Dr. Jodie Horton Expert

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Board Certified OB/GYN

There’s been a lot of uncertainty around health screenings during Covid-19.  However, there’s one thing that remains certain-health maintenance is still important, including annual mammograms. During Breast Cancer Awareness Month, I encourage you to take ownership of your breast health. Here is some information to help you take control of your health and get to know your breasts. 

Get To Know Your Breasts

Adult breasts are made up of 15-20 lobules that produce milk and ducts that carry milk to the nipple, fat that gives the breast its shape, the nipple, and the areola, the darker area around the nipple.  

Breast Cancer 

One in eight women (12%) will be diagnosed with breast cancer. In 2020, an estimated 270,000 women will be diagnosed with invasive breast cancer, with the average age of diagnosis around 50 years old. Things to look for are a lump in the breast, enlarged lymph nodes under your arm, skin dimpling, and nipple discharge.  Breast cancer is slightly more common is white women when compared to Black women. However, Black women tend to have a more aggressive form of breast cancer at diagnosis and have death rates that are 40% higher than white women. 

Screening

It is recommended that you get a mammogram every 1-2 years starting at 40 years old. If you’ve had an abnormal breast exam, your doctor may also order an ultrasound to look at a specific area in your breast. 

Family History

It’s important to know your family history.  Your family’s medical history may put you at increased risk if they have a history of breast or ovarian cancer.  If a first-degree relative (parent, sibling, or child) has a history of breast cancer or has a genetic predisposition for breast cancer, then the screening guidelines will be different.  Self-breast exams are recommended every six months, and a mammogram should start ten years before the age of the earliest diagnosis in the family but no earlier than 25 years old. 

Genetics

Everyone has the BRCA (BReast CAncer) 1 and 2 gene. These genes are responsible for preventing you from developing breast and ovarian cancer.  However, if this gene is altered or broken then it has a mutation which increases your risk of cancer. One in 400 or 0.25% of the population has the BRAC 1 or 2 gene mutation.  55-65% of women with BRCA 1 mutation and 45% of women with BRCA 2 will develop breast cancer before the age of 70. BRCA 1 and 2 gene mutation also increase a woman’s risk of ovarian cancer.  The risk of ovarian cancer is 2% in her lifetime. The risk of ovarian cancer increases to 4045% in women with BRAC 1 and 10-30% in women with BRCA 2 mutation. 

Breast Self-Exams

It is recommended to do a breast exam once a month starting at age 25.  Doing a monthly breast exam helps you to be familiar with the look and feel of your breasts.  If you notice a change in your breast like a lump, nipple discharge, or dimpling, notify your doctor for further work-up. The best time to do a self-breast exam is 3-5 days after your period and if you don’t have a period, then do an exam the same day every month.

What other questions do you have around Breast Cancer and getting to know your breasts?

With love, 

Dr. Jodie horton

Hi.  I am Dr. Jodie.  I am an OB/GYN and super excited about this group.  I think age is just a number although my body sometimes disagrees. LOL.  I looked forward to talking about all things wellness and 50+.

October is Breast Cancer Awareness month and I wanted to shed some light today on breast self-examinations and the importance of doing these are frequently as possible. I can't tell you how many patients I see that have never done a self-exam before and are almost too scared of their bodies to do so. I want to help change that and provide some insight as to how you can do these self-exams at home. Women of all ages should feel comfortable getting to know their bodies, especially their breasts. 

As you all may know, a breast self-exam is where you are checking for any changes in your breast. There is controversy as to whether this is necessary or beneficial, however, I always encourage my patients to do a self-breast exam. It's so important to know what your breasts feel like so that you can identify any changes that might need more attention.  

The best time to do an exam is 3-5 days after your period starts and should be done monthly.  This is the ideal time because many women may experience breast tenderness and fibrocystic changes that can be caused by hormonal fluctuations during ovulation. If you don’t have a period, then do a breast exam the same day every month.  

The best way to do a breast exam is to lay on your back. Place one hand behind your head and with the opposite hand press firmly down and move your fingers in an up and down motion or circular motion until you have examined the entire breast.  Next, sit to stand and look at your breast in the mirror. You want to check for skin changes such as dimpling, indentation or skin that looks like an orange peel.  While standing, feel your armpit for abnormal breast tissue and enlarged lymph nodes.  Squeeze the nipple, checking for discharge.

If you have any abnormal findings or concerns, always discuss it with your provider for reassurance or further testing.  

Here's to healthy and happy breasts.

With love, 

Dr. Jodie Horton

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This girl loves the hot, long, summer days. So, as we get closer to winter (hello first day of Fall..you weren't terrible) it makes me sad! However, I always try to find the silver lining in everything, so I am sharing some tips to make the transition into Fall a little easier for those of you who are like me and will miss the summer daze and days! 

Let's kick this off with...

Exercise

We all know that exercising is good for your mental and physical well-being. As the heat becomes more tolerable, consider taking your workout outdoors. Even if it is a simple walk, enjoy your surroundings and green spaces. Some local gyms and fitness studios are hosting outdoor classes, from yoga to boot camp. You can socially distance while supporting a local business. The bonus is that you get to do your workout somewhere besides your living room!

Aromatherapy

Something about the fall makes me want to buy candles and diffusers. If you don’t suffer from allergies, open the windows and enjoy the cool fresh air.  Light a candle or put some essential oils in a diffuser. Aromatherapy can help you relax, feel calm, energized, and help you get in a more productive mindset.  Aromas like cinnamon bark and clove promote healthy immune response and overall wellness.  Add nutmeg to this combo for a pumpkin spice scent or orange for an orange spice scent.  For a crisp fall scent, combine ginger, patchouli, and orange.  

Sleep

Sleeping in the nude has many benefits. Only 8% of the population sleeps in the nude but let’s talk about why more of you should try doing it.  According to several studies, sleeping in the nude helps you fall asleep quickly and stay asleep by lowering the core body temperature.  For those of you who suffer from insomnia or menopause, this may be super helpful.  Other benefits are improved self-esteem, increased intimacy with your partner, decreased stress, and improved vaginal health. So go ahead and get naked!

Food

I love to wake up on Saturdays and go to the Farmer’s Market and see all the pretty vegetables and fruit.  I have been cooking (read my daughter cooks) with seasonal and local food that I pick up from the Farmer’s Market.  Eating seasonal produce minimizes the intake of chemicals and pesticides.  You are also getting food with better nutrient and vitamin content than produce that is out of season. Look for foods such as apples, avocados, beets, pumpkin, winter squashes, broccoli, corn, kiwi, strawberries, pears, and eggplant, to name a few. Let me know what some of your favorite fall recipes are.

Supplements

As we approach winter, the days get shorter, and the weather gets colder.  We also enter the flu season (on top of the current pandemic!).  We know that supplements are important for keeping us healthy.  Many vitamins are essential for a healthy immune response and our general physical and mental well-being.  Make sure that you are getting your vitamins and minerals to keep you healthy by taking a good quality multivitamin.  Oh, and don’t’ forget about your gut! 80% of your immune system resides in your gut.  The gut helps determine how we feel physically and mentally, so add a probiotic to your routine to keep you and your gut happy.

How was your first day of Fall? What do you love about the Fall/Winter time?

With love, 

Dr. Jodie Horton

Have you ever used a lubricant during sex? According to a study in the American Journal of Sexual Medicine, only 35% of women have ever used lube. 

You may not need a lubricant but let's discuss the different types of lubes and the benefits. You are absolutely right if you are thinking, the vagina is self-lubricating, particularly when aroused. Good foreplay will do the trick in most cases, but some women may experience vaginal dryness due to medication, hormones, stress, excessive exercising, breastfeeding, or menopause. 

Vaginal dryness can lead to burning, pain, tearing in the vagina, painful intercourse, and loss of interest in sex. So what's a woman to do? Use a lubricant! Even if you don't have any of these symptoms, a recent study found that lube makes it 50% easier for men and women to orgasm.

There are a lot of lubricants out there, but they are not all the same. There are three main bases for lube: water, silicone, and oil. When choosing a lube, check out the ingredients, especially if you have sensitive skin. Ingredients such as petroleum and silicone can coat the vagina, making it hard to clean and prevents the vagina from self-cleaning. Phenoxyethanol and propylene are both known skin irritants and should be avoided if possible. Avoid anything with flavor, fragrance, aroma, or warming/cooling. These products that promise to increase pleasure in the bedroom can be toxic to the vaginal tissue and disrupt the balance of bacteria normally found in the vagina. Those with sensitive skin should also avoid lubes with glycerin. Due to their sugar content, they are known to cause yeast infections.

1. Water-based. Water-based lube is going to be your go-to lubricant if you have sensitive skin or vaginal irritation during sex. It is pH balanced so it won't disturb the normal vaginal flora putting you at risk for infection. It also can be used with latex or non-latex condoms and sex toys. It will get you wet without the irritation. The only downside is that it may require multiple applications because it tends to dry out quickly.
2. Silicone-based. Silicone-based lubes last the longest and can also be hypoallergenic. These lubes can be used with latex condoms and not non-latex condoms. Avoid using silicone-based lubes with any sex toys that are made of silicone. It will destroy them by causing them to melt.
3. Synthetic and synthetic oil-based lubricants. Natural oil-based lubes, think avocado, coconut, or olive oil are generally safe for the vagina unless you are allergic to these food sources. Synthetic oil-based lubricants like creams and lotions can be used for masturbation but not for internal use. Synthetic products can cause vaginal irritation because they are harder to remove from the vagina. This could lead to vaginal infections like BV and yeast. You want to avoid using oil-based lubes with latex condoms because it will destroy them and potentially increase your risk of pregnancy. Make sure you read the ingredients. Ingredients like nonoxynol-9, propylene glycol, and chlorhexidine gluconate can cause inflammation and vaginal irritation for those with sensitive skin.

Vaginal lubricants can be a great way to help boost your sexual pleasure. Keep your comfort and safety in mind when deciding on a lubricant that is best for you and your body.

What other Q's do you have about lube?

With love, 

Dr. Jodie Horton

We all know exercising is one of the best things you can do for your mind and body. The question is, what can exercise do to your vagina? There is a lot of sweating and friction that can wreak havoc down there. Post-workout we usually make sure to freshen up. The vagina is no different and may even need some extra attention. 

The vagina has normal bacteria that prevents the overgrowth of bad bacteria like bacterial vaginosis and yeast. However, a warm, wet environment after a sweat sesh can be a breeding ground for infection. Here are some tips to keep the vagina fresh and clean after a heavy workout. 

1. Wear moisture-wicking breathable workout clothes with a cotton crotch to allow airflow. Materials like nylon and lycra can trap moisture and heat. Try to avoid these materials if you are susceptible to infections.
2. Cotton and seamless workout clothes are going to be the most vagina friendly and prevent chafing and irritation.
3. Go commando. Even wearing cotton underwear adds another layer that can cause irritation and trap moisture.
4. Ditch the thongs. The thong's friction and movement can introduce E. coli from the anus into the vagina and lead to potential urinary and vaginal infections.
5. Change your clothes as soon as you finish your workout. Always keep clean, dry clothes with you to change into afterward.
6. If you have time, take a shower and wash the vulva with warm water and mild fragrance-free soap and gently pat the vagina dry before putting new clothes on. In a hurry? Keep vaginal wipes handy in your gym bag.
7. Avoid using any douching, deodorants or sprays to mask odors. If you get frequent infections, use a fragrance-free hypoallergenic detergent to wash your workout clothes

When cleaning your vagina, it's so important to gently clean the outside, known as the vulva, with warm water and a mild soap. The vulva is the external female genitalia and includes the clitoris, labia majora, labia minora, and the vaginal opening. You want to avoid cleaning the inside of the vagina because it is designed to keep itself clean with the help of natural secretions. Washing the inside can disrupt the normal acidic pH of the vagina (between 3.5-4.5) and create an environment for bacteria and yeast to thrive. 

As we age, hectic schedules dictated by jobs, school, kids, and gym time can interfere with vaginal hygiene. Keep vaginal wipes handy in your purse and gym bag is always a good idea when on the go. 

If you are a woman approaching menopause, a decrease in estrogen can lead to a reduction of the good bacteria that helps maintain a normal pH of the vagina. The pelvic floor muscles also get weaker and have decreased tone. You may notice leakage of urine with certain exercises. The combination of altered pH, decrease in Lactobacilli, urinary incontinence, and the moisture and friction from exercising can be challenging. To prevent urinary incontinence, you can do Kegel exercises  to strengthen the pelvic floor muscles that support the uterus, bladder, small intestines, and rectum. Adding probiotics and using the tips mentioned above will help your vagina stay healthy when exercising. 

By following these tips, you CAN still keep your vagina happy and healthy, even when working out.

With love, 

Dr. Jodie Horton

We wait long and hard for our treasured summer months and for some women, those summer months increase the risk of urinary tract infections (UTIs). As the heat and humidity rise, it's easier for bacteria to grow. You lose lots of fluids through sweating and become dehydrated, putting you at risk for that pesky and irritating bladder infection. 85% of UTIs are caused by a bacteria called Escherichia coli or E.coli that is found in your gut. 

All women are at risk of cystitis and are 4 times more likely to have a bladder infection than men. The reason is because of our anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder. Other risk factors include sexual activity, immune system, certain types of birth control, and even our age. 

Here are some tips to prevent UTIs during the summer months: 

Water Water Water. Stay hydrated so you can flush out your kidneys and bladder. You should be drinking at least 2L of water every day. I like to keep a stainless steel water bottle to keep my water cool. Pro tip, add a couple of lemons to your water to help prevent bladder infections. Lemons act as a diuretic so that you will flush out bacteria that may be harmful. It also maintains the correct pH level in the urinary tract, preventing bacteria from growing. 

Avoid sugar. Sugary foods, beverages, juices, even cocktails, promote the overgrowth of bacteria in the bladder. If you have recurrent bladder infections, you may want to eliminate sugar in your diet. If you are diabetic, make sure your blood sugars are well controlled. 

Urinate after sex. Women are having more sex during the summertime, according to studies. Urinating after sex may lower the risk of a bladder infection by flushing out bacteria that may get into the urethra during sex. 

Holding your pee. Go to the bathroom when you need to and make sure you completely empty your bladder. Self-explanatory, but not emptying your bladder when you need to can lead to a buildup of bad bacteria in your bladder. 

Make sure you wipe right. Wipe from front to back to keep bacteria around the anus from getting in the vagina or urethra. Stay extra prepared and keep pH balanced vaginal wipes handy if you’re at the beach or pool. Always make sure to keep the area clean and dry by changing out of your bathing suit immediately. Remember, moisture is bacteria’s best friend! 

Undies. If you are prone to UTIs avoid thongs because it can easily spread bacteria from the anus to the vaginal area and urethra. Worried about panty lines? Go commando!

Could be your BC. Be aware that certain forms of birth control like spermicidal foam and diaphragms could be the culprit. These forms of birth control are known to increase the risk of UTIs. 

Age. Obviously we can’t change our age. However, after menopause, a decline in circulating estrogen in our bodies can cause changes in the urinary tract system that make you vulnerable to infection. The hormone estrogen allows the “good” bacteria called Lactobacillus to thrive. These bacteria produce acid, which lowers the vagina's pH, which helps keep the “bad” bacteria in check. Add a probiotic to your daily supplements. 

Add proanthocyamidins (PAC) either as a supplement or in your diet. Proanthocyamidins are a cranberry extract that prevent E.coli from attaching to the bladder and causing an infection. Foods rich in PAC include grapes, red wine (Yay!), cranberries, strawberries, blueberries, apples, and red cabbage. 

Try these tips for a happy bladder and happy summer. However, if you are experiencing pain or burning with urination, frequent urination, lower belly pressure, cloudy, bloody, or urine that has a strong odor, seek medical attention. 

With love, 

Dr. Jodie Horton