GynoFiles

Women with a variety of vaginal issues from painful sex, to chronic infections and incontinence can benefit from vaginal therapies.  At Women's Health Practice we have treated women from age 29-89 with success, and usually it means a uniquely designed combination therapy.  Sorting out which vaginal therapy to use is complicated, and of course should be done with your personal consultation.  Vaginal health for the average woman means: not getting infections, having comfortable intercourse, being able to be aroused and have an orgasm; vaginal health is also, to most women, about not having bladder symptoms, not having unusual discharge, and not having unusual odor. It is also important for young people to help preserve fertility and not jeopardize hormone levels or menstrual cycles. Vaginal therapy decisions can be more complex than those features: vaginal health also means maintaining the pelvic floor, maintaining skin health, and maintaining a youthful l...

1. Vaginal yeast infections and bladder infections can have some similar symptoms, or can occur together. Women given antibiotics for bladder infections can then get a vaginal yeast infection, however it is possible that the offending organism is actually the same candida of a vaginal yeast infection, but actually was in the bladder to begin with. 2. Women who report that frequent bladder infections may be suffering from other conditions (stones in the bladder for instance), but most likely are having chronic bladder infections and not another condition . Bladder infections aren't usually a confusing diagnosis to make based on symptoms alone. Lower abdominal pain, especially above the bladder, pain with trying to pee, and having to pee all the time are the most common symptoms. If you see blood (hematuria) it's even a more obvious diagnosis. So most women will know if they ave had a an issue of recurrent bladder infections. 3. UTIs could be an STI. B ladder infections cal...

Many women don't realize the health significance of Bacterial Vaginosis (BV). BV may only be an annoying discharge or odor, but BV can develop into more serious conditions. BV can cause PID which can lead to infertility or chronic pelvic pain, Preterm birth, low birth weight in pregnancy and make other STDs easier to catch. It is not an infection to self diagnose, but come in to get an accurate diagnosis. Effective treatment is important for BV often will subside and return if not completely eradicated. When BV recurs and recurs and gets to be frustrating! Often it's a bacterial infection, and then a subsequent yeast infection. And women are left figuring out whether they should simultaneously treat for yeast. there is a new options: treat with standard antibiotic therapy, which is usually metronidazole, and do remember adjust your diet, especially add in probiotics to prevent yeast from colonizing in your colon that can be a source of yeast infection. By taking in probiotic...

Vaginal Health Preservation Through Prevention is Now Available and Non-Invasive! For those at risk for declining vaginal function there is a solution we recommend. The decline in estrogen from early menopause to through the transition into menopause produces a condition of vaginal, vulvar, and other genital tissues including the bladder. The surface tissue becomes thinner, the underlying tissues and supporting ligaments of the vaginal, vulvar, rectal, and bladder areas specifically by having less musculature and the ligaments weaken as well. The health of the vagina can be spared by minimizing the effects of drying and thinning and lowering hormone levels as you age by non-invasively and proactively treating the dryness as you age. Not only is vaginal health impacted, but women also then are at increased risk of urinary tract infections (UTI) for the same reasons of decreased estrogen. The Physiology of the Changing Vaginal Tissues What possibly most impacts women...

All of medicine should be "personalized" or now as the correctly termed changed from personal to "prioritized".Vaginal health is no exception.Thus testing, prevention, treatment, and rejuvenation can all be part of focused individualized vaginal health.  The field of genomic medicine, what your genes and what genes the bugs we have living with us,  have has begun to make it's way into  disease management, and interestingly enough, this applies to vaginal health too. Individualizing your gyno care based on either the unique genes or the unique function of the genes in our system apparently also applies to the genes of the bacteria we harbor in our vaginas. And that can translate into specific bacteria that for us are either normal, or not normal and produce symptoms. Vaginal infections are common if you do not have healthy colonies of lactobacilli and interesting it is how we get these colonies to be healthy. If you have symptoms of vaginal pain, irritat...

With such a large percent of menopausal women experiencing feminine symptoms, newer compounds are always welcome to be able to address all the concerns women have. The newest compound to be tested ins one called Vagitocin, which is a vaginal oxytocin therapy. Most women are familiar with oxytocin's use in labor as the medication pitocin, but it has a direct effect when used in the vagina. The vaginal symptoms that gynos most want to treat include experience vaginal dryness, irritation, burning, itching or discomfort, and painful sex. The biggest contributor to painful sex is vaginal atrophy or vaginal thinning, drying and becoming less elastic. Vaginal atrophy is a consequence of the lining tissue of the vagina becoming thinner, drier, and less elastic due to the lack of estrogen. Since estrogen lack causes these symptoms estrogen therapy can resolve the condition in the right dosage, however both side effects and adverse effects can affect a woman's ability to tolerate ...

After years of thinking the interior of the uterus is a sterile place, and that babies develop in a sterile bubble, the advances in genomics have shown that the uterus has it's own microbiome as well. Just like we now know that the bladder, the placenta, and the vagina each are not sterile, but have their only healthy bacterial environment.  In a paper in the Am J of Obstetrics and Gynecology Dr. Linda Giudice points out that we are soon going to be able to understand your personal biology to help you be treated more individually. Thus the microbiome that no one checked in the past is going to be checked in the future we predict!    A study out of the University of Washington has just shown that DNA from bacteria are present in 95% of uterine specimens at the time of hysterectomy. This refutes the long held theory that the uterus is sterile. By also looking at local tissue markers for infection, in most cases there was no inflammation although there were bacteria....

Estrogen therapy for menopausal woman increases her chances of getting a yeast infection. Prior to menopause a premenopausal level of estrogen, within the levels of the normal cycle, helps to keep yeast infections away by having a healthy vaginal immune environment. Premenopausal women have a normal pH, a normal (low) level of various bacteria, a high level of Lactobacillus , as well as a healthy level of WBC cells. Among the issues that abound about vaginal yeast infection in menopause an important question remained for gynos: was it the fact that women started having sex again, or the estrogen treatment that predisposed her to more yeast infections? Now that the vaginal healing microbeam CO2 laser therapy MonaLisa Touch and Femilift have been in use for healing thin atrophic tissue an interesting phenomenon has been noted: no significant increase in yeast infections. Although we have told women that the treatment mimics what estrogen does for the tissues, subtle and important di...

The bacteria (and of course viruses) we live with reflect our gender as well as whether we have pets, clean, or the climate we live in according to a new Scientific American article . A microbiological detective in the right lab with just a bit of the dust from your house can determine whether males, lots of testosterone, or women, lots of estrogen have been living in your home. A predominantly male house has more bacteria than a predominantly female home. Once bacteria is in the house it can get in the air and along with mold, viruses, fungi, and dust mites produce the air born havoc known as bioaerosols that cause allergies. As for women, their normal bacterial environment...both home and body, can be affected by their menstrual cycles as wel l. None of this new research tells us exactly what bacterial environment is best, but gynos do say that balance in all things is the healthiest way to live. So get on in to gab about it!

In a fascinating look at the environment of the uterus and fallopian tubes at the time of hysterectomy, it is now discovered that the uterus is not a sterile environment. Dr. Shana Miles of Walter Reed Hospital . We have long ago known that the microbiologic environment of the vagina is extremely important to maintaining health. It has been shown that we all have unique types and number of bacteria in the vagina. They vary by age, by our health, by medical treatments such as antibiotic use, and the numbers and types of bacteria in the vagina even seem to have an ethnic component . And ways to improve the bacterial environment are part of routine gynecologic care, although we now have new ways to improve these colonies as well, including the MonaLisa Vaginal Procedure . In the paper Dr Miles presented at the ACOG Annual Clinical Meeting the results of cultures of the uterus, the fallopian tubes, and the ovaries were shown to have bacteria in 90% of the samples! It is true that the ty...

Tampons inadvertently forgotten can remain retained in the vagina for a fairly long time. Generally speaking odor and discharge occurs that is bothersome enough that patients will seek evaluation, and your gyno will quickly be able to diagnose and resolve the situation! It's not uncommon to actually insert a new tampon mistakenly thinking that you have removed the previous one, especially at night. The fancy term is 'neglected vaginal foreign body ' and the most common symptom reported is odor after intercourse. Surprisingly few women will develop secondary bacterial infections with retained tampons, and the odor is literally due to the tampon itself. Because the tampon gets wedged so high in the vaginal vault, it is difficult to feel and actually difficult to remove without seeing your gyno. Strong odors are not normal, and a simple gyno exam can determine the cause if you oops, forgot to remove a tampon. Often she will want you to use a round of antibiotics, but often...

Trichomonas vaginalis is the most common curable sexually transmitted infection worldwide! And it can cause a fairly raging discharge and infection, or just be sitting quietly around for your gyno to stumble on during your pap smear. And it can be similar in men: from lots of symptoms to not many symptoms of infection at all. There are no FDA approved DNA tests that help us make that diagnosis, but often the organism can be found scooting across the slide during direct microscopic examination of vaginal discharge. When gynos examine the discharge they perform a test called a wet mount which suspends the discharge in a droplet of saline fluid so that the organisms can be seen better. Trichomonas vaginalis , also called Trich, is an STD, caught through sexual contact, but it's not a virus or a bacteria but a parasite that exclusively infects the urogenital tract. A new report from Medscape claims that Trich is getting exceedingly common, in fact new statistics indicate T vaginalis...

The doctors Stein and Leventhtal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome. The definition has been changed so that almost 1/10 women can meet the definition and in fact many women with perfectly regular menstrual periods are surprised to learn upon visiting their gynos that they are now diagnosed with an important condition that can have fertility and  life long health consequences. If you’ve got to shave your chin regularly, you may just have that sort of genetics, and on the other hand your ovaries may be producing too much testosterone, or one of the other boy hormones that emanate from the ovary or the adrenal gland. The most common symptom of PCOS is hyperandrogenism (...

Bacteria The vagina is a very complicated place, in fact containing 1,000,000,000 bacterial colony forming units per gram of secretions. So keeping the healthy mix of just bacteria, let alone the fungal and other organisms healthy is tricky business! When it comes to infections we first to establish whether this is a new infection or truly the same organism that is not treated from your last gyno visit. Then it's whether the treatment was effective to begin with, and finally, should we look into health factors or medication factors that cause the problem. With birth control pills, there has been a lot of conflicting data, some studies say yeast  infections are caused by birth control pills, others have no link, and others say fewer infections. We also think that being on the birth control pills actually decrease episodes of bacterial vaginosis.

Most women worry about their pap smears showing cancer. We worry the most about a pap that shows high grade squamous intraepithelial neoplasia (HGSIL), but of women who have the low grade form, LGSIL about a third will still have serious precancer. And pap tests do show more than just cancer or precancer, they can help figure out infection or precancer. If you have culture tests, often they are the best check of infection. There are ways to detect infection, including tests on the pap cells themselves, or on the liquid that the pap cells are suspended in after collections. So if you get a pelvic exam, find out what types of infection tests. Years ago the only time we could identify an infection would have been to culture for it. Now tests of the organism with tests called PCR are actually done. With these PCR tests, technically we cannot say if it is still an active infection, or a newly treated infection, but eventually all tests go to negative if some one is treated. Infections ...

To those with intimate gyno knowledge, the Clue cell is a nick name for vaginal wall cells, seen on a smear, that have bacteria on their surface. Your gyno will see these when you come in to be evaluated and she looks at a smear under the microscope. In actuality that is all that is needed for a fairly firm diagnosis of bacterial vaginosis, and it's a quick and relatively cost effective way of making that diagnosis too. These cells can be detected on smear when women have  Bacterial Vaginoisis (BV). This infection gets started when you loose the normal vaginal lactobacilli that produce the hydrogen peroxide discharge that keeps the vagina very acidic. If the pH changes, becomes too basic, other bacteria will overgrow. And those there are normally over 100,000 colonies of bacteria growing in the vagina, and those that produce BV are only 1%, a slight increase in that 1% can cause the infection. Vaginal itching is very common in with these infections, and it can occur in women of ...

Some women get vaginal infections over and over. and the Should you blame your birth control pill for all your vaginal infections? Should you stop your pill if you get many vaginal infections? Should you change your pill if you get vaginal infections? All such good questions! When we say women are getting vaginal infections on the pill usually it is either  a chronic yeast infection or chronic BV infection . We no sooner get one cleared, they have another. It has been tempting to blame many factors for the recurrence of any infection. The vagina is a very complicated place, in fact containing 1,000,000,000 bacterial colony forming units per gram of secretions. So keeping the healthy mix of just bacteria, let alone the fungal and other organisms healthy is tricky business! When it comes to infections we first to establish whether this is a new infection or truly the same organism that is not treated from your last gyno visit. Then it's whether the treatment was effective to begin...

Vaginal itching is very common in young girls. Both yeast infections and bacterial infections are known to both produce vaginal itching and vaginal discharge.And in posts on both ewe have discussed some of the causes and cures. But if your young kido is complaining of itching or has a vaginal rash, it could be yeast, it's not likely to be bacterial, and they also are more likely to pick up other bugs. If there is a bloody or actively painful discharge in a young girl before puberty, it's more likely to be something that she's stuck into the vagina, and that does have to be checked. If she's had recent diarrhea, some of those same organisms can cause infections. They also are more likely to get an obvious rash from scratching as the skin is so sensitive, even normal sexual exploration can cause enough irritation to be mistaken for an infection. And pinworms are occasionally seen as well. Those are a bit harder to detect in a regular exam, but pediatricians recommend p...

Vaginal infections are not just annoying, they can have other repercussions besides a couple of nights of missed sex. Recently a group of obstetrical researchers from southern California institutions, pared with some southeast Coast epidemiologists have come to the conclusion that having a bacterial infection during pregnancy is not only potentially a more serious physical infection than in the non-pregnant state, but that these infections are linked with psychological stress in the pregnancy as well. Their study, reported in the May 2011 American Journal of Obstetrics and Gynecology does have to be viewed with some skepticism, in that some research shows that about 40% of the pregnant moms will have one of these infections over time, so looking for markers of stress in such a large group, who likely have many differing medical histories makes some of us gynos wary of the conclusions. BV is associated with about a 2 x greater risk of preterm delivery, and stress weakens our innate a...