General Vaginal and Vulvar Care
– Mindfulness
– Wash the inner vulva area with water only. Avoid all soap, fragrances, deodorants, bath oils, etc. – The vulvar and vaginal tissues have a natural moistness that can be dried by using soap. – Your vagina is like a self-cleaning oven. No need to put anything up or in to clean it. – Wear cotton underwear. Thongs are not recommended because they can be tight on the tissues and not allow them to breathe. – Avoid laundry detergents that have artificial scents and dyes, as these can irritate the vulva.
Vulvar pain
– Mindfulness
– If you have pain with urination after intercourse, tipping the pelvis slightly forward while urinating usually results in less contact of the urine on the skin of the vulva. – Try gently spraying the vulva with lukewarm water and gently patting dry after each urination using white, unscented toilet paper. – Drying the vulva with a cool hair dryer after urination can help with bringing cooling relief to the area, or if toilet paper is too irritating. – For very tender/sensitive vulva, wash your hair with your head tipped back or forward over a sink or tub so that no shampoo or conditioners run off onto the vulvar area. – Perform diaphragmatic “360” breathing, focusing on relaxing and lengthening the pelvic floor with each inhale. (This can help decrease pelvic floor muscle tension or spasming, which can also irritate the vulva.)
Topical Estrogen
– Detoxification
Our vaginal and vulvar tissues are estrogen dominant tissues. The hormone estrogen helps to keep the vagina moist, maintain thickness of the vaginal lining, and keep the tissue flexible (“elastic”). Vaginal dryness can occur when your body does not produce enough estrogen. This is very common in the peri-partum (including the entirety of breastfeeding) and peri-menopausal stages of life. Signs and symptoms that you may not have enough local tissue estrogen include: dryness or soreness in the vagina, itching, redness, or soreness of the vulva, feeling an urge to urinate more often, pain while urinating, or pain with initial penetration during intercourse. When the body doesn’t produce enough estrogen, adding a local topical estrogen can ease the uncomfortable changes that occur in the vagina, vulva, and urethra. Estrogens work partly by increasing a normal clear discharge from the vagina and making the vulva and urethra healthy. Using or applying an estrogen relieves or lessens: – Delivery options include: Extended release insert, liquid filled capsule, and topical cream. Most patients prefer the capsules and inserts over the cream simply because the cream is messy and can be difficult to apply everywhere. – Brand names include: Estrace, Estring, Femring, Ortho Dienestrol, Premarin, Premarin Vaginal, Vagifem. * It can take up to 4 months of consistent use to appreciate any tissue-level changes due to topical estrogen use. * This is a prescription medication. You will need to talk with your OBGYN or Primary Care Provider to see if this is right for you and ask them for a prescription. Want to hear a more in-depth conversation regarding topical estrogen? I LOVE this podcast on it: https://podcasts.apple.com/us/podcast/54-vulvovaginal-hormone-therapy-with-urologist-dr/id1556324013?i=1000578411413
Good Clean Love with Hyaluronic Acid
– Detoxification
If topical Estrogen isn’t right for you (medically or personal preference), then this product is another wonderful option to replenish tissue hydration in vaginal and vulvar tissues. This product is water-based, hypoallergenic, 100% paraben-free, glycerin-free, artificial fragrance-free, and pH-balanced vaginal moisturizer that reduces tissue dryness that may be causing discomfort. The other good news about this product is that it’s affordable and available over the counter, on Amazon! https://a.co/4T8VH8Q
Slippery Stuff Lubricant
– Detoxification
Slippery Stuff is the only lubricant I recommend to patients. It is water based and water soluble, odorless, latex-compatible, and tends to stay slipperier longer than other lubricants on the market. Using a lubricant during intercourse can decrease any tissue irritation, especially for patients with pain at initial insertion. Great news again, this is super affordable and available online at: https://a.co/49bbCVD
Intercourse
– Exercise
* Wash hands prior to intercourse: You and your partner should wash hands before engaging in sexual interactions. Washing hands reduces the amount of irritants and bacteria that may find their way to the vulvar area. * Lubrication: Preferred brand: Slippery Stuff (Water based lubricant that is pH balanced with no dyes or scents are recommended for use. Using a lubricant that is not the same pH as the vagina can alter the body’s natural microbiome and lead to bacterial or yeast infections. Dyes, scents, warming/cooling and flavors in lubricants can contain extra ingredients that can irritate the skin. Silicone and oil-based lubricants can both react to and degrade silicone sex toys, condoms, etc. Additionally, silicone lubricant can be clogging to pores.) * Condom choice: non-latex, non-lubricated, non-flavored, non-scented, without spermicides are recommended for use. Dyes, scents, warming/cooling and flavors in lubricants can contain extra ingredients that can irritate the skin. Polyurethane-based condoms are recommended. * After intercourse Urinate within 5 minutes of completing intercourse. Urinating quickly after intercourse helps to flush out potential bacteria from the urethra and prevent UTIs. Wash your hands before urination so that you do not transfer irritants or bacteria to your vulva via the toilet paper.