Transcription:
Vaginal Health

Emily LaSota, MD: Using lubrication is a great way to just help the vagina accommodate sex a little bit more easily without as much pain and discomfort. Obviously, foreplay and increasing natural lubrication is the first way to go. But if that's not enough, lubricants can help.

Caitlin Whyte: It might not be immediately obvious when something could be wrong down there. But there are signs every woman should be looking out for when it comes to their vaginal health. Proper vaginal health affects more than just your sex life. It's an important part of a woman's overall health, including fertility.

So what should we be looking out for? Dr. Emily LaSota breaks down the do's and don'ts of proper vaginal health and the signs you should be looking out for regularly. She is a board-certified obstetrician and gynecologist on the medical staff at Southwest General.

This is Southwest General Health Talk. I'm Caitlin Whyte. So starting us off here, doctor, let's talk about general cleanliness and preventative care. What are most women doing wrong and right when it comes to washing this area and keeping it clean?

Emily LaSota, MD: So to me, taking care of the vagina is common sense, but a lot of women think that it's a little harder than that. So I see women coming in doing really too much to their vagina causing more problems. So I think it's important to know that the vagina is pretty much self-cleaning., It cleanses itself. There's no need to douche. There's no need to clean inside the vagina. That's usually when people get problems.

The vulva is the outside of the vagina. So it is the skin outside. And if anyone's listening to this podcast, get used to me using the word vagina and vulva a lot today. So make sure you're comfortable with that. So the vulva is the outside of the vagina. Cleaning that, water only should be sufficient. If people feel the need to use a gentle soap, that's fine. But things that could be chemically irritating, so wipes things that people market as feminine products, they can have chemicals that can cause irritation. Even if something is branded as all natural, we have to be careful. People can have allergies to things as all natural as peanuts. So if your vulva doesn't like it, you probably don't want to be using it. Especially women with sensitive skin, we all have different types of skin. Some of women's vulvas are more sensitive than other people.

If you're having a problem, if you're having irritation, look at things that could be touching your vulva that could be causing irritation. Things such as simple as detergents, scented soaps from Bath and Body Works, dryer sheets, lubricants that you're using during sex can cause irritation. And then we all think about when we want the vulva, the pubic area, we want it to feel and look a certain way, so a lot of women wax or shave, that can cause irritation or microabrasions. If your vulva is doing fine and you're waxing and shaving, you can continue your regimen. But if you're getting recurrent problems, sores, pain, itching, redness, maybe you have to change up your regimen. Use a shaving cream or don't shave at all. Use clippers. Clippers like men use on their faces can cut the hair very close without causing those microabrasions of the vulva.

Caitlin Whyte: What are your recommendations for bikini line, shaving all of our pubic hair?

Emily LaSota, MD: So a matter of hygiene is personal preference. If a person can shave and it doesn't cause problems, do that. I do see generational differences with older women preferring one look and style, younger women preferring something else, but it's totally unique to that individual. If waxing, if shaving is causing problems, use clippers, use a different shaving cream. You don't have to shave for someone else or do something for someone else. Don't shave when you come to your gynecologist appointment, just because you think that we want it to look like that. Do it for yourself. Don't look at what other people are doing and say, "I should do that." Don't look at people on social media or even friends or family. Do what's right for your vulva, your vagina. That's what's best.

Caitlin Whyte: Now let's talk about safe sex. What are some do's and don'ts when it comes to both pregnancy and STD prevention?

Emily LaSota, MD: So condom use is the best way people can prevent against sexually transmitted infections. Number one, keeping your vagina safe and healthy is making sure that you don't contract things like gonorrhea, chlamydia, trichomonas, which can infect the vagina, cervix and even cause longer-term problems such as pelvic inflammatory disease. So condoms can really protect against those types of infections.

Now during sex, some people feel dryness. Using lubrication is a great way to help the vagina accommodate sex a little bit more easily without as much pain and discomfort, obviously foreplay and increasing natural lubrication is the first way to go. But if that's not enough, lubricants can help. Lubricants a lot of times are marketed as "all natural." Now, we have to remember, even if it is a very natural lubricant, your body can have a reaction to it.

One lubricant that I recommend to people that a lot of people tolerate really well is coconut oil. I tell people it's easy. You can get it at the grocery store and you don't have to be embarrassed to buy it. And even some people have it in their kitchen. So it might even be easier to get than go to the grocery store, go to your kitchen. And I think it smells and tastes pretty good without drying up or leaving a residue that a lot of over-the-counter lubricants do.

Caitlin Whyte: I'd love to know more about, you know, the kinds of underwear, leggings. Is there anything we should know about fabrics or styles, some other clothing options that are better for our vaginal areas?

Emily LaSota, MD: So our tissues like to be dry and not suffocated. So a lot of fabrics that are rather tight or that hold in moisture or sweat can cause irritation to our skin and our vulva. Some people can wear them, no problem. But if you are someone that notices a lot of irritation, switch to things that are a little bit looser, a little bit more cotton-based. So really, again, just listen to your body and kind of make changes to see how your body reacts and get it comfortable.

Caitlin Whyte: Now many doctors, other medical professionals, even just influencers are on TikTok, in social media, you know, with their own kinds of products they like or ideas they have. When it comes to medical advice, especially, you know, vaginal health, sex advice, how should we treat what we see on social media?

Emily LaSota, MD: So I have patients that come in every day saying, "I was going to do this" or "I did this because I saw it from an influencer on Instagram or TikTok," those people are most of the time not physicians. And most of the time, they're doing it for some kind of personal gain, usually monetary gain. They're advertising for some kind of product or company.

There was a recent product that was from the company that makes Vagisil called OMV!, which was basically a glitter wash that was marketed towards teens to get rid of something they called period funk. I think that a lot of people on TikTok and Instagram who are teens saw that and thought, "Oh, there must be something wrong with my body. I better use this wash so that my vagina is taking care of or my vulva doesn't smell bad." There's probably nothing wrong with their vulvas or vaginas, but it's a marketing ploy to sell a new product. So we have to be very careful what we're hearing from social media.

What I say is, yeah, you can follow, you know, bands or celebrities or whatever on Instagram or TikTok. But when it comes down to medical advice, see a gynecologist, see a doctor, talk to us. So seeing a doctor, it's not as glamorous, but come in and get your pap smear. Maybe get tested for HPV. Get STD screening with us. And if you're having a problem, don't necessarily go to social media for your answer. Yes, you can Google to try to get an idea of what's going on, but really there's no substitute for an exam in the office. You might be having something that's totally normal. You could also be having something that's bacterial vaginosis or a yeast infection, that's called candidiasis. But self-treating with something maybe the wrong treatment and it might make things worse. So really, there's no substitute for coming in and talking with the doctor.

Caitlin Whyte: So from our teens to our 30s and 40s, all the way through menopause, how do our needs change with age when it comes to proper vaginal health and care?

Emily LaSota, MD: Prior to menopause, the vagina typically is very healthy and has less problems than after menopause. The vaginal tissues rely on the hormone estrogen to be healthy. Estrogen provides the vagina with elasticity, durability, and moisture. After menopause, estrogen levels in the body decrease significantly. So due to that, over time after menopause, the vagina becomes less elastic, less durable, less moist. That can cause a problem for women at rest, but usually I see it in women who want to continue to be sexually active and their vagina just doesn't feel good during sex.

Vaginal estrogen is a prescription cream that is a safe option for almost all women, but not a lot of women know about it. Mostly because a lot of women don't feel comfortable talking to their friends or even their doctors sometimes about painful sex or uncomfortable sex. So if you are post-menopausal and you're having vaginal discomfort, contact your gynecologist about vaginal estrogen. It is a great medication.

Caitlin Whyte: And wrapping up our talk here, let's touch on cancer awareness. Are there things we can do to avoid cancer or some signs that might warrant a trip to our doctor?

Emily LaSota, MD: When we're talking about gynecologic cancers, cancer can arise from the vulva, the vagina, the cervix, the uterus or the ovaries. It's a good thing to get your annual exams, even if you're not due for a Pap smear. Just come in and have your doctor look at your female organs, make sure everything looks normal. While you may be able to look at the outside of your vagina, you can't look in the vagina or at your own cervix. So come in, let us take a look.

If you notice anything different, anything new, come and let us take a look. If you notice a mass or a sore, let us look. If you're having bleeding after menopause, that is not normal and can be a sign of cervical or uterine cancer. Come in and call us. Get your regular Pap smears. Pap smears can catch pre-cancer or changes in the cervix before it gets to cancer. Cervical cancer in the United States is very low because we have preventative Pap smears. And as well, HPV is a virus that you can get through sex. If you use condoms, it can prevent HPV transmission. And we have HPV vaccines that can prevent you from getting infected, even if you are exposed to HPV.

So follow what your gynecologist is recommending. Get annual exams. And as uncomfortable as it is, treat yourself to an ice cream or a milkshake afterwards, but come to the doctor and get your Pap smear.

Caitlin Whyte: Great. Well, Dr. LaSota, are there any other tips or myths you'd like to bust before we close?

Just overall being healthy can improve your vaginal health. So make sure you take care of your body. Hydrate, eat a well balanced diet, maintain a healthy weight. See your primary care doctor, whether that be your OB-GYN or your family practitioner. Get screened for conditions like diabetes, which can if uncontrolled, lead to vaginal problems or yeast infections. Use common sense. Don't take too much advice from social media.

And if you are interested in learning more about the vagina, the volva and all those questions that you wanted to ask your OB-GYN, but were too embarrassed, there's a great book that came out recently. It's called The Vagina Bible. It's by a doctor named Jen Gunter. She's an OB-GYN in Northern California. She's also awesome, so you can follow her on Twitter. So in this case, you can take some of the things she says on social media in terms of advice. But the Vagina Bible is an awesome book, so I would highly recommend it to anyone out there.

Emily LaSota, MD: Wonderful. Well, doctor, thank you so much for joining us and for sharing this important information. I know I personally learned a ton today.

To learn more about women's health services at Southwestern, visit SWgeneral.com or call (440) 816-5050. That's (440) 816-5050. This is Southwest General Health Talk. I'm Caitlin Whyte. We'll see you next time.