Tuesday, December 14, 2010

The Unhappy Vagina or Something's Wrong Down There

OK, I have become an ambulatory gynecologist. What does that exactly mean? After doing annual womens' health screening, my number two most seen problem is the UNHAPPY VAGINA.

I just returned from a meeting of the American Society of Colposcopy and Cervical Patholgy. Otherwise known, as cervix , vagina and vulvar specialists. We wreaked havoc on the psychological health of the media guy who ran the slide shows. We were fascinated by all the varying lumps and bumps on the vulva, new and terrific diagnoses of "Unhappy Vagina Syndrome".

Many women come in to see the gyn with a "something's wrong down there" problem. It's up to me to figure it out and fix it. AND FAST. This is usually a problem that occurs on Friday and needs to be fixed by Friday night. Monday, hmmm somthing may not be quite right. Tuesday, OK maybe I should get something. Wednesday is a trip to the drugstore. Thursday, it's not gone, and getting worse. Friday gets a call to the gyn. GET ME IN NOW!

Most of what women self diagnose as yeast infections are not. They are a myriad of other problems, some infectious, and many are from irritants and allergens.

About one third are correctly self diagnosed and treated at home with over the counter medications. Of those that need the doctor, we never see anything uncomplicated. It can be from a week to years in the making. From normal cervical mucus, to a mixture of problems that envies an onion. After upteen years I have gotten pretty good at figuring this stuff out.

I have a secret weapon, Ladies Magic Cream. I have sent the secret formula to Clevland Clinic to see if it is worth commercializing. We'll see. In the mean time, it is always worth a trip to the gyn to figure out if it is an infection, what type, mixed or single. Irritant, allergen, hormonal, or normal.

Yeast grows in especially hot and humid conditions. For heaven's sake, lose the underwear at bedtime.
Cool and dry makes a happy vagina.

Bacterial Vaginosis is the newer name for nonspecific vaginitis, gardenerella, etc. This is an upset in the normal bacterial ecology. Someone other than the lactobacilli grow, and a stinky discharge with burning is the winner. This is treated with antibiotics. Over the counter stuff rarely works.

Irritants come in all types. The changes in your detergents, soaps, clothing, shampoo, pads, etc will make you red and on fire. The tip is to lose the irritant and soothe the unhappy vagina. It ususally takes a trip in to see the extent of the damage to Rx something to relieve inflammation and institute a regimen of healing.
The bathtub is your friend. No soap, just water.

Allergens are rare, and have a delayed reaction. That is the key difference between them and irritants. Again, discovery and avoidance is how it is managed.

All in all, my experience validated me as a major geek interested something that would get you in prison in several countries.

Until next time...........


  1. I couldn't find your email, so I'm posting a question here. Are there normal causes for infrequent periods (i.e. skipping 3 or 4 periods at a time)? Is it something to worry about?

  2. Informative and entertaining at the same time. Thanks.

  3. Dear Robin
    No it is not normal to skip like that. Yes it is something that needs medical attention. The cause should be determined, and then treatment depends upon the cause. Childbearinging also factors in to the decison making. Good Luck!