Many women understandably deal with sexual dysfunction in silence, some harboring shame, embarrassment and fear that things will never get better. It can be overwhelming trying to find a provider that can help you. You may have reached out to your gynecologist to discuss your declining libido or pain but were met with a blank stare and even worse, told to “...relax and drink a glass of wine” or that “pain with sex is normal, use a lubricant.”
Perhaps you have gone to 8 different gynecologists and have been repeatedly told you have chronic yeast or BV or even both and no matter how many medications you have tried you’re left with the same symptoms. Or you’ve been told you have vulvodynia, vestibulodynia, and/or vaginismus but left the office without a concise treatment plan or an understanding of what any of the V- conditions actually mean.
Maybe it was a diagnosis of lichen sclerosus, lichen planus, or lichen simplex chronicus and you’re not confident your provider knows the up to date, optimal treatment guidelines. They may have handed you some kind of steroid with vague instructions and a warning about cancer.
I get it. I know what you’re going through. By the time my patients walk through my door they’ve usually experienced at least one of the above scenarios. They feel defeated and confused. I understand the confusion and fear that comes with a diagnosis that is not well known by your provider and the frustration that comes along with seeing multiple providers only to be left with more questions than answers.
So let me assure you that your pain is not in your head and your desire to have a fulfilling pain free sex life is a reasonable expectation. I fully understand the difficulty in finding a compassionate, knowledgeable medical provider when your pain lies between your belly button and your knees but at the Centers for Vulvovaginal Disorders we have answers for all of these questions and the up to date, optimal treatment guidelines to having a satisfying, pain free sex life.
It is possible and you deserve it!
-Tara Ford, PA-C
When a patient comes to me complaining of vulvovaginal irritation one of my first questions is, “Do you use soap on your vulva?” I am often met with a quizzical look and the dreaded response, “Yes, of course, I separate the labia and soap up down there!”
When I hear that answer my heart sinks. The goal of vulvar care is to keep the vulva dry and free from irritants and unfortunately women have been told for eons that our vulvovaginal areas need to be cleaned.
The tissue in the vulvovaginal area is very sensitive and the harsh chemicals in soap and other products marketed to keep your private area “clean” can really harm you in the long term. I see it everyday. Even the soaps that are for sensitive skin or marketed as gentle should never be used on your vulva. Also, the vagina cleanses itself naturally in the form of normal, vaginal discharge. So avoid using douches as these products can upset the natural balance of organisms in the vagina as well.
So what’s a girl to do?
Water. Your vulvovaginal tissue only needs water. Put some water on your hand while you’re in the shower and wash around (no washcloths) or if you have a removable shower head you can give her a quick spray. That’s it. Water. Trust me, be gentle. Your vulva will thank you.
-Tara Ford, PA-C
Are you concerned that you have more vaginal discharge than normal? Many of my patients ask about vaginal discharge and my first point is to make clear that vaginal discharge is normal. All women have some sort of discharge throughout their lifetime, some more than others. It is also normal for the amount of discharge to change throughout the menstrual cycle, peri-menopause and menopause. Some patients complain that they need to wear a panty liner otherwise they soak through their underwear and other patients complain that their discharge has disappeared.
So, the natural question becomes, “What is normal?”
Well, what is normal for one woman is not normal for another. Everybody has their own unique body chemistry and it is normal for that to change throughout one’s lifetime. So, if you find your underwear is wet or sticky and mostly white or clear, that is usually “normal”. If you find your discharge to be green, yellow, gray, and/or has a malodorous fishy smell that could be an indicator of an infection and should be evaluated. If you are menopausal and notice that your body is not producing vaginal discharge and you’re feeling irritated and sex has become painful you should be evaluated for vulvovaginal atrophy.
Otherwise, if you feel that at certain times of the month you are too wet, I have a couple of suggestions. You can carry an extra pair of underwear in your purse and change your underwear when needed. I caution the use of pantiliners daily as they can irritate vulvar tissue. Instead, I recommend reusable cloth pantiliners that you can wash with gentle detergent. Mama Bear, Luna Pads or GladRags have some great products available.
I hope this helps to ease your anxiety about your vaginal discharge. Again, if the discharge is colorful, malodorous, and/or you’re experiencing vaginal dryness and irritation seek out medical attention. If not, this is your normal and there is nothing to worry about.
-Tara Ford, PA-C