The warm weather is finally here, the pools are opening, and we are planning trips to the beach. So don't let your period get in the way of your fun. Wearing pads or panty liners are out of the question when taking a dip in the water, but don't worry; there are other options to consider.

Tampons are readily available and easy to use. Just remember to change your tampon every 4-6 hours and use the lower absorption possible for your flow. 

Menstrual cups are another great option and are just as safe as tampons. One benefit is that they collect more blood than a tampon and can stay longer, typically 6 to 12 hours, depending on your flow. Another advantage is that they are reusable, making them a good economical and eco-friendly choice. There is a learning curve to inserting and removing a menstrual cup, but once you find the right one, you are good to go.

Menstrual discs are similar to cups as they collect blood rather than absorb blood like a tampon. Some women find that menstrual discs are more comfortable than cups.

Period friendly swimwear. I didn't know this existed until now, but what a great idea. The swimwear has built-in, leak-proof protection. The downside is that it is not ideal for heavy menstrual flow. 

We are all ready for the warmer weather and long summer days but as the temperature rises, so does our risk of developing urinary tract infections (UTIs). Urinary tract infections are among the most common infections that women experience, and 60% of women will experience a UTI at least once in their lifetime. 

UTIs occur when bacteria (most commonly caused by bacteria found in the gut called E. coli) travel through the urethra (pee hole) into the bladder. Common symptoms include frequent and strong urge to urinate, burning sensation when urinating, cloudy, bloody, and strong-smelling urine, lower abdominal pain, and sometimes fever and chills.

So why are UTIs more common in the summer? It is not well understood why UTIs occur more frequently in the summer, but several theories exist. Dehydration is more common during the summer. It is important to stay hydrated to help flush out any harmful bacteria from the bladder. A recent study found that when the outdoor temperature reaches 80 degrees Fahrenheit, there is a 15% increase in UTIs. The reason is that bacteria are more likely to grow in warm and humid environments. When we think of the summer, we think of the beach, lake, or pool. The moisture from bathing suits and undergarments is a breeding ground for bacteria that can cause UTIs.

So what's a girl to do? 

• Drink lots of water to dilute your urine and flush out the bladder. 
• Don't hold in your urine for a long time. Bacteria can sit in the bladder multiple and increase your chance of developing a UTI. 
• We should all know this, but I'll say it anyway- always wipe from front to back. It is more hygienic and prevents bacteria from the anal area to the vagina and urethra. 
• Avoid tight and wet clothing. 
• Always keep dry clothing with you and change immediately after if you plan on spending time in the water or outdoors. 
• Urinate immediately after sex. It is often a common cause of UTI because the urethra is exposed to bacteria from your partner's genital area. 
• And, of course, add a probiotic containing lactobacilli which can prevent E.coli and other bacteria from invading the bladder and causing infections.

UTIs are uncomfortable and painful. Following these tips can help prevent a UTI this summer. If you are experiencing any symptoms of a UTI, contact your provider so you can be tested and treated immediately to avoid more serious problems.

Everyone will experience mood swings from time to time, but if you have rapidly fluctuating emotions that go from happiness to anger, irritability, and even depression, there may be something more serious. Typical mood swings are often triggered by work-related stress, significant changes in your life, diet, sleep, and relationships but can also occur without an obvious cause.  Mood swings are also common in people with underlying mental health issues. When mood swings are frequent and intense enough to disrupt daily living, including work and relationships, 

Everyone will experience mood swings from time to time. Still, if they are frequent, intense, and unpredictable enough to disrupt daily living, including work and relationships, you should consult your doctor.

Mental health conditions such as bipolar disorder, depression, personality disorder, schizophrenia, and attention deficit disorder(ADHD) can cause severe shifts in mood. Hormones can affect the chemistry of the brain and cause changes in mood.  This is most common in teens, pregnant women, women who have premenstrual syndrome (PMS), and perimenopausal or menopausal.  Your physical health can also impact your mental health and emotional well-being.

The good news is that mood swings are manageable with lifestyle changes, therapy, or medication.  You can help regulate your mood by keeping a schedule, particularly an eating and sleeping schedule, exercising regularly, getting enough sleep, practicing relaxation techniques, avoiding stress, and talking it out with friends, family, or a therapist. Eating a healthy diet and taking supplements can also help manage your moods. Making these changes can be challenging and take some time, but in the end, you will have a positive outlook and better quality of life.

We are all tired.  Our lives are so busy, and it never feels like we can get enough sleep. Unfortunately, it can affect all aspects of our lives, including our sex life. A lack of sleep can decrease sexual desire and arousal.  So what’s a girl to do?

We often talk about behavioral and lifestyle changes that can improve our quality of sleep, but we don’t really talk about how sex can promote better sleep and less stress. The research found that sex with orgasms can help people fall asleep. This may not be surprising to some, but keep in mind when other things like sound machines, teas, and essential oils aren’t working. Orgasms cause the body to release hormones such as oxytocin and prolactin and inhibit cortisol. Oxytocin and prolactin increase after an orgasm, promoting feelings of satisfaction, relaxation, and happiness. Cortisol, a hormone associated with stress, alertness, and excitement, decreases following an orgasm.  

These changes in hormones make you feel tired and ready for a good night’s sleep.  And if you are single, don’t worry.  This benefit is not limited to sex with a partner.  Studies also found that having an orgasm through masturbation is also beneficial.

It’s pure panic when we miss a period. We start looking at the calendar and counting the days from our last period.  But slow down.  There may be other reasons why you might have missed your period or it is late besides pregnancy.  But before we do get into other causes, it is always recommended to take a pregnancy test just to be sure. And if you are not pregnant, here are some common reasons why aunt flow didn’t pay you a visit.

1.  Stress. That’s right. Stress can wreak havoc on your body including your period. Stress can cause a hormonal balance by messing with a part of your brain called the hypothalamus that regulates your hormones causing you to miss a period or two. Relax, which is easier said than done.  Focus on self-care and your mental health and learn new ways to cope with stress and stress relieving techniques.
2. Birth control.  One of the benefits of birth control besides preventing unplanned pregnancies is that it can improve our periods. When used as directed, it can decrease the number of days you bleed, improve cramping and pain associated with your periods and reduce the flow.  Some birth control may even stop your flow. As long as you are using the birth control as directed there is no need to panic.
3. Changes in Weight. Extreme weight loss from not eating or excessive exercising can cause a hormonal imbalance, stop ovulation and resulting in missed periods. Excessively low body weight, low body fat, and high energy expenditure can be contributing factors.

If you miss three or more periods in a row, you should see your doctor. Your doctor may do some blood tests, a pelvic exam and get an ultrasound to help determine the cause and treatment. If you are worried about missed or irregular periods, you should keep track of your periods and associated symptoms with an app. This information will help your doctor diagnose the cause and determine the right treatment.

Sexual satisfaction is a part of a woman’s physical and mental health.  At some point in our lives, our sexual desire will have its highs and lows.  Life changes such as menopause, pregnancy, stress, fatigue, and illness can affect our desire and decrease libido. 

What are the symptoms?

You may wonder if you don’t want to have sex as often as your partner, then you may have a low sex drive.  This is not necessarily true because everyone’s sex drive is different.  If you have little to no interest in sexual activity, never have sexual thoughts or fantasies, or are concerned about your sex drive, you may have a low libido.

What are the causes?

There are many external and internal causes of low libido. Medical conditions such as hypo or hyperthyroid disease can increase the risk of sexual dysfunction up to 75%.  Thyroid disease can decrease testosterone levels and lead to fatigue and depression, decreasing your sex drive. Hormonal imbalances experienced around perimenopause and menopause can also lower sexual desire due to the decline in estrogen, progesterone, and testosterone.  Stressors such as financial problems, relationship issues, work-related stress, and family problems can not affect your sexual but your overall health.  Constant stress can also lead to mood disorders like depression. Depression can cause low energy levels and low self-esteem and may even cause a person to view their partner negatively. Keep in mind that medications like anti-depressants are known to affect libido too (you can’t win!). Nutrition and vitamin deficiencies can affect your sex drive too.  Zinc, omega-3, vitamin D, vitamin B12, and magnesium are all essential for hormone production and improving your mood.

There are many causes of low sex drive. It is important to focus on your physical and mental wellbeing which can impact your sexual health. Eating a well balanced diet, excising and taking a multivitamin everyday is a good place to start. If your sex drive causes concern, it is always best to discuss it with your doctor to development a treatment plan.

Spring is here and that means out with the old and in with the new.  So what does that mean for your vaginal health?  If you are stuck with old habits that aren't doing you any good, now is the time to start new ones!

1. Start with throwing away some of those old underwear with the holes or broken elastic.  I know they are comfortable, but invest in some new ones preferably made of breathable fabrics like cotton or bamboo.  Research shows that you should replace underwear at least once a year because even your clean undies can harbor bacteria.  
2. I say this all the time but I’ll say it again because it is important: keep your feminine hygiene simple. Use a fragrance free, no-dye cleanser or soap to clean the vulva only.  No douching or sprays. The vagina is self cleaning.  Sometimes we may do too much that will get rid of bacteria such as lactobacilli that is important in maintaining good vaginal health. Keep in mind that some vaginal discharge is normal.  Every vagina is unique but they due share some common characteristics.  Every woman has her own amount of discharge and distinct smell that varies from woman to woman. As long as there is no itching, pain, irritation, or foul smelling discharge, it is normal. 
3. If you to choose to shave, make sure you use a clean and sharp razor with a hydrating shaving cream.  After shaving, exfoliate the bikini area to prevent ingrown hairs.  
4. The last thing on your list is to make sure you are updated on your Pap smear to test for cervical cancer. I know it’s not anyone’s favorite thing to do, but it is so important to do.  It could save your life.  

Let me know what questions you have about vaginal health! 

As women, we have enough to worry about when it comes to our bodies, but we all dread a UTI or vaginal infection. We often miss the early warning signs that something is brewing until it’s too late. If you are asking is this a UTI or vaginal infection, you’re probably experiencing uncomfortable symptoms and may have an infection. So let’s talk about the early warning signs so that you can get treatment as soon as possible. 

Urinary Tract Infection

Because a woman’s urethra (pee hole) is short, it is easier for unwanted bacteria to reach the urinary tract and cause a UTI.  You may experience lower abdominal or back pain, frequent urination, passing small amounts of urine, occasional pain with urination, and cloudy or foul-smelling urine.  These are some early signs of a UTI. If you ask yourself if you have a UTI, then you should probably see a doctor.  It requires a simple urine test because it can lead to a more serious kidney infection if it goes untreated. 

Bacterial Vaginosis

Most women with BV don’t have any symptoms; however, there are some common signs and symptoms that you should look out for. Burning with urination is often seen with a UTI, but BV can cause vaginal irritation and burn when pee comes in contact with the vagina.  Thin white, grey or green copious discharge, fishy odor, especially after sex, and itching are also early signs that you may have BV. 

Yeast Infection

We often are told that a yeast infection causes a thick white cottage cheese discharge; however, most women initially present with itching, irritation, redness, and swelling around the vagina. Taking antibiotics can decrease the lactobacilli in the vagina.  Lactobacilli is needed because it keeps yeast and bacteria in check and prevents infections like yeast and bacterial vaginosis.  Other risk factors are pregnancy, weak immune system, stress, and hormonal changes.

The key is to stay in tune and listen to your body.  Keep your feminine hygiene routine simple, take probiotics if you are at risk for infections, eat a healthy diet and drink lots of water.  If you think something is off, it’s always good to consult your doctor to diagnose and treat you properly.

xo,

Dr. Horton

We all know that wrinkles, grey hair, and achy joints are a part of the natural aging process but what happens to the vagina and vulva as we get older?

Pelvic floor muscles that support the bladder, uterus, and bowel may start to lose their support. When these muscles weaken, women may experience a decrease in pelvic floor strength, leading to issues like urinary incontinence or organs like the bladder, uterus, or bowel falling out of the vagina, known as prolapse.

Pubic hair will become thin and sparse. You may find a grey hair or two as well.

As we get older and estrogen decreases, the body will lose fat and collagen. The vulva and labia will become thin and lose their fullness. The labia may become smaller and look paler due to decreased blood flow, and the clitoris may become larger.

A decrease in estrogen can result in atrophy or thinning of the vagina and bladder. This can lead to symptoms like the urge to urinate more frequently and bladder infections. The decline in estrogen can also alter the ecosystem of the vagina. The pH of the vagina may change, which leads to a decrease in the number of Lactobacilli in the vagina that is needed to maintain a normal vaginal pH and prevent infections.

Vaginal dryness is a common complaint as we get older. A combination of decreased estrogen and blood flow to the vagina results in less lubrication. Vaginal dryness can cause irritation, itching, and burning in the vagina. Vaginal dryness can also cause painful intercourse. 

Some of these symptoms are a normal part of aging; however, they can affect your quality of life. Discuss your symptoms with your doctor to give you treatment options specific to your needs.

There are so many things to consider when buying underwear. Your options are endless, and there is so much to consider! There's the waistband, the elastic around the legs, the cut of the underwear, the coverage, the comfort, and should I choose practical or sexy underwear? And, there may not be one pair of underwear that fits all occasions. Depending on what you are wearing or doing, you may choose to wear a different type of style or even go commando, but there are some things to consider when it comes to vaginal and vulva health.

Women with sensitive skin or who have chronic infections should consider what underwear they are wearing. Breathable fabrics like cotton and bamboo are the best to allow the vulva and vagina to breathe—these moisture-wicking fabrics all this sensitive area to stay cool and dry. The possibilities of underwear are endless so if you choose other synthetic materials like nylon, silk, or lace, make sure there is a cotton gusset because yeast and bacteria thrive in moist, dark spaces.

Consider the cut and comfort of the underwear over the aesthetics. If underwear is too tight or the elastic around the legs doesn't have a good stretch, it can cause friction and irritation. This can lead to ingrown hairs, cysts, and chafing in the groin area. For those who like to wear thongs, the good news is that thongs do not increase the risk of vaginal infections. The material is what matters. Opt for a thong that fits properly and has a cotton gusset. You can even go commando and let the vulva be free and unrestricted.

Choosing the right underwear may make a difference in your vaginal and vulvar health. It is a delicate area that is sensitive to any changes, including what you wear. So choose wisely.