Pink Prescriptions - July 2021

Dryness, Leaking, Cramps & Your Vagina: What’s Up with Your Care Down There


July 2021 Issue - Pink Prescriptions
Dryness, Leaking, Cramps & Your Vagina: What’s Up with Your Care Down There

We all have questions about the care down there that sometimes just feels a little awkward—or maybe a lot—to talk about, even with your doctor. For some women, it’s just difficult to casually hold a conversation when words such as vagina, sex, labia and the like have to freely flow. Read on to see what our local medical experts had to say on subjects important to women’s health. Be sure to tell your doctor everything with no fear or hesitation. Your health is what’s most important, and besides, they tell us they have heard it all!

PinkRx0621 Tracyby Dr. Erica Downey, Riverside Women’s Care
What are the new pap smear screening guidelines, and how should I decide how often to get examined?

Pap Smears are screening tests for cervical cancer and may be performed as a part of the Women’s Preventive health visit. Pap Smear guidelines have changed in the last 15 years due to our expanded knowledge of the underlying cause of cervical cancer, the HPV virus. The exact timing of screening is at the individual provider’s discretion, however, guidelines recommend every 1-3 years from age 21-29, then every 3-5 years, with co-testing for the HPV virus, from ages 30-65. These guidelines can vary, however, based on the patient’s history.  Because pap smears are only one portion of the Women’s preventive health visit, these visits are still recommended annually. 

What facts do I need to know about the HPV vaccine?
The current HPV vaccine protects against 9 strains of the HPV virus, the virus that causes cervical cancer and genital warts. It is currently recommend for both males and females from ages 9-45.

Board Certified in Obstetrics and Gynecology, Dr. Erica Downey has been a practicing OB/GYN physician for 6 years in Northeastern Ohio. She joined the team at Riverside Women’s Care and is eager to bring her passion for women’s health to the Lowcountry. Dr. Downey enjoys caring for women during all stages of their life journey. She brings a holistic viewpoint to her practice and believes in the treatment of the “whole person”.

PinkRx0721 AshbyBy Eve Ashby, DO, FACOOG, Beaufort Memorial Hospital
Are yeast infections more prevalent in the summer?
What are some tips to avoid one?

All that itches isn’t necessarily yeast! While it’s true that yeast infections are more common when there is warm, humid weather, sometimes using perfumed soaps and sprays, or washing more frequently, can cause burning, itching and even discharge. Any of the new over-the-counter sprays and vaginal washes can cause skin sensitivity or reactions to the perfumes that mimic the symptoms of a yeast infection.

There are several situations that can lead to true yeast infections:
• Staying in moist or wet clothing (sweaty gym clothes, bathing suits)
• Recent antibiotic use
• Recent intake of steroids, such as prednisone
• Elevated blood sugars or having diabetes
• Use of autoimmune medications for chronic problems
• Having an autoimmune chronic disease

The best way to avoid vaginal or vulvar itching is to use only unscented soap, avoid washing underwear in perfumed detergents or fabric softeners and change out of wet or damp clothing promptly. Over-the-counter treatments for yeast infections include miconazole, clotrimazole, and for recurrent problems, vaginal boric acid suppositories can also help. Consult your GYN provider if these measures don’t work, as there may be other causes of vaginal discomfort.

Eve A. Ashby, DO, FACOOG, is a board-certified gynecologist with Beaufort Memorial Lowcountry Medical Group and sees patients in Beaufort and Okatie. A graduate of the University of Medicine and Dentistry of New Jersey, Dr. Ashby is also an Assistant Professor and Regional Director of Medical Education for A.T. Still University School of Osteopathic Medicine

PinkRx0721 LangleyBy Michael Langley, MD, Matador Core Performance 
I have frequent urinary tract infections and no one seems to be able to help me. Is there any hope? 

Yes! Studies show that a urinary alkalizer, an appropriate probiotic, and in some cases use of vaginal estrogens may help. There are also a number of supplements and prescription medications available, when taken daily, that may reduce UTI frequency. New studies also show that pelvic floor therapy to strengthen the pelvic floor muscles may also reduce the risk of UTIs.

I am having issues with decreased vaginal sensitivity and difficulty climaxing. What treatment options are available? 
There are a number of topical options, including estrogen related compounds, as well as homeopathic remedies, including CBD derived products. Pelvic floor physical therapy has also been shown to be beneficial. Probably the most cutting edge technology available is High Intensity Focused Electromagnetic (HIFEM) treatment rendered by BTL aesthetics Emsella chair. This FDA cleared device uses HIFEM to induce 11,000 Kegel contractions in 28 minutes. This has been shown to improve overall vaginal health by improving muscle and blood supply. This results in better sensitivity and a more enjoyable experience.

Michael Langley, MD is a board certified urologist with over 25 years of experience. His major clinical interest is in the management of challenging cases of prostate cancer, urinary incontinence and kidney stone disease. In addition, Dr. Langley is Medical Director at Matador Core Performance, the only urologist-supervised medical spa in the Lowcountry. Matador Core Performance is in Bluffton. 843.757.6367 |

PinkRx0721 Coleyby Katherine Coley, M.D., Advanced Women's Care of the Lowcountry
Will my vagina ever be the same after having a child?
Any pregnancy, even one that ends in a c-section, can cause a lot of changes to the pelvic floor. The pressure from carrying a baby, the relaxation of the ligaments from the hormonal changes, and the inevitable constipation that comes with pregnancy all wreak havoc down there. Add in a vaginal delivery and possible vaginal tear from childbirth, and it can be a whole new world! This doesn’t mean that it will never be good again, but it might not ever be the “same”. Doing exercises to keep the muscles toned with Kegels, or really any core exercises, will tighten that area back up. We also have devices that use radio frequency energy to repair the tissue and do the Kegels for you to train those muscles and give a foundation which you can then continue at home on your own. There are options, and your doctor can help!

Help! I have a great sex life, but I’m beginning to experience some of the signs of aging. How can I be proactive to stay healthy down there?
As women age and lose their estrogen production the vaginal tissues thin, become dry, lose elasticity and can sometimes even tear easily with friction. This can cause burning, pain, bleeding and even avoidance of sex due to the discomfort. Sometimes lubricants or coconut oil can help smooth the way, but sometimes estrogen is needed. There are many options for stimulating the vaginal estrogen receptors, and they do not always involve directly using estrogen itself. Your personal and family history of breast cancer, blood clots, or stroke will help determine which options are best for you. It is important to talk with your doctor to see what will be the best fit for you, but even if you have had breast cancer yourself, or for some reason cannot use an estrogen product, there are options! 

Dr. Katherine Coley is a Board Certified Ob/GYN at Advanced Women’s Care with 13 years of experience. She graduated residency from New York Presbyterian hospital/Weill-Cornell program. Call for more information: 843-341-9700.

PinkRx0721 Masavageby Marlena Mattingly Masavage, M.D., FACOG, Beaufort Memorial Hospital
Heavy periods, major cramps—why me?
Should I worry about endometriosis?

There are a number of reasons you may be experiencing painful periods. These reasons can be as simple as age, family history and whether or not you are a smoker. Most likely the pain is caused by natural chemicals called prostaglandins that cause the muscles and blood vessels of the uterus to contract. However, the pain could be the result of an underlying condition such as fibroids, pelvic inflammatory disease (PID), or endometriosis, a condition in which tissue from the uterine lining develops outside the uterus in other areas of the pelvis. These lesions can cause inflammation, pain and scar tissue on surrounding organs. Other symptoms of endometriosis can include pain with intercourse, pain with bowel movements or urination, excessive menstrual bleeding and infertility. Approximately one-third to one-half of women with endometriosis have difficulty becoming pregnant. One in 10 women in their childbearing years suffers from endometriosis. But because the symptoms can often be mistaken for other conditions that cause pelvic pain, it’s a difficult disorder to diagnose. If other possible causes have been ruled out, the only way to know for certain you have endometriosis is to undergo laparoscopic surgery that allows the physician to look inside your abdomen for signs of endometrial tissue.

While there is not a cure for endometriosis, it can be treated with medication, such as nonsteroidal anti-inflammatory drugs to ease painful menstrual cramps. Hormone therapy, including birth control pills, patches and vaginal rings, may also be used to slow the growth of endometrial tissue. If hormone therapy doesn’t alleviate the chronic pelvic pain, or if a patient is trying to become pregnant, the next step would be laparoscopic surgery to remove the tissue growths.

Marlena Mattingly Masavage, M.D., FACOG, is a board-certified OB-GYN with Beaufort Memorial Obstetrics and Gynecology Specialists in Okatie and Beaufort. Dr. Masavage graduated with high distinction from the University of Kentucky College of Medicine and is a fellow of the American College of Obstetrics & Gynecology.

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