Many women see me for vaginitis and it’s often a result of the whole system being out of balance. Women can have yeast overgrowth in their intestines that needs to get healed before the vaignal sympoms will resolve. But sometimes, women are using products that are constantly disrupting their vaginal flora and predisposing them to vaginitis. I’d like to give you a little background info and then some simple tips to prevent vaginitis in the first place.
Here are a few foundational principles to make sure everyone is on the same page. The vagina is meant to be acidic. A normal vaginal pH is 3.8- 4.5. Things that are basic can through this off. Common offenders are semen, blood and soaps.
In a healthy vagina there are both yeast and bacteria that are living in balance. Take some antibiotics, the bacteria get killed off, and the system is overrun by yeast. Some women will have bacterial overgrowth right after taking some yeast medicine.
Yeast overgrowth usually itches, burns and stings. You may have thick curd like discharge and may also have red, swollen inflamed labia. Bacterial overgrowth is called bacterial vaginosis or BV. It causes thin fishy smelling discharge which is worse after sex.
Other sources of vaginitis are infections like chlamydia, trichomonas and gonorrhea as well as foreign bodies like retained tampons. If you have new sexual partners or have symptoms that aren’t resolving please seek medical care from a gynecologist. Practicing safer sex and using condoms with vaginal and anal sex is a great way to avoid these infections.
Vaginitis can also be allergic. Many over the counter vaginal preparations have alcohol in them so they won’t grow bacteria while they sit on the shelf. But putting alcohol in the vagina can cause irritation and further irritate an already inflamed vagina. Sometimes women are using benzocaine in drugstore preparations and this is a common contact irritant. I would avoid these preparations or at the very least test them on the inside of your arm before applying them to your genitals.
Here are some tips to keep your vaginal ph healthy:
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1. Bamboo underwear. Bamboo is naturally wicking, sustainable and naturally antimicrobial. It helps you stay feeling dry.
2. Pick a better pantiliner: Some women will react to the chemicals/ fragrances in pantiliners. Try products that are dioxin free like seventh generation pantiliners. When you can, skip the paniliner all together, your vagina needs air and all pantiliners limit air flow.
3. Vinegar baths: If you feel unclean after sex, or working out don’t douche with commercial products. You can shower first and then take a tub bath with 2 cups of plain white vinegar in tub. This will re-acidify your vagina. No soap or shampoo in the tub.
4. Boric acid is an old fashioned remedy that treats both yeast and BV so it prevents treating one imbalance and causing another. You can get boric acid from a compounding pharmacy 600 mg in a vaginal capsule 1 per vagina at bedtime. (THIS IS TO BE USED VAGINALLY NOT ORALLY) 1X a week for prevention 3 week for a yeast or BV infection.
5. Diet: Pay attention to what you are eating. If you are consuming a lot of refined sugars or carbs, you are feeding the yeast and bacteria exactly what they want! If you get chronic yeast infections, make sure your blood sugar has been checked and that you are not diabetic or prediabetic.
6. Use condoms with your own lube: Some of my patients say they are allergic to condoms as they have irritation after using a condom that likely has spermicide on it. If you aren’t allergic to latex- you can tolerate bandaids fine, consider using a non lubricated condom and putting silicone based lube or good clean love lube on the inside and outside of the condom. The spermicide contains some pretty harsh chemicals and that may be the source of the irritation.
7. Vinegar in the cold water wash-If you have great workout gear you are probably washing it in cold and hanging it up to dry. Adding some plain white vinegar to your cold water wash will help decrease odors as well and killing some germs that aren’t killed in a cold water wash.
8. Non toxic soaps: Many women are washing with fragranced body washes. They are full of chemicals and colors. Even if the genitals aren’t directly washed with these products, there is still “run off” from washing the body above it. I like Kiss my face olive oil soap.
9.Probiotic– taking a oral or a vaginal probiotic can help restore the vaginal balance. I would look for a probiotic with 3rd party verification that contains at least 20 billion CFU.
10. Avoid glycerine based lube: Glycerine acts like sugar and can lead to imbalance. If you are in a monogamous relationship, and don’t need a condom for birth control and don’t mind messing up the sheets, you can use coconut oil for lube. If you need to use a condom use silicone based lube or Good Clean love as lube.