Ladies, gather round.
We all know our bodies are seriously impressive, but when’s the last time you stopped to appreciate everything it can do?
The female reproductive system is a complex one—the vagina can expand enough to accommodate a baby, is self-cleaning and boasts more nerve endings than any other part of the body. But even though it’s capable of incredible things, it’s also susceptible to complicated health issues. Here are some easy ways to care for your closest lady friend and some common health concerns that may arise during your lifetime together.
As with any major organ, those in the reproductive system have their Kryptonite. Some of the most common conditions to be aware of include:
Endometriosis: A painful condition in which the tissue inside the uterus begins to grow outside the uterus. In other words, a uterus gone rogue. The primary symptom is pelvic pain that often intensifies during menstruation. It affects one in 10 women in the United States.
Fibroids: Muscular tumors that grow out of the uterine wall. Some women with fibroids experience pain and heavy menstrual bleeding.
Ovarian cysts: Fluid-filled sacs on the surface of one or both ovaries. Many women will have cysts at some point in their lifetime, and they will come and go with no symptoms. Feelings of pressure on the bladder or in the abdomen can signal a cyst growing larger and mean it’s time to visit your friendly neighborhood gynecologist.
Polycystic ovary syndrome: A common endocrine disorder occurring in women of reproductive age, PCOS may cause enlarged ovaries that have small collections of fluid, called follicles, located in each ovary. Approximately 5 million women suffer from PCOS, which can cause infrequent or prolonged menstrual periods, excess hair growth, acne and obesity.
Aging Below the Belt
Valerie Altman, ARNP, has been practicing in the state of Florida for 33 years and caring for patients at the Citrus County Health Department since 1997. She sees many patients with concerns about changes in their reproductive health as they age. One of the most common?
“One of the major annoyances is incontinence. The pelvic floor weakens, and the bladder can drop. Who wants, at any age, to worry about urine leakage?” says Altman.
Many women experience weakening of the pelvic floor muscles over time, whether from aging, childbirth or weight gain. Because these muscles support the uterus, bowels and bladder, women may experience incontinence or decreased sensation during sex as they age and the muscles weaken. Common signs of a pelvic floor issue include accidentally leaking urine when laughing, coughing, sneezing or jumping; feeling a sudden urgency to go; or not making it to the bathroom in time at all.
And, of course, there’s menopause. Although some women don’t experience the infamous symptoms, like hot flashes and insomnia, others aren’t so fortunate. For those with long-lasting discomfort from symptoms, there are solutions.
“They may get changes in the vagina, which can get less lubricating and less elastic, so sex becomes uncomfortable,” says Alice Carlisle, ARNP, Ph.D., who has practiced in Ocala for 21 years. “Sometimes if they’re not experiencing hot flashes but just experiencing trouble with the vagina, I recommend lubricants over the counter. The next step would be a topical hormone, either a cream, a small pill or a ring. Those are all very low-dose, so they don’t carry many of the risks often associated with hormone replacement therapy.”
Another aging concern is painful sex, or dyspareunia, which affects a startling 25 to 45 percent of postmenopausal women.
“As for dyspareunia, that’s usually due to dryness and fragile tissue. It can get little tears and cause pain. And Viagra created a bit of a problem,” Carlisle laughs. “It means men can get an erection and have sex again, when maybe the woman hasn’t been having sex for a few years. The vagina shrinks from non-use. I encourage them to use a lube and take it slow.”
Low Libido, Or Something More?
Before getting concerned about a barely-there or long-gone sex drive, Altman says take a moment to evaluate your relationship for any obstacles between you and intimacy. For many women, low libido is a matter of timing. With only so much energy each day, leaving sex until bedtime means two tired people crashing and burning instead of getting hot and bothered.
“Women have to be in the right mood. And women are busy! They have a lot of responsibilities,” she says. “Maybe shake things up and have sex in the morning when you’re more energetic.”
If you’ve tried hacking it on your own and no amount of tips and tricks are working, consider asking your doctor about possible causes. Hormone imbalance or thyroid dysfunction can dampen the sex drive, as well as depression or certain medications.
After the FDA approval of Addyi, or “the little pink pill,” many women may feel it could offer a simple solution. That’s not necessarily the case.
“It’s very expensive, and insurances are slow to get on board. Unlike Viagra—men take a pill when they want to have sex—women who go on this pill have to take a pill every single day. And there are side effects associated with it as well,” says Carlisle. “I tell patients they have to talk to their partner about what they want, what pleases them during sex, and set aside time for sex. That could mean they’re having sex every Tuesday night, or a goal of twice a month. We do sometimes give women testosterone treatment, but it’s a very complex issue.”
All women experience peaks and valleys in their sexual desire, but consult your doctor when your problem disrupts your life or your relationship or begins causing physical pain.
Coming Soon In Birth Control
“They’re always working on longer-term birth control methods so women don’t have to come in as often,” says Altman. When it comes to innovation in the birth control realm, it seems she’s right—it all comes down to giving the products we already use a longer life.
For starters, longer lasting vaginal rings are in the works. Bayer, maker of Mirena and Yasmin, is testing a one-year ring that releases 40 micrograms of levonorgestrel per day. In addition, a new patch called Twirla is in clinical trials now. It uses about half the estrogen of other patches and features an adhesive that leaves no stickiness behind when removed. It’s the little things.
The downside of longer-term methods may come when trying to become pregnant. After fending it off for so long, letting the baby-making magic happen may take some time. Carlisle counsels her patients about which method is right for them by taking into consideration their plans to conceive.
“Research says the return to fertility with Depo-Provera is up to a year. In my practice, I’ve seen patients get pregnant within a month, and some take nine months. The same can go for Implanon and Nexplanon,” she explains. “With IUDs like Paraguard and Mirena, or Nuvaring or pills, usually pregnancy is achieved within six months, but I have a lot of patients who get pregnant within a month off the pill.”
Underwear Dos & Don’ts
If your vagina could give its two cents, it would kindly request you wear cotton underwear, please.
Cotton should be your BFF (or if you’ve been pals for a while, good for you). Natural fibers wick away moisture and let out heat while synthetic materials, like nylon, hold in both. We all know that combination increases the risk of yeast infections.
Legging lovers, shapewear fans and skinny jean diehards, bad news—wearing too-tight garments too frequently can lead to urinary tract infections. After a day in tight quarters, try to wear loose pajamas or go commando at bedtime to, uh, get some fresh air.
And one more thing: It may be best to avoid thongs. Their shape makes it easy for bacteria from the behind to make its way to the front, if you follow. If something like E. coli makes its way into the uterus or bladder, you’re looking at anything from a bladder infection to pelvic inflammatory disease. Who has time for that?
HPV BY THE NUMBERS
Human papillomavirus (HPV) is extremely common—around 80 million people (or one in four) are currently infected, and nearly 14 million more become infected each year. There is no treatment for HPV infections, but it’s important for parents to consider vaccinating their children—both boys and girls—to prevent precancerous changes and cancer in their futures and their partner’s.
Data from 2015 shows 49.10 percent of male and female 12 year olds in Florida have received the HPV vaccine. In Citrus County, that number is only 18 percent. Carlisle says the STD label placed on HPV may be the problem.
“I highly recommend the vaccine to my patients, but there was a time when mothers didn’t want to give the vaccine to their daughters, maybe thinking they were condoning sexual activity, or they weren’t sure it was safe. But we have so much literature saying that if they’re vaccinated prior to the first episode of sexual activity, we can decrease the instances of cervical cancer,” she says.
HPV is believed to be responsible for 90 percent of cervical and anal cancers, 70 percent of vaginal and vulvar cancers and 60 percent of penile cancers. Approximately 23,000 women and 15,793 men are affected each year by cancers caused by HPV. Vaccination could prevent the majority, around 28,000, from occurring.
Nationwide, four out of 10 girls are unvaccinated and six out of 10 boys are unvaccinated.
The three types of HPV vaccine, Gardasil, Gardasil 9 and Cervarix, all protect against HPV types 16 and 18. These two strains cause seven out of 10 cases of cervical cancer. Gardasil and Gardasil 9 also protect against types 6 and 11, which cause nine out of 10 cases of genital warts.
A study published in the journal JAMA Oncology in January found that among a group of 1,868 men in the United States, 45 percent had genital HPV infections. Only about 10 percent had been vaccinated for HPV.
The HPV vaccine is recommended for young women through age 26, and young men through age 21. The best time to vaccinate is at ages 11 or 12. All children who are 11 or 12 should have two shots of HPV vaccine six to 12 months apart. Teens 13 and older will require three vaccinations over a six-month period.
Ask your family physician if the HPV vaccine is right for your child, and visit cdc.gov/hpv to learn more about vaccine options.
Source: cdc.gov, plannedparenthood.org
A study published in January 2016 in the journal Cancer revealed that more women are diagnosed with cervical cancer than previously thought. Prior data stated cervical cancer killed about 5.7 out of 100,000 black women and 3.2 out of 100,000 white women annually in the United States. Unfortunately, that data didn’t account for women who had undergone hysterectomies, which remove the cervix (and therefore the risk for cervical cancer).
The new study subtracted these women from the data and discovered the death rate is actually 10.1 per 100,000 black women and 4.7 per 100,000 white women. Those rates are 77 percent higher and 47 percent higher respectively.
The American Cancer Society recommends that women begin cervical cancer screenings at age 21 with a Pap test every three years. At 30, women should have a Pap test and HPV test every five years.
We Are The Champions
Ladies, while you may not appreciate your monthly menstruation or the sole responsibility of bearing children, it’s important to remember what makes your vagina kind of cool. So, how are vaginas bad***? Let us count the ways.
It’s got twice the sensory power of a penis. The clitoris has 8,000 nerve endings to the penis’ 4,000, which is what makes the female orgasm more intense than males’. Sorry, not sorry.
It’s classy. Did you know your vagina has the same pH level as a glass of wine? The normal pH for vaginas ranges from 3.8 to 4.5. Most wines’ pH levels fall between 3.0 and 4.0.
It’s basically an apex predator. Ever heard of squalene? In the vagina, this substance serves as a natural lubricant. It can also be found in shark livers.
Exams For All!
Altman says the most important thing any woman can do for her health is to stay on top of her routine health exams.
“Have your mammograms, your colonoscopies, your cholesterol checks, and, in general, you’re going to be healthier. And do your screenings! You need to have a Pap smear every three years. If you come in for regular exams, you’ll never have cervical cancer. We will catch it before it’s cancerous. If you never come in until something’s wrong, who knows what I’ll find?”
If cost is what’s standing between you and your annual exam, check out the Florida
Breast and Cervical Cancer Early Detection Program.
Breast and cervical cancer screenings are available at little to no cost for those who are eligible. To see if you qualify, call your county health department or the American Cancer Society National Hotline at (800) 227-2345.
Citrus County Health Department 120 Montgomery Ave., Inverness, FL 34450 (352) 527-0068
Marion County Health Department 1801 SE 32nd Ave., Ocala, FL 34471 (352) 629-0137
Visit floridahealth.gov for more information.
Sources: womenshealth.gov, cnn.com, cosmopolitan.com, medicaldaily.com, healthline.com, bedsider.org, healthywomen.org