We specialize in gynecological vaginal health, have done clinical research, and welcome the chance to help you integrate your vaginal health into your overall health care.
Read below to learn more about what we offer.
Common vaginal symptoms:
Other Services and Conditions We Treat
MonaLisa Touch Therapy
Vulvodynia and Vestibulitis
Vaginal Lesions, Growths, and Bartholin’s Gland Infections
Excessive Genital Sweating
Customized Pessary Fittings
The main vaginal physiologic factor is dominance of good healthy bacteria the Lactobacillus, to have a healthy vaginal environment. You need a lot of them, approximately 1 million bacteria per mL of vaginal fluid! The Lactobacillus is present in much greater concentration than other 'good bacteria’ which are only present in a concentration of about 1000 bacteria per mL of vaginal fluid.. Research now shows we have 313 biochemicals within cervical and vaginal fluid, and the activity of the fluid probably has to do with what conditions actually take hold and become symptomatic. Lactobacilli species produce by metabolizing the sugars in the cells of the vagina and through this metabolism emit a small amount of hydrogen peroxide which then keeps the vagina very acidic. If the lactobacilli colonies decrease due to being over grown by other species the vaginal pH changes, becomes too basic (less acidic, the pH rises), and other bacteria, that are more hostile to vaginal health will flourish.
There is a hormonal component to vaginal infections. Premenopausal and perimenopausal are more likely to get yeast infections in the second half of the menstrual cycle, when estrogen is lower, and progesterone is more dominant. Douching, more a cosmetic than a health practice, doesn’t cause yeast or bacterial infections. In some studies receptive oral sex causes more yeast infections, and in some studies not, but few studies really culture the partner’s mouths! Dairy heavy diets, presumably teaming with probiotics, may be very heavy in sugars which could increase your risk of getting a vaginal infection, so often it’s not just the hormones, but hormonal changes with other cofactors can set up infections.
Contact dermatitis and Skin Conditions
Many vulvar conditions are associated with the vaginal infection. Strep infections of the skin, Herpes Simplex, Shingles, Folliculitis, Sebaceous cysts, lichen sclerosis, lichen planus, HPV, fissures, vulvar dysplasia (precancer), and contact dermatitis are usually conditions that would only have vulvar symptoms as opposed to vaginal symptoms and can account for the symptoms of irritation, itching, burning or urinary symptoms. Allergic symptoms may occur at any time, even if you have previously been exposed to the agent without symptoms, and the symptoms can occur within hours, but may occur days after the exposure. These conditions really should be diagnosed by a visit to your health care provider.
Yeast Infections, BV and Chronic Vaginal Infections
Most yeast infections are due to pesky and pervasive species of yeast called Candida albicans. Which accounts for 95% of those infections. If you try to self-diagnose, you’re probably right somewhere between 30 and 50% of the time. If you have struggled with what you think are chronic yeast infections prior to menopause, some of the same issues may actually resolve after menopause. One in 20 premenopausal women with a yeast infection will develop chronic and recurrent infections. Chronic yeast infection is define as infections that are recurrent, or resistant to normal short courses of medication therapy, and occurring more than 4 a year. We want to prevent this, and help you resolve any chronic problems. There are normally over 100,000 colonies of bacteria growing in the vagina, .BV can result when there is only 1%, greater increase in th vaginal bacterial population can cause discomfort and symptoms of infection
Vaginal Health May Mean Bladder Health
Vaginal and vulvar yeast infections and bladder infections can have some similar symptoms, or occur simultaneously. Women given antibiotics for bladder infections then can secondarily get a yeast infection, however it is possible that the offending organism is actually the same candida of a vaginal yeast infection, can infect the urine. Women having frequent occurrence of bladder infection symptoms may be suffering from other conditions (stones in the bladder, interstitial cystitis, urethritis), 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 of UTI and not vaginal yeast infection If you see blood in the urine, hematuria, it's more likely to be as a bladder not a vaginal condition and medical testing would be indicated.
The genital areas of the vaginal, urethra, vulva, all have various bacteria, and if we run around culturing the urine of women without symptoms many will have growth of some sort of bugs, urine is not sterile. For an infection to develop of the bladder but it is the growth of bacteria over the normal low level that is an infection, 80 to 90% of all urinary tract infections end up being E. coli and usually those cultures will be positive for of the microorganism. The most resistant types of urinary infection to get is that of E. Coli of the type that have something in their anatomy known as P-fimbria. It's a bowel bacteria that can attach on to the wall of the bladder. Although not a reason not to use a condom for protection, but using condoms and spermicide oddly can cause more urinary tract infections because the condoms and spermicide use seems to enhance the ability of these E. coli to adhere on to the bladder and in turn it can increase the risk of vaginal and bladder infection. Although many other factors play into whether a woman will acquire a bladder infection, an important factor is to consider: sex. It is important to get the bacterial count of the bladder down after sex. Peeing after you have sex actually can eliminate some bacteria that may just have been sitting around and help have fewer vaginal and bladder infection. We can help you assess and treat these things.
Sex Toy Use
Sex is definitely healthy and now and then it needs to be spiced up, and in women who do not have a partner or has a partner who may not be functioning for the full range of sexual intimacy sex toy and vibrator use is common. We understand you want to know your gyno's opinion on the medical considerations before you pick your passion. Sex toys are definitely one way to spice up your sex life, and sex toy stories. Vibrators and other toys can be very successful dilators, they can bridge gaps between partners or when your partner is on a trip, they can help with Kegel's exercise, just to name a few obvious benefits. We do have products for sale.
Vaginal dilators, which can be purchased as medical devices and not necessarily a sex toy, are prescribed by gynecologists for chronic infections and vaginal pain with intercourse, for women with bladder pain conditions, for women with lichen sclerosus and for women with vulvodynia, vulvar vestibulitis, or vaginitis. For the most part, there are specific medically sized dilators that are used, but in fact you can get some double duty from your sex toys. But being safe, and making sure that you get sexual and vaginal concerns properly evaluated is very important. Like other industries sex toys come with better labeling than they've had in the past, so do pay attention to the labels. Not using them if you have acute pain, infections, or undiagnosed bleeding are the main warnings.
It is possible to produce small amounts of tearing, bleeding, or pain with sex toy use when you are menopausal, if you are very dry and have not had sex for a long time, get an appointment first to be checked for what is called atrophic vaginitis. Initial reatment of atrophy is often relatively quick and very successful. The treatments will increase the nerve endings of the vagina, increase the pliability of the vaginal walls, and increase secretions that help the process of using a toy work. As discussed above, healthy vaginal tissue may mean healthy balance of vaginal bacteria, so if you are having difficulties using a sex toy, it's a reason your gyno may have to check you for infections. And make sure the toys are clean each time, and after each use, any surface with crevices has to be dried properly before storage or excess bacteria may accumulate. Proper attention to shaving techniques will also minimize bacteria around the vaginal area and will help minimize the chance of breakouts in the hair follicles where you have shaved, and then sex and sex toy use will not aggravate shaving rashes. Women have to be as much in shape for their toys as their partners! As for size, shape, and features: that's a whole wide world of options, and most are perfectly safe!
Rectal Health is Part of Vaginal Health
Itching that is only rectal may be a hemorrhoid, but sometimes the itching of hemorrhoid is complicated by the presence of a vaginal infection. The itching can be of the vaginal tissues, the vulvar tissues, the perineum (the tissue between the vagina and the rectum), or it can actually be in conjunction with anal itch. It's important to get this checked, as perhaps it's something you actually caught from your partner. Not all STIs have vaginal symptoms. Some STDs do present with rectal symptoms. Most often the STI in the rectal or anal area would be HPV if it is any condition like that at all, but actually, those cases are typically not symptomatic, those cases are typically found on examinations, often just routine examinations. But individuals with rectal irritation, itching, discomfort (proctitis) may in fact have GC, CT, a form of CT (chlaymdia) called LGV, syphilis or Herpes (HSV). All these conditions can be tested for, some also have ulcers, blisters, rashes, redness, few of these actually cause bleeding.
Tampons are designed to catch menstrual flow. They are easy to use, affordable, and preferable in many cases. Most postmenopausal women will naturally not have periods, and most women on hormone replacement therapy will have dosing specifically designed to not have periods, so tampon use will be less common in menopausal women. However, it’s important to remember that if you just have a bit of brown discharge, or menopausal discharge, it is not as comfortable or as healthy to use tampons for that discharge. Simplistically speaking choosing the right tampon shouldn't be difficult for most women and fairly quickly we learn that both the fit and the absorbency have to match your anatomy and physiology to be comfortable and safe. Once polyacrylate rayon-containing tampons were removed from the market very few cases of toxic shock are ever reported. Tampons are packaged to be sterile from production, but most are not sterile, and rarely there have been recalls of sanitary products that have been determined to carry bacteria from the manufacturing point. Tampons are not a typical source of infection. Night use for the most part is not harmful, but discouraged as a general rule whether a woman is menopausal or night. Tampons used when you do not have flow at all, or when the flow is light could be drying to the sensitive tissues and even 'catch' the lining of the vagina so that some flakes of tissue are passed. The shedding of a body part is medically called desquamation, and there are vaginal infections that cause this producing a discharge that under the microscope would look like many cells. This condition is still seen in menopausal women. Actually yeast infections can do this as can a disorder called inflammatory vaginitis. It is not known if stray fibers left in the vagina from certain types of tampons can be a chronic source of infection, but when women have chronic vaginal infections any possible source of contamination should probably try to be eliminated, including tampon use until cured. Again, a visit is important to determine what is really going on.
The perineum is the tissue between the vagina and the opening of the anus. It may have become thin or the muscle layers damaged in childbirth. Perineoplasty is a surgical correction of the layers that may improve sex and bowel function.
Excessive Genital Sweating
Women may have excessive sweating of the underarms, the palms, the breasts, or the genital regions such as the groin or vulva. This may or may not be accompanied by skin, metabolic, or hormonal conditions that could be treated. In some cases the sweating becomes so profuse that there is skin breakdown, or inability to workout. Neurotoxin therapy, such as Botox, which has been commonly used in the underarm area can treat excessive genital sweating as well.
Customized Pessary Fittings
The pessary is an inert silicone device that can be used to correct pelvic floor problems. Using a pessary can help uterine prolapse, cystoceles, rectoceles, and incontinence. We welcome the opportunity to evaluate the pelvic floor and your bladder function through examination and cystometric testing to see if this therapy would be beneficial for you. The proper use of a pessary can prevent unnecessary surgery. We offer customizable therapy for women who have not been successful with pessary use in the past but wish to consider the use of a pessary in the future. The use of MonaLisa touch vaginoplasty therapy has allowed women to receive a virtually painless therapy that will then enable them to comfortably use the pessary. We can also order customized modifications to a pessary to address your personal needs.