Below the Belt: The Gynecology Secrets You Need to Know

Below the Belt: The Gynecology Secrets You Need to Know
Stymied by rumors and half-truths about how to take care of your V zone? See what experts have to say about the secrets of sexual health.
By Colette Bouchez
Brunilda Nazario, MD

“I can’t tell you,” says Rebecca Amaru, MD, “the number of times women come into my office in tears because they’ve read or heard something about gynecology they think applies to them – and it doesn’t.” Amaru is clinical instructor of obstetrics and gynecology at the Mount Sinai Medical Center in New York City. She tells WebMD that a lot of what you read about gynecology or about caring for your V zone is either exaggerated or “just plain wrong.”

To help you sort fact from rumor, WebMD asked some of the nation’s top experts about sexual health and V zone care — topics that many women are too embarrassed to ask their own doctor about. What they said, may surprise you. Here are the gynecology secrets you want to know.

Secret # 1: Birth control pills may cause your sex drive to wane.

If your desire for canoodling hasn’t seemed quite the same since you started taking “the Pill,” it’s not your imagination says Amaru. “It’s 100% true that birth control pills can reduce the desire for sex in many women,” she says.

This is true not only for women in their reproductive years. It’s also true for women going through menopause who may use a low dose pill to control symptoms such as hot flashes and mood swings.

What can you do to get your sex drive back? Amaru says switching pill brands or formulations sometimes helps. “If it doesn’t,” she says, “consider switching to another form of birth control such as an IUD — if you’re in a monogamous relationship — or condoms,” she says. Another option is to take the Pill less frequently and use another method of protection to prevent pregnancy. If you’re using the Pill for relief of symptoms such as hot flashes, talk to your doctor about cutting back the dosage.

Secret # 2: To reduce some side effects of birth control pills — including nausea — insert them vaginally.

“Inserting the Pill vaginally is not harmful,” says Steve Goldstein, MD, professor of obstetrics and gynecology at NYU Medical Center in New York City. “And,” he says, “it can be very effective, particularly if you are suffering with any nausea or vomiting for any reason, including from taking the Pill.”

This little known secret came to light thanks to an Israeli study published in the journal Contraception. Doctors compared two groups of women using the Pill. One group took the pill by mouth; the other inserted it into the vagina and let it dissolve. The result? The women who used the vaginal route had less nausea, vertigo, headache, breast tenderness, period pain, and stomach upsets than the ones who took the Pill orally.
Secret # 3: Migraine headaches may increase your desire for sex — and orgasms may stop headaches and menstrual cramps.

Having sex may be the last thing on your mind while you have a headache. But don’t be surprised if you feel stronger urges to get intimate in the time leading up to a migraine — as much as 24 hours before. Doctors aren’t sure why this occurs. According to researcher James Couch, MD, of the University of Oklahoma Health Sciences Center, it may have something to do with an increase in the levels of serotonin. This brain chemical may be linked to sexual appetite.

Moreover, recent research has shown that for up to 20% of women, having an orgasm may stop a migraine in its tracks, immediately relieving the pain. But this isn’t the first time orgasm has been linked to pain relief. Goldstein says some women find it helps menstrual cramps — possibly because of a release of bio-chemicals that flood the body and relax the uterus, relieving pain.

Secret # 4: Avoiding sex will make painful sex hurt more.

Many women believe that avoiding intercourse and giving their vagina a “rest” is the best antidote to painful sex. Experts say the exact opposite is true. “There is some measure of truth to the axiom that if you don’t use it, you lose it,” says women’s health expert Christiane Northrup, MD. Northrup is the author of Women’s Bodies, Women’s Wisdom. Stop having sex, she says, and resuming it may be that much harder — both physically and in terms of desire.

At the same time, she says, pain with intercourse is not normal. It often occurs when your partner simply isn’t arousing you enough. In other instances, hormonally driven vaginal dryness — like the vaginal dryness some women feel when nursing a baby or going through menopause — can also cause sexual discomfort. A little dollop of a lubricating product or an estrogen cream applied directly to the vagina, Northrup says, is all you need to eliminate discomfort from painful intercourse related to hormones.

If arousal is the problem, Northrup says talk to your partner about increasing foreplay. Then do whatever it takes to get you through the excitement phase and make your body ready for intercourse.

Secret # 5: It’s easier to contract an STD if you have sex during your period.

While having sex during your period is the least likely time to get pregnant, it’s also the most likely time to catch an infection. The reason? “Changes in the acid/alkaline balance of your vagina during your menses make it easier for bacteria to proliferate,” says Nanette Santoro, MD. Santoro is director of reproductive endocrinology at the Montefiore Medical Center and Albert Einstein College of Medicine in New York City.
Secret # 5: It’s easier to contract an STD if you have sex during your period. continued...

“Normally the vagina is acidic, [a condition bacteria don’t like]. But blood raises the pH substantially, making it a more alkaline environment,” says Santoro. And that’s a condition that can allow bacteria to thrive.

Goldstein says, “If you’re not 100% certain of your partner’s sexual health, always use a condom.”

Secret # 6: Wearing cotton underwear and changing your laundry detergent really do work to reduce your risk of vaginitis.

Doctors say these long-standing axioms are not just an old wives tale. Vaginitis is an irritation of the vagina. It causes excess vaginal discharge, burning, and itching. Wearing cotton underwear and using a different laundry detergent can reduce the risk of vaginitis. Another way to avoid the risk is not to use perfumed soaps, intimate deodorants, or other fragrant products around your vagina.

If you don’t see at least some reduction in symptoms of vaginitis soon after you make these changes, Goldstein says talk to your doctor. Your problem could be bacterial vaginosis, a yeast infection, a sexually transmitted disease, or another infection that needs medical care.

Secret # 7: To reduce the risk of developing toxic shock syndrome when traveling abroad, bring a supply of US made tampons.

The potentially deadly infection known as toxic shock syndrome is on the rise again. It’s still linked to highly absorbent tampon use. These tampons are no longer sold in the United States, but depending on where you travel out of the country, you might still find them on store shelves right next to safer, less absorbent type. If you aren’t very familiar with the language in another country, you could easily come away with the wrong type. “To be safe,” says Goldstein, “bring your own from home, and never leave them in your body for an extended period of time."

Secret # 8: Avoid the use of tampons to protect against incontinence leaks.

Because a tampon in the vagina also exerts pressure on the urethra (the tube where urine passes out of the body), it can act as a kind of “stopper.” This may help control leaks, drips and dribbles. Doctors say it’s okay to use this method once in a while — for example if you tend to “leak” urine while exercising. However, Goldstein warns not to make a habit of it and says to remove the tampon as soon as you’re done working out. A tampon inside a dry vagina, he says, can cause significant irritation as well as microscopic tears in the skin. The irritation and tears can later open the door to infection. To help control everyday leaks, drips, and dribbles, you can use one of the new ultra thin incontinence pads. They are more absorbent than a typical menstrual pad and safer than a tampon.
Secret # 9: Intercourse won’t increase your risk of recurring yeast infection — but oral sex might.

Studies conducted at the University of Michigan Health System showed that men do not generally pass a yeast infection to a woman during intercourse. According to study author Barbara Reed, MD, MSPH, it appears that the risk for recurrent infections “is related to something else — perhaps the woman’s immune response to the yeast.”

Interestingly, however, the study, which looked at over 200 men and women, came to another rather surprising conclusion. Women who receive oral sex seem more likely to suffer from recurring vaginal yeast infections. This was the case whether their partner showed signs of yeast infection in their mouth or not.

“We’re not saying that oral sex is a problem for everyone, but if a woman is experiencing recurrent yeast infections, these activities put her at an increased risk,” Reed says. The CDC reports that up to 80% of women will have at least one yeast infection in their lifetime. A hormone imbalance, high blood sugar levels, certain antibiotics, birth control pills, or stress can also cause a yeast infection.

Secret # 10: That “urine-like” odor around your vulva may not be urine at all, but sweat — and there is something you can do about it.

Because secretions from sweat glands have some of the same components as urine, it’s common for some women who perspire a lot to experience a urine-like odor in the area of their vulva or even on their panties. But before you jump to the conclusion that you have an incontinence problem, Goldstein says try washing your V zone more frequently using a mild soap and water. Add a dusting of cornstarch-based powder to absorb moisture. Avoid nylon panties and panty hose, which tend to hold in heat and increase sweating. If the smell disappears then it was likely sweat and not urine. If it continues, talk to your doctor.

SOURCES: Rebecca Amaru, MD, clinical instructor of obstetrics and gynecology at the Mount Sinai Medical Center in New York City. James Couch, MD, PhD, professor of neurology, University of Oklahoma Health Sciences Center. Ziaei S. et al. Contraception, November/December 2002; vol 65 pp 329-331. MedicineNet: “Migraine Sufferers: Are They Sexier?” Steven R Goldstein, MD, professor of obstetrics and gynecology at NYU Medical Center in New York City. News release, University of Michigan Health System. Northrup, C. Women’s Bodies, Women’s Wisdom, Bantam, 2006. Nanette Santoro, MD, director of reproductive endocrinology at the Montefiore Medical Center and Albert Einstein College of Medicine in New York City. MedlinePlus Medical Encyclopedia: “Toxic Shock Syndrome.” News release, University of Minnesota.