An OB/GYN Answers Our Most Common Concerns About Our Vaginas

Well, fellow vagina owners, if there’s one thing we know for sure, it’s that health issues don’t take a break—no matter what’s going on in the world. Stress doesn’t help either. Or being in our 40s. (Which means overwhelmed folks in their 40s probably feel fan-fuckingtastic right now. Not that I’m speaking from experience or anything…)

The truth is, our bodies are magical and amazing, but even the healthiest among us isn’t immune to the occasional “issue”… down there. In the nether region. Okay, let’s just be blunt. It’s time to talk vaginal health.

If you’ve been walking around with a vagina for the past several decades, you’ve undoubtedly faced at least one or two of the problems listed here—discomfort, odor, infection, or maybe just pushing another human through there is what really did your vag in. But there are things we can do to ensure our vaginas are healthy, because guess what? We only get one! So we need to take care of it.

Scary Mommy wanted to consult an expert about issues we face in the area of vaginal health, and go beyond yeast infections, bacterial vaginosis, and STIs. We know to protect ourselves. We know to see a doctor and seek treatment for odor or discharge or itching or burning. But there are a slew of other issues, aren’t there? So we went a little “deeper.” What about other stuff like painful sex? And WTF is happening with our hormones? We got all sorts of answers and tips from Dr. Maria Sophocles, MD, gynecologist, founder and medical director of Women’s Healthcare of Princeton.

Sexual Discomfort

People, sex shouldn’t hurt. If it does, you need to investigate why. Dr. Sophocles says one issue could be vaginismus, the involuntary contracting of vaginal muscles, which is usually related to anxiety. Because that’s the thing — sex is mental as much as physical. If you’re anxious, your body (all of it) could be tense, making sex less than enjoyable. Another reason sex can hurt is due to vaginal dryness. Dr. Sophocles says the lack of natural lubricant is also often a result of anxiety, but can also be just an annoying effect of getting older. Yay.

“Sex and semen are not harmful or damaging,” Dr. Sophocles says, “but if it’s painful, consider whether it’s the position that’s painful, or ask yourself if you were really given enough time to relax and become lubricated.” She also recommends changing your “sexual scripting” meaning allowing more time for foreplay, changing positions, or even changing partners! (Hey, whatever works, right?)

She also says there is no shame in using lubricant. “There’s a bit of a myth that lubricants are just for older women, and that’s not true,” she tells Scary Mommy. “They’re helpful for anyone.”

Finally, if you’re over 55, sexual discomfort may be due to atrophy from a loss of estrogen. Dr. Sophocles assures us that any gynecologist can treat and correct that, so don’t be afraid to talk to your doctor if you’re in that boat. After all, 55-year-olds deserve to have enjoyable sex as much as 25-year-olds, right?

Safe Use of Feminine Hygiene Products

What if there’s a funk? Can we douche? Should we douche? How about any of the millions of other fancy products out there that are supposed to make us smell like a gentle rain in a meadow? Dr. Sophocles says no. “The American College of OBGYN and pretty much every other nationally respected OBGYN group recommends against douching. It disturbs the natural bacteria that are supposed to be living in the vagina and it affects the pH, not necessarily in a good way.”

However, she does go on to say, “That doesn’t mean that all feminine hygiene products are bad. There are gels and suppositories that actually help maintain a nice pH balance. RepHresh is one of them.” So yes, we can use products that help maintain the pH balance our bodies are naturally supposed to maintain. No, we shouldn’t try to make our hoo-has smell like gardenias.

Dr. Sophocles also says vaginal moisturizers are okay, which are different from vaginal lubricants. “A lubricant is something you use at the time of intercourse as sort of a band-aid to help sex be more comfortable,” she explains. “A vaginal moisturizer is something used a few times a week as a way to maintain moisture in the vagina. Many people as they age find that dryness in the vagina makes just sitting and walking uncomfortable, and for those, we recommend the use of a vaginal moisturizer such as Replens or Hyalo Gyn.”

But seriously, Dr. Sophocles says vaginal deodorants are a no-go, and that if your vaginal odor is strong to the point where it’s socially embarrassing, you need to see your doctor. Strong odor could just mean you have bacterial vaginosis, which is very common and is merely a shift in pH that causes embarrassing odor. It does, however, require medical treatment—not odor-masking products.

If, however, the odor is mild, Dr. Sophocles says to basically “do very little about it” because over washing and scrubbing will only irritate the delicate skin of the vulva and vagina. She says to “use mild soap and just let the soap from your body wash over the vulva. Wash gently between the inner and outer lips, rinse with water, pat dry.”

Hormonal Shifts Related to Menopause

Is anyone else just entering their 40s and wondering what TF is going on with their bodies? Thankfully, Dr. Sophocles says it’s not just me.

“The beginning and end of the reproductive cycle are a rocky road,” she explains. “When teens first start having periods, often the periods are irregular or problematic, and when women are in their 40s and enter what we call peri-menopause, this is also a time marked by hormonal fluctuations. This can lead to mood changes, changes in vaginal pH, changes in periods regularity, changes in cycle frequency or length, women can get heavy or irregular periods.”

Oh, so basically we get to have all the fun of the teenage years AND we have to pay bills and worry about our retirement now. Awesome.

“Peri-menopause is a frustrating and inconsistent decade or so,” she adds. Like as in ten years?! WTF? But Dr. Sophocles says there’s an eventual end to this exhausting roller coaster. “Once you’re done with menopause and the ovaries have shut down and you don’t have periods anymore, things tend to stabilize.”

So my 40s are gonna ROCK, is what I think she’s saying.

In all seriousness though, Dr. Sophocles does emphasize the value of taking care of our mental and physical health during this tumultuous time. “If you’re having mood changes and are a little grumpy and teary and can deal with it, fine, but if it’s impacting your family life, and your professional life, I think it’s really important to seek professional help. If your gynecologist can help you and offer solutions, that great. If not, don’t be afraid to talk to a mental health specialist,” she says.

And, don’t ignore major health signals either. “As far as periods go, if they get a little bit heavier but you’re not dizzy or weak, that’s fine. But if you’re bleeding between periods, or you’re bleeding so much that you’re bleeding more than five days in any cycle, that’s probably worth mentioning to the gynecologist, just to make sure it’s not some other problem like a fibroid or polyp or something,” she adds.

In the end, ownership of a vagina requires patience and accepting of things we cannot change (like fucking menopause and the fact that we ride the reproductive wave for what seems like 900 years), self-care (like gentle, mild cleansing of our physical selves and taking care of our mental health), and doing what we need to do to make our sex lives enjoyable. It’s a lot of work, but it’s worth it. Because in the end, being healthy is a gift and a huge responsibility. We run the damn world after all.