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Midlife Vaginal Health – Red flags and green flags
While October is Breast Cancer Awareness month, SheSpark is covering various feminine-related health concerns– including midlife vaginal health. We asked Dr. Minkin what the top three issues are that concern over-40 women. She provided easy “red flag” and “green flag” answers that better help you understand what’s normal and what’s not.
Midlife Vaginal Health Concern #1 – ODOR
Green Flag: In general there is very little to worry about- everyone has a scent.
Red Flag: A fishy odor is often associated with a bacterial overgrowth or trichomonas: in general I wouldn’t suggest women worry, but there are things they can do. Vaginal pH is relevant-and acid is good! So if a woman does notice a fishy type odor, she can try using a product like RepHresh, which will help return her vagina to a better (more acidic) pH, and the issue may be totally cleared. If it persists, don’t worry, but do check in with a care provider to make a diagnosis for you.
Midlife Vaginal Health Concern #2 – DISCHARGE
Green Flag: Having some moisture in the vagina is good-young women tend to have good moisture, and will have some discharge-older women, after menopause, who aren’t making much estrogen may well be drier. You will have different amounts of discharge at different times during the normal menstrual cycle because hormone levels vary-if you really want to have no variation, you can go on a birth control pill, which keeps hormone levels totally constant. At the time of ovulation (around mid-cycle for most women) the vaginal discharge may be more noticeably stringy-it may last that way for a couple of days.
Red Flag: When we start running into problems is with vaginitis. There are three basic types of vaginal infections: yeast, bacterial, and trichomonas (a parasite that can live in the vagina and be transmitted sexually.
•Yeast infections classically can present with a white cottage cheesy discharge which is itchy. She may want to try one of the over the counter yeast products. Another route that is helpful as far as preventing another episode is to load up on some “good guy” bacteria-probiotics, which will help maintain a healthier bacterial flora in her body. One product that can be very helpful is RepHresh Pro-B, which contains strains of acidophilus which are quite similar to the “good bacteria” of the vagina.
•Bacterial infections tend to have a yellowish or brownish type of color, and may smell bad.
•Trichomonas presents with a yellow-greenish discharge which smells bad.
If your discharge persists, you should check in with your health care provider who can get you a specific medication to take care of the problem.
And if you have significant pelvic pain with a discharge, you do want to see your provider right away, to check up on the possibility of a sexually transmitted infection -which would require special treatment.
The good news is that all are treatable. If you aren’t sure if something is off, you might want to try an over the counter remedy.
Midlife Vaginal Health Concern #3 – LABIA SIZE AND TEXTURE
Green Flag: All sizes and shapes are normal! In over 40 years of practice, I have never suggested plastic surgery revisions to any of my patients-I did once trim labia for a young patient of mine who was a star athlete, and found that her labia were so long they got stuck in her underwear-so I trimmed them a bit for her. But almost anything is normal.
Red Flag: The major issue on vulvar health is itching: if a woman has persistent itching of her vulva (including her labia) I would suggest she see her health care provider-just to make sure there is no evidence of a vulvar cancer or precursor.
Final Question: What feminine hygiene steps are most important for women over 40?
So, good hygiene? Don’t sit around in a wet bathing suit or gym clothes-change into dry underwear soon.
Wear cotton underwear as much as you can.
Don’t use toxic soaps with a chemical deoderant to wash the vulvar area.
If any of these problems do crop up, do try some good probiotics, and some gentle acidification like RepHresh, and you should do well.