulva (the area where the hair grows on top) and goes to the area of the uterus called the cervix. Certain things can affect your vagina - some we can change and some we can't.

Taking care to use condoms during sex to protect against infections is one thing we can control. Also, be aware that aggressive or forceful sex can cause pelvic fracture or other injury to the pelvic area as well as vaginal trauma.

Certain health conditions like diabetes and Sjogren's syndrome, an autoimmune disorder, can cause vaginal dryness. Certain antihistamines can cause also cause vaginal dryness. Prolonged use of antibiotics increases the risk of a vaginal yeast infection. Superabsorbent tampons can lead to toxic shock syndrome which is a rare, life-threatening complication of a bacterial infection.

Intra-vaginal birth control products like Spermicides, diaphragms or contraceptive sponges may also cause irritation and painful sex.

Anxiety and depression can contribute to a low level of arousal and resulting discomfort or pain during sex. Trauma, such as sexual abuse or an initial painful sexual experience can also can lead to pain associated with sex from scar tissue and anticipated pain.

Changes in your hormone levels can also affect your vagina. For example, estrogen production decreases after menopause, after childbirth and during breast-feeding. Loss of estrogen can cause the vaginal lining to thin (vaginal atrophy) and this can make sex painful.

But, honestly, there are many other common conditions that can affect your vagina. These might include persistent or recurrent genital pain just before, during or after sex (dyspareunia). Pain during penetration might be caused by involuntary spasms of the muscles of the vaginal wall (vaginismus). And, sexually transmitted infections, including genital warts, syphilis and genital herpes, can affect the vagina, causing abnormal vaginal discharge or genital sores.

Also, a bacterial or yeast infection can cause inflammation of the vagina, called vaginitis. Symptoms usually include vaginal discharge, odor, itching and pain.

Women at any age can also suffer from prolapse of the uterus, bladder, and rectum, which can put pressure on the vagina. This happens when the supporting ligaments and connective tissues that hold the uterus in place become weak and can cause the vagina to be pulled down as well.

The vagina can also form cysts and abscesses, which will cause pain during sex or make it difficult to insert a tampon.

Vaginal cancer is very rare, but unexplained bleeding or pain should always be checked out by a doctor. Look for changes in the color, odor or amount of vaginal discharge and vaginal redness, itching or irritation, bleeding between periods, after sex or after menopause, a mass or bulge in your vagina, or a sensation of pressure or heaviness in your vagina

You can take steps to protect your vaginal health by being sexually responsible. Use condoms or maintain a mutually monogamous relationship with a partner who's free of sexually transmitted infections. You may want to consider being vaccinated to protect yourself from human papillomavirus (HPV) as well as hepatitis A and hepatitis B. Practice good hygiene by not douching, using perfumed soaps, feminine sprays or scented tampons. Change tampons frequently (do not leave them in for longer than 5-6 hours). If you use sex toys, clean them after every use.

Using WaterWorks is a wonderful way to maintain vaginal hygiene naturally, without disturbing your natural vaginal flora. Check out the Website to see how it works!!

Kegel exercises can help tone your pelvic floor muscles. Simply tighten your pelvic muscles as if you're stopping your stream of urine. Once you've got the hang of it, do at least three sets of 10 a day.

Limit the amount of alcohol you drink and don't smoke or use drugs. Smoking increases the risk of bladder cancer and alcohol increases the risk of breast cancer. Alcohol and illegal drugs can cause sexual dysfunction. Nicotine can inhibit sexual arousal and if you're under the influence, you're more likely to take sexual risks.

Just remember to see your doctor if you are having unexplained vaginal pain. It may be something simple, but you want to know so it can be taken care of.

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How Can I Feel Cleaner During and After My Menstrual Cycle?

I can't believe another week just flew by and October is almost over. Wow! The Holidays are here - the kiddos will be out in their costumes ringing our doorbells all bright-eyed and excited, some even accompanied by their family dog in costume! It all makes me smile, and I know you all have traditions that you celebrate this time of year that make you feel the same.

Well, this week Nicole wrote in and asked a great question.

How can I feel cleaner during and after my menstrual cycle?

Many women on their cyclesconstantly feel unclean due to the bleeding making them feel messy, and because the pH change can cause unusual odors.

The constant wetness or overflow from heavy bleeding can stain our underwear or soak through onto our outer clothing, making this time challenging.

Some of the the best tips are the simplest:

**Shaving or trimming excess pubic hair helps prevent dried blood, or tiny blood clots from sticking to the hair. This can help make you feel cleaner and help prevent odor.

**Using tampons also can help some women feel cleaner, as the bleeding is contained internally as opposed to the feeling of sitting on a soggy, wet pad all day.

**Resting more often and not missing sleep is very important. Increasing to 2 or 3 baths or showers a day can also go a long way in helping you feel more fresh.

I am shocked to read and get questions from so many women who douche during and after their cycles to feel cleaner. This is absolutely the worst thing you can do! I have stressed in the past that I, as well as most Ob/Gyn's, do not want you to ever douche because of all the problems it causes (as we have discussed previously).

When a women is on her cycle, the cervix, which is the opening to the uterus through which the menstrual blood and babies come, is slightly open. If you douche at this time, the forceful pressure of the flow of fluid can force bacteria and old blood from the vagina back up into the uterus and fallopian tubes, potentially causing PID,
(pelvic inflammatory disease), infertility or peritonitis.

The affects of tubal scarring can happen without even having symptoms of fever or pain when it happens. If this does happen pregnancy can become difficult and many women have had to see infertility specialists for invitro-fertilization. The consequences can be serious.

WaterWorks is the new popular vaginal cleansing system and the only one I would recommend to help with feminine odor. Even though it looks and works a lot like a traditional douche, it is very different because: 1) It uses only natural tap water; 2) The gentle flow of water is directed downward instead of up or out like most douches; 3) It uses the unique and safe odor-elimination power of stainless steel combined with running water. lows through a reusable stainless steel vaginal end. The reaction of running water with its stainless steel nozzle effectively eliminates vaginal odor without and because the water sprinkles out of the vaginal end instead of shooting out, risk of infection entering the uterus and fallopian tubes. and causing scarring and infertility.

The best part of it is you can reuse it, and you can use it every time you shower or bathe without causing vaginal pH changes.

While I do not recommend using any douches during heavy flow days, women who want to feel fresher during their cycle can use WaterWorks on light days (spotting days) and, most definitely, I recommend using WaterWorks right after your menstrual period is over.

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Can WaterWorks Help With Vaginal Discharge in Addition to Vaginal Odor?

This week the question is:

“I know WaterWorks helps with vaginal odor, but I have a lot of discharge, will it help me with that too?”

It seems kind of funny, but problems with vaginal odor and discharge seem way too embarrassing to bring up over lunch with the girls, even though in my experience, based on what I hear safely behind closed exam room doors, it's one of the most common problems women have. Maybe it would be good to know that the women closest to us suffer too.

Because vaginal odor can be caused by an imbalance of the normal bacterial flora in the vagina, odor and discharge often go hand in hand. Bacterial Vaginosis (BV) and yeast infections can both be culprits of recurrent odor and discharge.

Unlike store bought douches which contain chemicals that can make the situation worse by destroying that normal ecosystem WaterWorks uses of only tap water for vaginal cleansing, so it can be used every time you shower without causing any adverse effects. In fact, by using WaterWorks, a healthy balance can be created as the abnormal discharge and bacteria are removed and normal vaginal pH can be restored.

This is best seen by using WaterWorks to rinse out semen after sex. What is really happening has to do with the composition of the semen, which is a sugary, alkaline substance created to protect the sperm from the acidic environment of the vagina. If not for this, the sperm would die on contact with the vagina and no one would ever get pregnant. After sex, semen remains inside and if you have sex again within a day or two, it gives the vagina no time to restore the normal flora that creates the acidic environment. Once this happens there can be persistent discharge and odor that reoccurs.

So back to the question as to whether WaterWorks helps to eliminate vaginal discharge with the odor, the answer is yes. We have many women writing in and telling us how much they love WaterWorks. The WaterWorks system is a reusable vaginal cleansing system that has been FDA cleared for vaginal odor and it is the reaction of the stainless steel nozzle end that is designed to comfortably insert into the vagina, with ordinary tap water that eliminates or reduces the unpleasant odor.

The unique design and gentle sprinkling action will rinse unwanted discharge and semen from the vagina and help facilitate the natural healing process of your own body. No chemicals and no medications. What a wonderful gift to every woman.

Oh, and just for the sake of any curious readers, I do not receive commission from any of the WaterWorks that are sold, so there is no monetary incentive for me in telling you about it. I was just so excited when I discovered WaterWorks and met the inventor, because now women had a natural way to combat feminine odor and discharge without having to use chemicals or medications. All natural. What could be better than this?

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Struggling With Yeast Infections Since 5 Years Old. What Can I Do?

Dear KnowYourV,
I am a 31yr old woman; and since I was about 5yrs old I have been struggling with yeast infections (strawberry shortcake bubble bath caused it to start). They progressively have gotten worse with age.

They also have caused me to have medication prescribed (generic Diflucan) and a topical cream (Nystatin) over the last two years. But I can't seem to shake this infection or whatever it is.

I have been diagnosed with "trick" and given antibiotics and I haven't even had sex prior to this diagnosis. My "V" is discolored and wrinkly around the opening only on one side of my lip as if I have warts or something (which all my tests came back negative). When I use the Nystatin, it relieves the itching, swelling and discomfort (which helps) but nothing will heal the bubbly raw "scar" that keeps getting irritated - for whatever reason I'm not sure. It swells and itches and it's like the worst thing I have ever experienced.

Sex is out of the question because of it being raw and it's very unsightly. I have purchased WaterWorks and it really does help me get thru the day mainly because it's like an overproduction of yeast that greets me every morning or evening. Prior to WaterWorks, I had to swab out my "V" multiple times a day. I don't have medical insurance, so this is a financial pickle for me to keep going to the doctor with no resolution.

All of that being said, could my diet be preventing me from healing? Or could my bout of an eating disorder/depression (going days w/o eating, but drinking heavily, be the culprit? I'm at a loss here. I just don't know what else to do. Do you have any suggestions?
Sincerely,

Over It


Dear Over It,

I'm sorry to hear that you have been struggling so long. Bubble bath and soap can cause problems mainly because soap is alkaline, and the vagina stays healthy by remaining more acidic. So what we see with too much soap and bubble bath is rashes and allergies on the labia.

The Diflucan and Nystatin can help with both internal and external yeast infections, but only for a short time. Yeast and bacterial infections can always come back over and over. The medication is a treatment not a cure.

Trichamonas is passed sexually and can colonize or sit in the vagina for months if untreated. So there may be no way of knowing exactly when you got it.

Yeast infections can get better - as you have experienced - and you may feel OK for a few days, but then it can come right back. Why? Because anything that changes the pH of the vagina like sex, period blood, soap, hormone changes or feminine perfume sprays can bring them right back. That's why WaterWorks really helps, as it can be used to rinse out semen after sex, blood after a period and excess discharge. The plain water and medical grade stainless steel nozzle are very effective at healing the vagina and preventing reoccurrence.

I'm sorry I'm not there to look at the area on the one side of your vaginal opening-lip area to know what it is and biopsy it, but you need to see your gynecologist and have this done. Your doctor will want to determine what it is (including ruling out cancer or lichen sclerosis - as many lesions can cause ongoing, reoccurring, itching and swelling). Even reoccurring yeast infections can cause lesions like this that are raised, swollen and bumpy. They can make the normal vaginal tissue feel bumpy and look worse than normal. It is good sign that misstating helps, and it is possible that you just need to use it much longer or try a prescription antifungal/cortisone cream combination.

The opening of the vagina and the vaginal walls are "bumpy" naturally. This is called rugations and often women worry that they are warts. The rugations are a sign that a women's hormones are still working and that the vagina still has it's stretchability. As women age and go through menopause they stop producing hormones, and if they are not on hormone replacement, the vaginal walls will thin and shrink and lose their ability to stretch so vaginal sex can become very painful, or even impossible.

I hope this helps you to understand your body better and prompts you to see your gynecologist about the one side that is not healing. Hopefully (s)he can give you refills, so you can fill your meds and treat the infection as soon as you feel it coming back. Continue your daily use of WaterWorks as well.

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How to Prevent Urinary Tract Infections

This is a great question, because UTIs (urinary tract infections) are one of the most common infections in women, and one of the easiest to prevent. The answer to the above question is yes, it is very important to get up and empty your bladder after having sex. Also,you should clean the vaginal area, because bacteria from the rectum, vagina or your male partner can get pushed up your urethra (the opening on the outside of the female body where we urinate, and which connects to the bladder during intercourse.

Staying clean is one of the most important ways to prevent UTIs. That is why so many women are using WaterWorks, because they know it is the only FDA-cleared vaginal cleansing device that can be used to rinse out semen and discharge from the vagina. It rids the vagina of unwanted odors, semen and discharge that can linger for hours after intercourse, and which put you at higher risk of vaginal and urinary tract infections.

Douching has generally never been recommended by doctors because it uses harsh chemicals that can destroy the natural vaginal floral needed to keep the vagina healthy. But, many women struggle with the feeling that their hygiene is incomplete without cleansing their vagina. WaterWorks, although it looks a lot like a douche, is entirely different. It uses only plain, natural tap water in a reusable, refillable bag that is connected to sturdy plastic tubing. The nozzle is made of medical grade stainless steel designed to comfortably fit into the vagina and which allows the water to sprinkle out, in a gentle, downward fashion disposable douches that shoot chemical solution out forcefully, disrupting the healthy vaginal flora chemical douches can actually create a cycle of recurrent UTIs and vaginal infections.

When trying to prevent UTIs, it is also important to drink lots of water to flush out your kidneys and bladder help keep them clear of bacteria. Cranberry juice and some other citrus and fruit juices can acidify your urine, and the lower pH prevents the growth of bacteria. It is important to urinate after sex, but it is also just as important to empty your bladder before sex, as less trauma occur to an empty bladder during intercourse.

Urinating when you feel the urge and not holding back too long is important if you get frequent UTIs. Of course, making sure to always wipe from front to back ensures that the fecal matter from the anal area doesn't get near the urethra. Wearing thong underwear is controversial (from a medical perspective), and maybe should not be worn if you are someone who gets frequent UTIs. Regardless of style, cotton underwear seems to the best choice.

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Can Ovarian Cysts Cause Vaginal Discharge?

Vaginal discharge can be a perplexing problem. Especially when you know something has changed, but all your tests at the doctor's office are negative for an infection. It's not always explained or even obvious why we are having changes, and most of the time the symptoms come and go - so it can be confusing.

Many women know that ovarian cysts can cause pain but do not realize that they can cause all sorts of other symptoms. Not sure why you're having low pelvic pain and pressure? Suffering an increase in vaginal discharge? Maybe you are experiencing symptoms of ovarian cysts.

Ovarian cysts are fluid-filled sacs on the ovary that are a result of ovulation. Each month, a woman produces many follicles, which are fluid-filled cysts that the egg matures in. These (and most ovarian cysts) are benign and harmless. Most cysts are a direct result of ovulation, and therefore very common. Thankfully, most cysts resolve themselves without intervention.

Once a single ovarian follicle ruptures and "pops" out the egg, all the rest of the maturing follicles from that cycle should shrink back and dissolve. But, sometimes one or more do not do this and, in fact, they keep growing. They have been known to get larger than a baseball! If this ruptures, it can cause internal bleeding and extreme pain. When a cyst ruptures, the pain can be so severe that many women pass out.

Most women will have an ovarian cyst at some point, but won't even know it exists because most of them are painless. They simply swell up, then leak the fluid back into your bloodstream on their own. There are other types of benign cyst that occur but it is impossible to know whether a cyst is benign or cancerous by how you feel. That is why it is important to see your doctor for blood tests and an ultrasound to determine if it needs to be removed or has malignant qualities.

The following symptoms could indicate the presence of ovarian cysts:

• Constant pain. Take note of when you experience pain. Is it cyclical? Are you experiencing pain during the first half of your menstrual cycle, but it goes away just after the time you should be ovulating? If so, you may have a follicular cyst, which is considered a harmless, functional cyst. Do you experience pain in the latter half of your cycle? You may have a corpus luteum cyst, which is also related to ovulation, is also benign and is considered functional. But, if the pain is persistent and not cyclical, it's a good idea to get it checked out sooner rather than later.

• Both benign and malignant cysts can grow to be very large. They may place pressure on internal organs and cause you discomfort and pain with sex.

• Larger cysts can also place pressure on your bladder or colon. This leads to frequent trips to the bathroom. Large cysts can also obstruct the colon, causing narrow stools. Hormone-producing cysts can cause an increase in vaginal discharge and menstrual irregularities, such as spotting. Because cysts sit very close to the opening of the fallopian tube, they can discharge blood or fluid as they drain, and it will run down through the intrauterine cavity, through the cervix and into the vagina.

Most ovarian cysts resolve on their own with little or no pain and will go undetected. But it is always best to have your doctor check you if you are having any of these symptoms. Vaginal discharge can disrupt the normal vaginal flora and actually bring on more bacterial and yeast infections. WaterWorks is a great system to use to maintain feminine hygiene and clear any abnormal discharge or odor. It works best when added to you regular hygiene regime and used at least 3-4 times a week.

I hope this helps you understand your body better. Take care and be safe. Thanks for all your questions. It helps others when you ask your questions, because we are all learning and experiencing the same things.

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Is It Normal to Have Vaginal Discharge?

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.

Infections require medicated vaginal creams or antibiotic medications, but here are some tips for preventing vaginal infections that can lead to abnormal discharge:

• 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.

We are lucky enough to have WaterWorks, which is FDA cleared for feminine cleansing and to reduce vaginal odor problems. Everyone loves this, as it functions just like a douche, but isn't. It is made of medical grade stainless steel and uses no chemicals (only plain tap water) and it can safely remove vaginal odor with the first use.

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Should I be Tested For an STD?

For many of us this may be an uncomfortable and embarrassing question. I know many of my patients will tell the staff they are coming in for a different reason, and only when they are finally in the exam room with me they are comfortable enough to share their concerns about possible STDs. 

Some of them have just discovered that their partner has been cheating on them, and are emotionally devastated. Maybe you or someone close to you has recently experienced this and can understand how scary it can be not knowing if you might have contracted something serious from an unfaithful partner. Even if you are single and dating and are careful to use condoms everytime, the worry is still there as condoms don’t protect from all STDs. 

Testing for STDs should begin when you become sexually active or have symptoms that make you worry that something may be wrong. Symptoms like vaginal bumps, blisters or open sores should be shared with your OB/Gyn.

So should vaginal discharge that is odorous, itchy, bloody, or higher volume than normal. If the infection gets to your kidneys or fallopian tubes and into the pelvis, it can cause fevers, severe pain and possibly PID (pelvic inflammatory disease). PID can cause scarring of the fallopian tubes and eventually infertility. I would never want to think that any of you or my patients would suffer from this and try to self- treat because they were too embarrassed to see their doctor. We are here to help you and want to see you get better. 

The home tests that you can get from the drug store can be used, but will often read positive when no infection is present at all. So a follow-up with your doctor is still a good idea. 

The best time to screen for STDs & STIs is during your annual exam. It is also a good time to ask questions and get information on prevention.

Some STDs (like HIV, Hep B, & Herpes or syphilis) may not show up right away on initial testing and take a few months to pick up on a blood test, so follow-up in 6 months to confirm that tests are truly negative.

I hope this helps. I know a lot of my patients ask me if douching helps get rid STDs and I have told them that it can actually force the infection up further through the cervix and into the uterus and fallopian tubes. This in itself can cause PID as discussed above.

A much better way to clean out your vagina is to use the WaterWorks Vaginal Cleansing system. It will rinse out excess discharge and infection-causing bacteria. [Note: this will not cure any STD or prevent an STD]. WaterWorks uses only fresh water (no chemicals!) and is FDA cleared. It does not use a shooting action so will not push the infection further up into the uterus or fallopian tubes. It may help you heal faster along with taking the prescribed medications. Don't share your WaterWorks with anyone else!

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