Troubleshooting Your Vagina

By The Women's Health Big Book of Sex

Troubleshooting Your Vagina

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  You seem to be getting more yeast infections now that you've been wearing thongs regularly
  The cause: That thin strip of fabric may save you from the dreaded visible panty lines, but it also serves as a superhighway for microbes. When the underwear hits your perineum (the patch of skin between the vagina and the anus), bacteria hitch a ride straight to your vagina. "A thong is actually a connector," says Adelaide Nardone, MD, an OB-GYN in Providence, Rhode Island. As you move, the fabric shifts and before you can say "Monistat," you've got a yeast infection. To make matters worse, thongs tend to rub, causing tiny tears in the delicate skin around your vulva and clitoris, creating access for microbes.
  
  The cure: You don't have to toss your thongs as long as they're cotton or have a cotton crotch. The breathable fabric keeps you drier, so bacteria can't grow as easily. You might also consider growing out that Brazilian bikini line: Hair serves as a barrier between you and your panties, so leaving more carpet on the floor provides cushioning for your vulva, says Nardone. And don't wear thongs when you exercise. Invest in some workout bottoms with cotton crotches and go commando at night.
  
  
  
  
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  You haven't had a period since you went off the Pill (and you're not pregnant)
  The cause: The hormones that are used in birth control pills can interfere with those your body naturally produces to cause ovulation and menstruation. They can do this for some time after stopping the pill. The absence of a menstrual period, called post-pill amenorrhea, is not uncommon, especially if your cycle was irregular to begin with, explains Christos Coutifaris, MD, PhD, chief of reproductive endocrinology and infertility at the University of Pennsylvania School of Medicine.
  
  The cure: If you still haven't gotten your period within 3 months of tossing your last pill pack, schedule an appointment with your gynecologist. Amenorrhea can be a symptom of other health issues.
  
  
  
  
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  It feels like a tiny water balloon is growing in your vagina
  The cause: A clogged Bartholin duct. These two tiny tubes on either side of your vagina secrete lubrication in conjunction with the Bartholin's glands (two pea-sized organs under the skin) when you become sexually aroused. Sometimes secreted lubrication gets trapped in the duct, causing a soft, squishy cyst that swells near the vaginal opening.
  
  The cure: Clogged Bartholin ducts are usually benign and don't require treatment. You may be able to unplug the duct simply by sitting in a warm bath for 20 minutes two or three times a day. "If it looks like a pea and goes away on its own, then it was probably temporarily clogged, and I wouldn't worry about it," says Colleen Kennedy, MD, assistant professor of obstetrics and gynecology at the University of Iowa. If the cyst becomes painful or increases in size, see a doctor, who will most likely recommend a procedure called marsupialization. This in-office treatment involves draining the cyst, then sewing the cyst wall to the outer skin to create a new duct. It will heal in about a month.
  
  
  
  
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  Lately, even when you're turned on you're not very lubricated
  The cause: Vaginal dryness can result from lots of different things, including but not limited to dehydration, taking certain medications (even over-the-counter antihistamines), nursing, or a thinning of mucosal tissue and changing hormone levels during menopause.
  
  The cure: Personal lubricants. Always have them on hand for getting wet and wild. Choose water-based lubricants; they are safer if using condoms. Oil-based lubes can damage the integrity of condoms. And avoid colored, scented, and flavored lubricants, which can trigger yeast infections and may ultimately exacerbate dryness.
  
  
  
  
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  You think you gave your guy a yeast infection
  The cause: It's uncommon, but it does happen, according to David Weiner, MD, a urologist at St. Luke's-Roosevelt Hospital in New York. A man can develop similar symptoms—redness, itching, or unusual discharge—after having unprotected sex with an infected partner. He's especially at risk if he is taking antibiotics, has diabetes, or has an impaired immune system (all of which can allow yeast to flourish) or if he's uncircumcised. "The foreskin creates a moist environ¬ment that is conducive to yeast growth," Weiner says.
  
  The cure: Over-the-counter antifungal medicine can be used to treat the condition, but it's best to hold off on having sex until your symptoms—and his—are completely gone. That way, you won't risk re-infecting each other.
  
  
  
  
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  Sex in the missionary position is painful
  The cause: Certain sex positions could be more painful than others if you have a tilted uterus. Some 20 percent of American women have a retroverted uterus, which is when the top of the uterus naturally slants toward the spine or tailbone instead of up toward the belly button.
  
  The cure: Visit your gynecologist for an exam to determine if yours is tilted. A sharply retroverted uterus can make using tampons or a diaphragm difficult because they can dig into the body of the uterus. Sex can be painful for the same reason. "Different positions, such as woman on top, can alleviate the discomfort," says Mary Jane Minkin, MD, an OB-GYN at Yale University School of Medicine. If you're trying to conceive and have a tilted uterus, lying on your tummy after sex may help sperm swim into your cervix.
  
  
  
  
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  Your libido has hit the road
  Possible cause: You've hit perimenopause. Prior to menopause, hormonal shifts—specifically decreasing estrogen— lead to physiological changes that can make sex seem about as appealing as running a marathon with a pebble in your sock. Sensitive vaginal tissues become less lubricated, the ensuing dryness leads to pain, and painful sex quickly turns into no sex. Hot flashes don't help either.
  
  The cure: Talk to your physician about the pros and cons of hormone replacement therapy (HRT), which may lessen menopausal symptoms. New research shows an estrogen cream or suppository may ease dryness without the risks of HRT. Lubricants can also help, especially if pain during intercourse is a problem.
  
  
  
  
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  There's a burning sensation when I pee after having sex
  Possible cause 1: The friction of thrusting could have irritated the urethra, which is a common thing. Vaginal dryness and prolonged intercourse could contribute.
  
  The cure: Soaking in a warm bath after sex can provide some relief. Using lubricants during sex may prevent this from happening again.
  
  Possible cause 2: An infection in the urinary tract or vagina. If you notice pain only after the urine touches your vulva, it's likely the latter. Pain that persists or gets worse as you continue to empty your bladder is more likely to be a bladder infection.
  
  The cure: Visit your doctor. Typically, antibiotics are prescribed. You can reduce your chances of getting a urinary tract infection by urinating before and after sex.
  
  
  
  
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  Often after intercourse, you detect a strong fishy odor and some itching but have no other symptoms
  The cause: It could be bacterial vaginosis, a very common vaginal infection in which the normal balance of bacteria in the vagina is disrupted by an increase in harmful bacteria. Bacterial vaginosis can be triggered by douching or by new or multiple sex partners. Other symptoms include vaginal discharge, itching and a burning sensation. Untreated, BV can lead to significant health problems, including premature delivery, postpartum infections, pelvic inflammatory disease, and increased vulnerability to HIV infection. It's estimated that up to one-third of pregnant women in the United States have BV.
  
  The cure: While BV can clear up on its own, treatment with the antibiotics metronidazole or clindamycin is recommended. Women who've had a premature birth or low birth weight baby should be checked for bacterial vaginosis regardless of symptoms.
  
  
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  You lack energy and have trouble getting and staying asleep. And you have little interest in sex
  The cause: You could be suffering from depression. When you're feeling down in the dumps, desire can take a big hit. Women tend to isolate themselves and that can strain even the strongest of romantic relationships.
  
  The cure: Antidepressants may lift the dark cloud, but some affect your ability to have an orgasm. If you notice your sex drive takes a nosedive after you start a new medication, tell your doctor; she may be able to prescribe an alternative. And consider seeing a psychologist for talk therapy. Exercise also helps; it enhances mood and energy, and it boosts blood flow to the genitals.
  
  
  
  
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  You're a mom, an employee, a wife and you're too stressed for sex
  The cause: You're a mom, an employee, and a wife. Besides totally tuckering you out, the chronic stresses of modern life can also trigger a cascade of hormonal changes that mess with your body's sexual-response cycle. And here's another modern sex buster that adds to all the craziness: today's always-connected technology.
  
  The cure: With spontaneous sex almost out of the question, you need some serious "life management," experts say. Put a lock on the master bedroom door and set a technology time limit. Shift gears with a soothing bath, suggests Los Angeles–based sex therapist Linda De Villers, PhD. Plunging into warm water takes you away from the laptops and cell phones that clog up your day.
  
  
  
  
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  You've just had a baby and you're not interested in sex
  The cause: See "You're a mom, employee, wife," on the previous slide. Give yourself a break: you're tired. Also, you may not feel happy with the new shape of your body due to pregnancy. Many women find themselves withdrawing or not willing to experiment sexually if they're overweight or shaped differently postpartum. Emotionally, you may have bought into the media's idealization of what is really sexy: that you have to look a certain way in order to have really good sex.
  
  The cure: Bask in the feel-good glow of compliments. Feel free to ask the new dad what he likes about your body; his praises can help you feel more positive. "Women have a talent for disliking the very things about themselves that other people find very attractive," says sex therapist Linda De Villers, Ph.D. But, also, don't underestimate the mental boost of shedding some pounds. Surveys and studies show that losing weight helps women feel sexy. In fact, even afive-pound weight loss has been shown to jump-start sex drive.