It's not a bad word, but it often feels like one.
Sometimes, it seems we'll jump through any hoop to avoid saying it. Even Grey's Anatomy, a medical show (albeit fictional), used the phrase '"va-jay-jay'"—coined by the ever-present Oprah—to keep it out of scripts. What's so scary about this word?
There. It's written. It's right there.
Are we all OK? Still breathing? Still with me?
The vagina, while often shrouded in secrecy, is a body part much like an arm or leg: It serves a purpose and therefore needs to be taken care of. But that's easier said than done, right? Our culture has told us that while it's totally fine to reach out for help in the case of a sprained or fractured limb, issues of the vagina are personal and not to be discussed.
With recent legislation regarding women's healthcare, the vagina is getting quite a bit more attention than in the past; hundreds of thousands of women marched with signs bearing the once-taboo word or sported "pussy hats" to pay homage to their bodies. This is fantastic! And, quite frankly, the vagina deserves the recognition. Too long has it been absent from conversation or gone unappreciated. Because of this, many people with vaginas are unsure how to take care of them, or are uncomfortable asking for help when it comes to their vaginal health.
It's OK to feel this way.
But you shouldn't have to.
Like any other body part—because remember, that's all it is: a body part—vaginas require assistance from time to time, to, as Oprah would say, "live their best lives." Many women don't realize what they experience, while common, is treatable. There are several factors that influence vaginal health and these change throughout the lifespan. Much like metabolism, the vagina of a 17-year-old doesn't work quite the same as the vagina of someone who is post-menopausal. Pregnancy, breastfeeding, menopause and other hormonal fluctuations commonly cause changes in the vaginal tissues. A variety of birth control methods, as well as cancer treatments, can also have an effect.
Some common issues people with vaginas may experience include dryness, bladder leakage, pain during sex, lack of sensation, and/or difficulty orgasming. That's right: Even difficulty orgasming can be treated like a medical condition—and doesn't mean anything is wrong with you. Anyone who's ever had a urinary tract or yeast infection knows vaginas are sensitive and can be temperamental; these conditions don't mean there's anything wrong with you. In fact, they're extremely common. We just never hear about them, because we tend not to talk about them. Again, the good news is that we can do something about all these things to improve vaginal health. Some call it vaginal rejuvenation, because:
1. It sounds great.
2. That's exactly what it is—rejuvenating your vagina to improve its overall health and well-being.
There are several steps you can take to improve your vaginal health. While not all steps will fit your lifestyle or situation, collaboration with a healthcare provider could help you make the most appropriate customization of this program to improve your health.
Vaginal tissue, like any other body tissue, can become dry. If you notice dryness or pain during intercourse, moisturizing can help. Vaginal moisturizers do not contain hormones and are easily available over-the-counter or online. They can be used daily or as needed. You can talk with your healthcare provider about how to use these products.
NOTE: Moisturizers do not take the place of lubricants.
Massage as an aspect of vaginal health is often overlooked, but has direct benefits to tissue—most notably increasing blood flow. Depending on your comfort level, vaginal massage can be performed by a partner, yourself or a device. When used in combination with other steps listed, massage can help revitalize vaginal tissue and release tense vaginal muscles.
HOW TO DO IT: Massage should start externally and after application of lubrication. Start by applying gentle pressure to the labia majora (outer lips) on both sides, slowly pressing and releasing in a circular motion. Move to the labia minora (inner lips), then hold and gently stretch the labia between the thumb and index finger to lengthen them, progressively moving downward. Insert a lubricated thumb downward into the vaginal opening while applying contrasting pressure with the index finger at the base of the vaginal opening. It's recommended to apply this technique for about 10 minutes.
Vibration, like massage, increases blood flow to help speed healing and combat dryness. This step may not be comfortable for everyone or may warrant further discussion with your healthcare provider prior to implementation. If vibration is an option, there are many devices available to you. Some vibrators stimulate only externally, some only internally, and some externally and internally simultaneously. Vibrators are made with many materials, among them glass, plastic and silicone. It's important to find a size, material, and vibration intensity and speed you are comfortable with. Sex therapists, sex counselors and sex educators are well-versed in this area and can answer any questions you may have. They can also help you decide which device is best for you and how to use it.
Vaginal hormones may not be appropriate for everyone. It's important to talk with your healthcare provider about the risks and benefits, prior to starting medications. For the appropriate person, vaginal estradiol (estrogen) and sometimes-vaginal testosterone are an effective and safe way of treating vaginal dryness and pain. Lack of estrogen in the vaginal canal changes the pH to a more basic level, which leads to increased risk of vaginal infection. Bladder symptoms such as frequency and infections are also more common when estrogen is lacking.
NOTE: There are many misconceptions regarding hormone use, and it's important to see a provider who specializes in hormone therapy to help you make the most informed decision. Vaginal hormones come in many forms, including creams, suppositories, rings and tablets. Talk to your healthcare provider if you think prescription hormones may be the right option for you.
Scientists and medical providers have been using laser medicine to rejuvenate skin for many years. Recently, scientists discovered methods for treating the vagina with laser therapy. The only vaginal laser that allows clinicians to customize treatments, diVa has no reusable parts, so you can rest easy that the device being used has not been used on any other patient. DiVa works by delivering two different wavelengths to the walls of the vaginal canal at once: The first deeply resurfaces tissue layers, replacing them with improved quality tissue; the second laser heats the layers where collagen exists. In a recent diVa clinical study, women reported minimal discomfort and no adverse effects, and a whopping 92 percent reported that their expectations were met. A typical diVa treatment lasts three to five minutes, with no resulting downtime. Treatments are repeated every four to six weeks for a total of three treatments, followed by annual checkups for maintenance. Often, women who have been treated by diVa no longer need to use vaginal hormones.
As you can see, there are many steps you can take to improve your overall vaginal health and/or improve any issues you may be having. I know this is a lot to sort through, but have no fear. Take a breath. Your healthcare provider is there to help you figure out what treatments will be most beneficial to you. Don't hesitate to talk to someone about what's going on—there may be an easier fix than you realize!
Remember that the vagina, remarkable as it may be, is merely another part of the body. There's no shame in asking for help to keep it as healthy as possible.
Written by Nisha McKenzie, PA-C, IF, CSC, Grand Rapids OB/GYN and Director of the Center for Women's Sexual Health.