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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What Causes Menstrual Cramps?

I hope everyone had a great week. This week we are moving on from the menopause topic and have a question that I think all of you struggle with (some of you more than others, but I know it is a common problem).

Dear KnowYourV, what causes menstrual cramps, and is there anything I can do to help make them better?
Thanks, Alison!

Well, Alison, dymenorrhea is the medical term for the painful cramps that occur before or during your period. Most women feel cramps in their lower abdomen and lower back. Because they can start the day before your period, they can last up to 3 days and can be mild to extremely painful.

Cramps are caused by contractions in the uterus, which is a muscle. The uterus is a hollow, pear-shaped organ where a baby grows, and it contracts throughout a woman's menstrual cycle. If the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain can result when part of the uterine muscle briefly loses its supply of oxygen. This is similar to how a side ache feels when you run too far without stopping to rest. Your side aches and cramps because of a build up of something called lactic acid in the muscle due to lack of oxygen. It hurts when that happens! That's what's happening in your uterus when it's cramping.

Some of the best remedies to help alleviate the pain and cramping are simple things like aspirin, Tylenol, Motrin or other over-the-counter pain relievers. Sometimes prescription strength pain relievers can be used, but either way it is best to start pain medications the day before your cycle, as this blocks the onset of the cramps altogether and may even help reduce menstrual blood flow. Please always discuss the use of any medications with your doctor or other healthcare professional.

You can also use heating pads or hot water bottles on your lower back and abdomen, or a hot bath if it helps. Massage of the lower back and abdomen can also be helpful. Some women find that avoiding caffeine, alcohol and smoking during this time can help. Women who exercise regularly often have less menstrual pain.

If these steps don't help your pain, or if you've already tried them and they haven't helped, you may need to make an appointment with your gynecologist for a thorough evaluation. You could have endometriosis, fibroids, interstitial cystitis, diverticulitis, adenomyosis, cervical stenosis or pelvic inflammatory disease.

So as you can see it can get more and more complicated. I hope this has helped you begin to get an understanding of yourself so you can begin to feel better!

Thank you to those of you who wrote in and came into the office for WaterWorks this week. I know you will love it as we all do. It is a fantastic way to maintain feminine hygiene without the use of medications or chemicals. It couldn't have come at a better time, when all of us are searching for more natural ways to take care of our bodies.

I have had so many patients who have battled vaginal odor for years report that they no longer have problems, even after the first time they used WaterWorks. And you don't need to have a vaginal odor problem to discover the benefits of WaterWorks. Many women use it every day just to feel fresh and clean. You can even use it to rinse out semen after sex which will make you feel fresher right away. The medical grade stainless steel nozzle reacts with normal tap water to remove odor as you rinse. No more douching (which we prefer you never do anyway!)

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Pap Smears During My Monthly Cycle?

This question worries more patients coming in for their pelvic exams and pap smears than any other general question we get when they come in for checkup.

Different doctors may have different policies on whether to do pap smears during the menstrual cycle. So if you start your cycle prior to your appointment call your gynecologist‘s office to get advice about rescheduling.

It is a very intimate exam and can be stressful because they worry about having to undress and be examined, and hope it won't hurt or uncomfortable. Hygiene is a big concern. Most of us in this country are very clean, but many women also make sure they have their legs and underarms shaved and all other areas trimmed or waxed, according to personal preference, and a lot of patients feel uncomfortable being examined during their cycle. It is always a patient’s choice to reschedule if she is uncomfortable.

What has changed for doctors? It used to be that if a woman started her cycle she had to reschedule because the pap sample was smeared on a slide and then sprayed with fixative. The pathologist would then have to examine the slide under the microscope. So if there was a lot of blood & mucous it would obscure their ability to see the cervical cells and make a correct diagnosis. Today we obtain the sample exactly the same, but instead of smearing it on a slide the entire sample goes into fluid. Once the pathologist receives it, the bottle is placed upside down in a centrifuge to separates the blood, mucous, and discharge from the cervical cells. Once separated those cells can be placed on a clean slide to be thoroughly examined.

That said it is usually best to reschedule if you are having your period. The pap test is the most effective screening tool for cervical cancer, and hormonal changes that occur during the time of the menstrual cycle can cause cell changes which make it slightly more difficult for the pathologist to interpret the sample. The changes would not be mistaken for cancer, but could cause the pap test to be reported in such a way that a repeat may be needed to clear up the confusion. I'm sure we all agree that one pap test a year is enough! So why go through that trouble and worry.

The best time during the cycle for a pap test is, day 10 to day 20 if possible. Day one is the very 1st day that blood is seen, even if it starts as spotting. You should also stay away from vaginal intercourse, douching, tampons, vaginal foams and jellies, vaginal inserts, and any sprays or deodorants 48 hours prior to the appointment. These can interrupt an accurate reading of the sample.

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