How to keep your New Year's resolution WITHOUT peeing on yourself! No, seriously....

OMG!!! Another Year Older!!!!

As I sit here sipping wine and contemplating my sanity, I do have to say that it is very nice to have a relatively quiet passing of the new year holiday season; and by that I mean without fire alarms, ambulances or other embarrassing emergencies that do nothing but constitute gossip and discontent amongst the family and co-workers that we tolerate with endearing submission!

That being said, let's get down to brass tax: weight. Oh, yea....I just went there!  I don't hear too many resolutions such as "this year I'm gonna have more orgasms" or "this year, I'm gonna save my millions for charity".  What I generally hear is "I wanna get in shape". OK, missie, well that's just great. WTH are you referring to, anyway?? Marylin Monroe? Jane Seymore? Kirk Cameron?  Ooooooooo,  I get it...John Wayne! :D  Either way, "getting in shape" is a broad term for "fixing myself to my standards". So, given today's standards, I'm going off the assumption that you want to look like a 20 year old sorority girl at a pool party in her prime wearing a thong. Welp, gotta tell ya that unless you are already that girl, ain't gonna happen. However, you DO have the right to look downright HOT no matter what your age, so we are going to discuss a few ways to get this done.

MAJOR CAVEAT:  I've read a few of the muscle building magazines for women and some of those exercises may tighten your tushie but will also open your bladder for peeing. Yup, that's right. Peeing all over yourself during exercise, laughing, coughing, sneezing or any other time is a MAJOR bummer, not to mention a total turn-off for your significant other. I can't think of a time where I've heard a woman say "WOW doctor....this incontinence (peeing on one's self) is AMAZING!!! My guy loves it,  and no lube!!"  Uhhh, no. First and foremost, wide-leg exercises should be avoided. Why? because the wider your legs are during a squat, the more weight is focused on the center of the gravity which is...yes, you guessed it...the bladder, vagina and rectum. Those things are all supported by a group of muscles that CANNOT be fixed without surgery, and once you mess them up you will need surgical correction. Now then, let's talk about how to lift that butt up without ruining your "down there" lady bits.

So most women would LOVE to have the all-tight rear that we had in our teens, or at the very least that bootie other enviable women had or currently have.  To help me develop a bottom line workout plan that will tighten your tush AND leave your poor bladder and vagina alone, I spoke with Personal Trainer Extraordinaire from Gold's Gym, Pat Saracino.  Pat has developed a "down there" workout plan to keep your butt off the floor and your legs looking model-hot without compromising the all-fabulous vajay-jay.  Here's what he got!

“Down There” workout plan

Warm up/ Cool down

1.     Externally rotated straight leg raises 2x 25 each leg

2.     Lying hip abduction straight leg 2 x 25 each leg

3.     Supine single leg raises,  Toe out 2x12 each leg, toes up 2x12 each leg

4.     Exercise ball hamstring curl 2x20

1.     Weighted Bench Squats 15,12,10

2.     Leg Press, high narrow stance 3x25

3.     Tall step up 3x 15 each leg SUPER SET:

4.     Deep wall squats 3x20

5.     Dumbbell Romanian deadlift 3x12 SUPERSET:

6.     Lying hamstring curl 3x15

7.     Cable hip abductor/ adductor/ flexion 3x15 each

       And before you ask, yes I did try each and every one of these and they have the doctor seal of approval. Just remember: NO wide legs. Keep your legs right at shoulder width OR closer, as if you were casually standing. keeping your feet together during these will take ALL the focus off of your vagina and bladder and keep it on your legs and butt, where it belongs anyway.

     The warm-up can be a light 10 min jog or 10 min on a machine of your choice, just to get your heart rate up.   You can google or youtube how to do these for proper execution or just tell your trainer if you have one. Be up front and tell your trainer that you love your vagina and won't do wide-leg anything so they get the idea. Men AND women alike will appreciate that one!

      One other thing: you are going to want to adjust your diet. My general advice to get people on the right track is this: if you have to google it, don't put it in your mouth. Can you grow, harvest or kill it yourself? No? Then don't eat it! Gross!  I know for a fact that I cannot go out and harvest locust bean gum, whatever that is. So ditch the boxed/bagged/canned food and start eating stuff you can get yourself. Wanna make something? Fine. Do it from scratch using ingredients you KNOW are good. Lay off the oils, fats, and other crap that companies put in your food. Personally, Bob's Red Mill makes some great, simple foods that are healthy; Kashi cereal is good as far as cereals go and frozen veggies are nowadays as good as fresh. Is this stuff more expensive? No, not really, if you add up the cost of making it yourself. Big Lots sells that Bob's Red Mill for way cheaper than the grocery stores. Too busy? I don't think so. Crock pots are a working mom's best friend! Learn it, love it, and stay away from the jar sauces. Back away from the jar. Herbs and spices work just as well at flavoring if not more.  

      Try this recipe: Take a whole chicken (around 7 or 8 dollars); in the morning before work, prepare it like this: cut up a lemon and half an onion into large chunks. add a generous splash of olive oil to wet it. Throw in a handful of sea salt (also cheap now), and fresh rosemary (1.98 at most stores, the little packs of fresh herbs). No need to cut up the rosemary, just throw it in there. Mix it all up, and stuff it right up the butt of that chicken. Drop it in the crock pot on low for 4-6 hours with a cup of water; your crock pot should automatically switch to the "keep warm" status. When you get home, voila! A wonderfully fragrant and flavorful roasted chicken. Make some whole grain side (such as cous-cous) and veggies (steamed broccoli or other) and there you have it. Dinner in a snap!  What to do with the left-over in the crock pot? Don't throw it out!  Leave it for the weekend. Dump the whole thing in a big pot with lots of water and boil it for an hour or two. Pour it in a strainer, save the broth and rinse with cold water. pick out the bones and skin, left-over rosemary branches (leave the green leaves that are left) and lemon. put it back in the broth, add some celery and carrots, and  BAM! Home-made stew that didn't come from a can! Awesome, right? Now, miss "I don't eat healthy because it costs too much!". Add up the cost. 2 meals at least, more if you pick at the chicken for lunches, 12-15 dollars tops. See? 

Alrighty, my dears, time to go. My own workout is calling, and yes, you guessed it...today is legs day!  Take care, and feel free to post your questions! More to come!-The Doc

Birth Control 101- Part 2, the REST of the Story!

Good afternoon to all of my lovely readers, both female, male and all of those in-between! :) 

Having a good form of birth control that is used properly BEFORE....hang on, lemme repeat that...BEFORE getting it on is the best way to prevent unintended pregnancy!  Ya, ya...I know you know that. You'd never believe half the stories people come up with, though...let's listen in, shall we?

Patient: Well, I took my pill almost every day, I only missed a few here and there!
Doctor: That explains a lot, actually....

Patient: My IUD was bothering me so I pulled it out myself. I'm still covered, right?
Doctor: Ummm, no.

Patient: I just use Plan B whenever I need to, there's no risk in that because it's not doing anything major, right?
Doctor: (insert head slap here)

So let's say you are on the ball, packed your own jimmy's and got your freak on with the Saturday night Mr. Right Now and everything was awesome! Until you noticed the leak in the condom, noticed it "fell off" or some other issue went south. This guy is no keeper, so now what???

Emergency Contraception
This is an extremely controversial topic so let me be very clear about one thing. This blog is an information source, not a place to vent my political hang-ups or moral issues. My role, as well as those of other doctors, should be to serve, not judge! So before anyone gets their panties all knotted up remember one thing: I am obligated to convey all available options to whoever needs it with appropriate risks and benefits outlined. Judging others is not in my human job description. That is for someone or something else. :)

Emergency contraception is just what it sounds like-for emergencies only! It lowers the chance that pregnancy will occur and is to be used within 120 hours after unprotected intercourse. There is no guarantee that pregnancy will NOT occur, but these methods decrease the liklihood.   These are to be used if you think your normal birth control method failed, if there has been a rape or sexual assault of any kind (meaning you either knew you were being raped or were drugged and raped or possibly raped) or if you just plain forgot during the heat of it all.  There are a few different ways to use emergency contraception. IF YOU TAKE A PREGNANCY TEST AND IT'S POSITIVE, IT'S TOO LATE FOR THESE! You have to follow up with your doc to discuss your options at that point. That, and there's some side effects to these like vomiting, crankiness, headache, dizziness....yay for being a girl!

1)  Single Pill method: Plan B is available to anyone who asks the pharmacist for it, if they have it in stock. Doesn't matter how old you are, you can still get it. If you puke it up, you might need another one but ask your doc first BEFORE just popping one.  Next Choice is another one, available to those younger than 17 with prescription and those older than 17 without a prescription. They'll ask for ID so don't try to pull one over on the pharmacy peeps. These are only 75% effective when taken ASAP, and it's worse the longer you wait. So clearly the best method is prevention in the first place!  We think these stop ovulation, not cause abortion. If there's a mini-me in progress, it doesn't stop that pregnancy so don't even go there.

2) Two pill method. Prescription only to those under 17, no prescription needed if you are over 17. Take one immediately, then the next in 12-24 hrs. if you puke any of them up, call your doc.

3) Regular birth control pills-These can be used for emergency contraception but you need a prescription AND the dosages vary between pills. you MUST ask your doctor about these so you can get the right info cuz not everyone can use these (I'm sure you know that already, having read my previous posts!)

4)Ulipristol or IUD insertion: prescription only, gotta see your doc first for this.

There are some very good websites that address this issue:  www.acog.org    www.cdc.gov  www.not-2-late.com

At these sites you will be able to read more about the possible side effects of these types and where/how to get them. These are reputable sources with accurate up-to-date information.

NOTHING is 100% effective, not even these. You can STILL get pregnant, even after taking these if you hump the horsie again. Planned Parenthood can offer you free advice on these things as well as helping you find a good way to prevent pregnancy in general. You also might need STD testing (see my blog about vaginal funk!)  and to do this you have to go somewhere.

Ladies and Gentlemen, I think after such a serious topic I'm going to watch some Seinfeld re-runs and eat some lovely dark Godiva chocolate, my impulse-buy of the week.
Stay tuned for the next topic, Bleeding at the Speed of Light: When your "normal" isn't so very....normal.

Have a great day! -The Doc

Birth Control 101-Getting ready for getting it on, stress free: Part 1

Happy Hump Day everyone!
A fitting day for a fine discussion of birth control, so I'll start with a few phrases I've heard SO many times over the past several years:

Actual Conversation #1:
Doctor: Congrats, looks like you're expecting!
Patient:  But, but......but..... (bursts into tears)...WE WERE IN THE SHOWER!!!

Actual Conversation #2:
Doctor: Your pregnancy test was positive, so you are pregnant.
Patient: WHAT????!!! He pulled out! I don't understand!

Actual Conversation #3 (courtesy my ER doctor friend several years ago):
Patient: I had whammy in my cooter cat and now I think I got a baby in me.
Doctor: I'm sorry, you have a terrible pelvic infection not a baby. Really. 


OK, ladies. There is a LOT of information, debate and word-of-internet information about birth control. I'm here to give you the facts, plain and simple about all the methods available to you so you can hump to your heart's content, stress free. Of course if baby-making is the idea, skip this post and get a-going!

The most effective birth control known to man-kind is abstinence. That's right, no sex means NO chance of having a baby! Nothing is 100% effective. Even the Virgin Mary got knocked up, and if you are atheist well then still, nothing is 100% so there ya have it.

For those of us who haven't chosen the Sisterhood as a lifestyle, let's move on to more obvious things. Condoms. Condoms are 88% effective. Why only 88%? Operator error. What this means is that you must put the condom on BEFORE the penis goes into the vagina. Not after, not "just before he cums" or anything else. These are meant to protect you from sperm that leaks out the entire time a guy is hard. So before that thing goes anywhere NEAR your va-jay-jay, wrap it up. Not a fan? Let me just tell you about a store I saw one time, called Condom Kingdom. This place had it ALL!! I never knew the all-wonderous sex sock could come in SO many shapes, sizes, flavors, with add-ons and OMG that place was amazing. So before dissing on the sex sock, see what there is cuz you really have NO idea. I didn't. :) The bonus of condoms is protection against STD's as well and, when used correctly, pregnancy. Multitasking at its finest!

OK so let's say you've gotten a regular sex partner, you've both been tested (and treated if necessary) and condoms are nothing more than a Saturday night novelty. Hormonal birth control. This is a LONG subject, so I'll keep it fairly simple. Hormonal birth control has estrogen and progesterone in it. Some only have a type of progesterone.  Available forms are: pills, patches, NuvaRing, shots, arm implants and Mirena IUD (that one has a type of progesterone in it). Hormones are a medication and there are some people who should NOT be receiving estrogen-containing birth controls. people with certain bleeding disorders or lupus, smokers over age 35, anyone who's ever had a blood clot in their body or those with poorly controlled high blood pressure. Why? Because these people have blood that LOVES to clot. The estrogen in birth control pill makes this worse. Bad, bad and bad. If you smoke, stop. It makes you sound like a dude and cuts off an otherwise useful form of birth control. The progesterone-only birth controls like depo provera, Nexplanon (arm implant) Mirena IUD and the mini-pill are great however have known possible side effects such as irregular bleeding, weight gain, breast tenderness, moodiness, ovarian cysts and more hair in your brush than usual. These do not happen to everyone, but are among the more well-known side effects. So pick your poison, if you will, but unless you want more of your lil genetics running around I suggest you find something that works.
Actual question: "I heard Yaz is bad, so I don't know about that one".  Here's the scoop. Yaz is a form of birth control pill with a special type of progesterone in it. There may be an issue with this causing more than the usual rate of blood clots among pill users. Here's my medical advice: If you get a clot on ANY kind of birth control, regardless which one (cuz they ALL increase risk, remember?) You are banned from estrogen containing birth controls. Any of them. There have been two very, very large studies on this pill, one showed more risk and the other one didn't. So here we are back to square one on that with a warning pasted on the box. It's a decent pill and is known to be the least androgenic (dude-like qualities) of all the pills. Good for acne and bad PMS, too, so take into account what your issue is before watching late-night lawyer commercials.

IUD's. IUD's are a great form of birth control because you don't have to think about them. Mirena IUD is good for 5 years. Paragard copper IUD is good for 10 years. These both have multiple ways to stop pregnancy, none of it causing abortion. They do other things, like slow down the tubes and make the environment a poor one for sperm and egg to meet up. Mirena thins out the uterine lining too, making heavy bleeding a thing of the past for lots of women but has a side effect of irregular or sometimes constant vaginal spotting for at least 3-6 months after insertion. Paragard lasts 10 years but will cause an increase in cramping and bleeding.  There are only certain women who can't have either of these, such as those with known endometrial cancer. Doesn't matter if you've had a baby either, you can still get these. People will say "but doesn't that hurt more if you've never had a baby?!"  I can't really think of a vaginal procedure that's pain-free or comfortable. Never have I had a patient say "wow, that exam was so.....comfortable!" I just never hear that. So discomfort be damned, if you want this and are OK with a bit of mild discomfort then just go for it.  Your doctor will go over other risks, like what happens if it gets in the wrong spot or falls out.

That's it for today, Part 2 will deal with emergency contraception-what it is, how to get it if you need it and what the risks are.
Happy Hump-day!!!

Having Fun With Your Vagina-Sexual Pleasure Part 2: pain, pleasure and all sorts of stuff

Hello to all!

After perusing the more "adult" places in town and on earth, I have come to two seriously major conclusions: First, WHAT ARE THESE PEOPLE THINKING??? OMG, whoever encourages a woman to take a "stimulating" pill needs to have a lobotomy for thought-process improvement. Or at least for my own sense of justice. Second, there are more ways than one to have an amazing big O, and these places are a wealth of information and fun!

About those pills, supplements and whatever else is advertised to get a girl hot just by taking one, two, six, or whatever. These are NOT reliable ways to get you going. Why? Because girls are emotional creatures by nature, and if we don't "feel it", there's not much that's going to surpass that to really getcha in the mood. Some of these supplements, vitamins, pills or whatever are hawked as the way to pump up your sexual pleasure. They even show hot women in lusty poses with their lover poised to pounce. REALLY??!!  Most of these won't do anything, and some will actually cause severe irritation and itching. Um, and this is hot why????  Don't waste your money.  Let's talk about some REAL ways to hike up the horny in all of us.

There is actually a lot of reasearch in the gyno community about sexual libido and pleasure in women. Doctors talk about using viagra on women, and there is evidence this may actually work when all other causes for lack of horniness have been ruled out. This is a doctor-patient thing, and you CANNOT get this without a script so see your doc. Don't try to order over the internet, you never know what you are getting with this and your doc needs to review your other medications to make sure there are no dangerous interactions so if you have questions about this, go see your gyno.

Lubes. We talked about this before. Check em out, find a nice flavored one. Getting your partner in the mood is likely what's going to make it hot for you, too. These are a decent way to start, just watch out for the warming ones. They have a tendency to sting and burn. Keep an eye on the ingredients, cuz remember ladies: allergies are a sure fire way to turn hotness into not-ness so watch what you're putting in there.

Toys. There are more toys than I can list here. Take a look, see what tickles your pink (ha!) the most and give it a go. Remember, go to a reputable, clean store and the staff there should be able to point you in the right direction. This is no time to be shy, either! Ask for what you want and if something you see isn't instantly self explanatory, ask for assistance because these people have not only heard and seen it all, they can point you in the right direction for what interests you. You might even discover a hidden pleasure you never knew you had, so check it out! Remember: if you are sharing a toy with another female you CAN get STD's this way so the STD rules of testing your partner still apply. And don't forget to wash them. You can buy special wash because many of these toys will break down if regular soap is used. Don't forget this step, ladies. That's just disgusting!

One important point here ladies. There are numerous toys for anal exploration. Yup, up-the-butt fun. If you use any of these, be SURE there is a way to hang on to it on the outside. In other words, NEVER....wait, lemme say that louder. NEVER put anything in your butt that can be "lost" up there. Unlike your vagina, your butt is an opening to a VERY long tube called your colon. Things can and do get lost up there, and it acts like a suction tubing if you lose something up there. This may require a major surgery and sometimes can result in loss of part of your intestines. WOW, that doesn't sound hot at ALL!! Just be careful and don't lose your grip. Your surgeon will thank you and you will be one unhappy chick if your butt is clogged with something odd. We have found items like candles, cucumbers, toys, bottles, bottle caps and more. Talk about a great party story!!

Whew! I need a cold shower now! But let's talk about WHY this stuff happens in the first place! There are a lot of reasons girls aren't feelin the love, let me list a few here
1. Stress!!!!  You've heard it, you know it, so review your life before heading to the store to spend money on items that might be cured with  a quick review of what's upsetting you in general.
2. Medications. Some medications that you take might cause a decrease in sexual interest. Mostly that's going to be antidepressants. If you started taking an antidepressant of some sort and noticed you are having issues in the sack then talk to your doctor. There may be some other ones you can take that won't do this but for goodness sakes don't just stop them! That can be dangerous to your health so if you think this might be the cause talk to your doctor FIRST.
3. Chemo and radiation treatments. If you have been treated for cancer of any kind, this will definitely affect your libido on many levels. Your cancer doctor can help you with approved therapies in addition to your regular gyno so don't be afraid to ask. You've just been to hell and back so you deserve to be sexually happy, my dear wonderful survivor! We can help if you allow us and we will work closely with you to find the best way to get you back to rompin'!
4. Menopause. Changes in hormones are a huge contributor to our sexual function. Getting hot takes on a whole new meaning here! Vaginal dryness, irritation, moodiness, not to mention the irregular and sometimes heavy vaginal bleeding. There are lots of reasons women dread this normal change. There are a few ways to help the symptoms of menopause, some work and some don't. Soy is touted as being good for hormonal balance during this time but we as scientists aren't quite sure about this one as there doesn't seem to be a lot of hard evidence that it works. Black cohosh and Evening Primrose oil are used as natural substitutes and can sometimes work very well. They are generally safe, but talk to your doctor first so your gyno can review your history and any other current medications that may interact with these. Hormonal replacement therapy is also an option but not for all women; there are strict rules governing the use of hormones and your doctor can review these with you to see if you are a good candidate for hormonal therapy.
5. Pain- OK maybe some of us actually kinda dig the "hurts so good" but mostly if you can't stand the pain, getting it on is going to....well....kindve suck! So if you have pain with sex that doesn't get better, come in for an exam so we can determine the cause. There are a LOT of structures, bones, muscles, nerves and more down there, and to determine the cause of the pain we must do a thorough exam and history review. So before assuming the cause of the pain, get a full exam because it may not be what you think. We also have ways of helping this so see your gyno. Believe it or not, there is actual physical therapy for vaginas! Yes, you heard me right...it's a bona fide real scientific field and there are physical therapists who do only vaginas so this may be an option for treatment if your doc thinks it will help.
Man, that was a lot of info!! If you have questions, post it and I'll answer you because I guarantee that someone else likely has the same question and can benefit from the answer as well! Now get out there and get busy, ladies!
-The Doc

Having fun with your vagina-otherwise known as sexual pleasure

Happy weekend to all!
Gynogrl has been visiting all sorts of wonderful and sometimes VERY weird places in order to bring you the most information on what products are available to help us all have more fun in the sack. Women in general have so many questions about this stuff that this will also be a two-part post, since there are lots of issues to address. So get yourself some tea or wine, and cuddle up for some reading of the sexual kind!

Often times I have women come to me with all types of sexual issues ranging from lack of interest to flat-out severe pain. Let me start with some sexual pleasure basics. First, if you have studied psychology in college or just read a few books about human sexuality you will be familiar with good ol' Freud. This old coot was the de facto expert of his day in the field of gettin' it on. Interestingly enough, he also had this thing about discussing whether or not women could or should orgasm from clitoral stimulation or vaginal stimulation. He stated that clitoral stimulation was a juvenile form of orgasm and vaginal stimulation led to a "grown-up" form, more womanly orgasm. Hm. I bet he never had a rabbit vibrator or a vagina!  Women can and do climax from all kinds of stimulation, and some of it doesn't even have to do with either the vagina OR the clit! Maybe it's hot kissing on your nipples with some tongue action, or a super-hot makeout session. Either way, any climax is good and whatever it takes to get you there is where you need to be.

As you may have heard before, women and sex are very emotionally connected. Men are visual and as such any perceived hotness can lead to a stiffie for them.  Heck, seeing a new power tool can set them off! Girls however are NOT wired this way. We need emotional connections and if there are stresses in our lives in ANY part, we are less able to get our freak on with any kind of enjoyment. So if you are concerned that you "aren't in the mood" lately, ask yourself what is going on in your life. New baby? That's a sex killer. New job? Work stress? Financial stress? Family stress? Anything that distracts us in this way will do it so before you think you are "broken", take a look at your life and see what's up. 

OK, so your life is fabulous and you aren't stressed at all. Maybe your sex life is pretty dang good the way it is, and you just want to know what else you can do to up the ante. The first place some women head for is the lube isle at the drug store or the local adult book hangout. There are some amazing lubes out there and they come in all kinds: regular, warming, numbing, tightening, etc. The important thing about lubes is you want a water-based one so it doesn't interfere with condom use. Unless you WANT to play Russian Roulette with baby-making then hey, it's up to you. A few other words about lubricants. Warming lubricants can be very hot but can also cause severe, and I do mean severe burning and pain. This is a TOTAL mood killer, since if you are sensitive to this you will jump right up after applying, screaming, running to the bathroom for relief. OMG.  I suggest if you are going to try this, test it on a VERY small spot close to your vag. Most women are extremely sensitive and this small test will save you from burning your poor vag and giving your partner some very bad PTSD. Also remember that vaginal penetration causes very small tears in the vaginal walls sometimes and if you get some of this lube into those small tears you will NOT be a happy girl. Warming lubes are best used VERY sparingly. Tightening lubes. There are several of these that claim to tighten your vagina temporarily to increase sexual sensation. My advise is that these are fine but read the ingredients. Many of these have herbal components and if you have an allergy to these you will again not be a happy girl. If the ingredients are not clearly listed, DO NOT put this in your va-jay-jay. Remember, we don't put weird or unknown things up our crotch cuz the outcomes can be icky, icky icky.  Numbing lubes. Some of these are used for anal sex and some are used to decrease male sensation (ie, he rubs it on his penis so he can't feel as much and then doesn't ejaculate too quickly). Remember whatever is going on your partner or your toy is going to end up in your vagina at some point. So that numbing lube might just kill your vaginal sensation. Not cool, dudes! Use it sparingly on him, and use a regular water-based lube for you. Speaking of, there are a TON of regular lubes, some flavored and some just plain, ole slick-it juice. These are great fun to play around with, so test some out and see which one works for you.

Now that we've talked about lubes, let's talk about sex. We gynecologists have a saying about the male penis: long and thin gets it in but short and thick does the trick.  Um, what??? Well, this means that the majority of your vaginal sensation is in the lower part. So don't worry about finding Long John Silver, just get ahold of a guy who knows how to use it and you'll be set.  Remember that old dude Freud I talked about? Well, some women use vaginal AND clitoral stimulation at the same time to climax. One thing I've heard many stories about is when a girl orgasms using clitoral stimulation first (like oral sex or using a toy) then follows with vaginal penetration. This is an excellent (yeaaaaaa!) combination because once you orgasm that way, your vagina is engorged with blood and ultra-sensitive. Your partner doesn't like going downtown? Well, that my dear ladies is what a vibrator is for. There are ones just for clitoral stimulation so find a nice one that doesn't look too scary and get to it. Believe it or not, there really ARE some reputable adult stores where the staff will assist you in finding one, you just have to muster up the nerve to ask. And after conversing with some of these staff myself I discovered that, like me, there is NOTHING they haven't heard before or are embarrassed about so don't be afraid to ask! Stick to a store that appears friendly, clean, is on the beaten path (no back alley skeevy dives!) and one that displays everything clearly; staff should be friendly and helpful and will give you the info you need without embarrassing you.

Whew!! Time for a shower!!  Part II will talk about supplements in said book stores and what you can expect from these, a few popular toys and basically just getting back in the mood in general. We will also address pain during sex and what to do about that nonsense since no sex makes for cranky girls everywhere. Stay healthy, ladies! -The Doc

OMG, my vagina looks....WEIRD!!

Occasionally, I have a patient who comes in because she feels like "there's something falling out" or "I have something hanging from my vagina", or even "OK, that THING wasn't there before!!".  So let's talk about vaginal appearances, what's normal and when to come see one of us as a gyno.

Playboy, Hustler: I want to poke you in the eyeballs. Why?? Because women (and their dudes, chicks, or whatever) have developed a "vaginal ideal". That means that those perfect-appearing va-jay-jays, succulent labia and near-nauseatingly perfect thighs that all this vaginal perfection sits between has given us all an altered sense of what our down there parts are supposed to look like. Women are going to extremes including getting facial fillers injected into their labia to "make them look better" to match this vaginal ideal. WTF??? Besides, my friend who does photo editing states most of these are not "real" but are more of a "fixed up" version of a photo. So basically women are pursuing an ideal from what is essentially a cartoon. Awesome.

Let me just say this: vaginas and their accompanying labia all look different. Let me say this again. Lady bits all look different. There is no such thing as a "perfect" set of labia, or a perfect vag, clit, or any other anatomical part. We can all agree on certain movie stars or gym goers who have perfect anatomy however our lady parts are unique to us just like the shape of a face. No one gets their face bones rearranged on purpose. There is a major exception to this, as with anything. Some women suffer from excessively large labia. By excessively large, I mean the ones who have issues with their labia getting caught in their zippers and causing issues wearing every day clothing or exercising. This can be corrected and only a qualified gynecologist should do this. Ladies, do NOT go to a physician who says "yea, we can just cut/laser that right off!" because this person clearly has no idea how our lady parts function and nothing should "just be cut off" without a clear explanation of the risks and benefits. If this is procedure is done without knowledge or respect of what is functional vaginal tissue (and our labia have this) you can have life-long pain issues, loss of feeling or other serious issues that may never be corrected. There are a distinctly clear set of surgical guidelines and recommendations that must be followed and you need to be clear on the risks of surgery; so be sure your gyno knows their stuff.

Childbirth. Children change our lives in ways we could never have imagined (such as sleep patterns and the recall of how much of a pain we all were to OUR parents!). Sometimes, they change our vaginas, too. During birth, things stretch. A LOT. Most of the time, it snaps right back, wash after wash. Why do you think men call it "the wonder box"? Because it's capable of giving life, love and all sorts of interesting Saturday night fun. Sometimes there are tears in the vagina which are usually repaired. afterwards however things can look a bit different. Some pieces of tissue are larger than others, some stick out more and some are more noticeable. Don't worry, it's OK. Your significant other will still see it as your vagina.  But what about that bulging thing coming out?? Well, keep in mind that there are other things down there. Here's the order of it all: bladder sits on top of the vagina. Your poop chute, or rectum, sits just under the vagina. If your vagina is stretched enough during childbirth, sometimes it weakens the walls enough for these two things to bulge into your vagina. The fancy party words for this bulging  are "cystocele" (meaning bladder bulge) and "rectocele" (meaning rectum bulge). These are usually no big deal and aren't particularly abnormal unless you end up peeing or pooping on yourself, a party faux pas fer sure!!! We can fix that, so come in for a full exam if that's your issue.

Sometimes I have a young woman (young as in less than 70 years old) come in saying "my uterus is falling out!!". Keep in mind this is RARE in a young woman and I can almost guarantee that whatever it is, your uterus is not falling out. This happens frequently to women who are in their 70's and 80's though, so if THEY tell me their uterus is falling out, it likely is.

So about that weird "bump" that comes and goes. You know those tonsils you may have in your throat? No, you do not have tonsils in your crotch. However you do have lymph nodes, which are part of your body's own cleaning system. They sometimes swell up (just like tonsils) and then go back down. Bad stuff doesn't "come and go" but lots of other normal things do. If it starts to hurt and doesn't go away, come in and visit and we will check it out. But if a "lump" shows up occasionally and then goes away, likely it's no big deal. Just don't try to "pop" it, because if you do you will be in a LOT of pain (really, who "pops" a lump on their vagina anyway??? OUCH!) and doing that opens you up to infection. If you have a lump that is red, painful and appears to have pus in it, please come in to get it checked out. It could be something more serious and only your gyno can figure that one out. Don't pick or pop. You will not be happy when you can't walk because your vagina hurts too much. And for your own vaginal happiness, don't stab anything.  Stabbing a lump with a pin or needle is going to hurt like nothing else and besides, who wants to be the girl who goes to her gyno and starts off with "well, I stabbed it with.....". You will get the raised eyebrow, head shake and if you are my patient, the "why are you stabbing your own vagina??" question! Don't be THAT girl.

That's it for today, stay tuned for the next topic, how to have fun with your vagina. Otherwise known as sexual pleasure. Stay healthy! -the Doc

Whew!! What's that...SMELL?? Part 2- fixing a stinky vagina

Now that it's been established that all women have had a smelly va-jay-jay at some point, we really need to talk about fixing that stinkiness since no woman wants to be "THAT" woman who clears a room simply by sitting down. Ick.

Douching. I will be straight-forward about this one. No. No, no, no and no. There is never, ever a good time to douche, since douching clears away the good bacteria we all need to stay healthy. Besides, vaginas are supposed to smell like.....vaginas! Not Mountain Fresh, Berry Breeze or whatever other flavor of the month companies hawk as the newest thing. This brings up a very important point for discussion. Douching is advertised to help women "feel fresh". Ladies, if you have that "not so fresh feeling", you need to see your gyno. Douching has never once in recent medical literature been proven to help us "feel fresh" and I can guarantee that your vagina is not dirty enough to need cleaning. I will repeat that, just for clarity. Your vagina is not dirty, therefore does not need "cleaning out". I have seen diseased vaginas, those with bacterial or viral infections, some with yeast infections, and some poor vaginas that were just plain angry and red due to exposure to soap, douching or other ill-fated attempts to "clean it out". I have NEVER seen one that needed dusting or "cleaning out" and I have seen more vag's than any rock band in history.

STD funk. If you suspect an STD of any kind, run thy butt to the nearest gyno for testing. As I have said, monogamy on YOUR part does not guarantee the absence of STD's. The symptoms usually show up within 2 weeks of the first exposure (some earlier) so if you notice a "sore" spot, green or white discharge, a faint fishy odor or an odor that knocks your socks off, come get tested.  As I have said, gyno's have generally heard and seen it all so don't think you will "shock" us with your story of acquiring STD's. It's all been heard before. Your doc should take care of your health, not judge your lifestyle so don't feel bad about dishing on the number of sexual partners you've had, just be straight up so we can be straight-forward. And if your gyno is judgemental, just fart during the exam. It will be your best revenge.

Bacterial funk. As I said before, anything can change the bacterial imbalance of vaginas such as your hormones or sex. These funny smells are usually mild and go away on their own. Some women have major issues with recurrent bacterial infections. There is some evidence that all those probiotics people take to poop on a more regular basis may help women who have a constant battle with vaginal shtank. Give it a shot, these are oral supplements and easily found. If your funk doesn't go away, we can help you with medication either orally or a vaginal cream. Women who have had many yeast infections generally know what this feels like and can try an over-the-counter cream but if it doesn't work, come see us.

Funny story: I actually ran into a patient in the store who "read on the internet" (OMG) that she could put yogurt in her vagina. She was really going to do this. Just like with douching, don't stick weird things in your vaginas, please. It makes for a gross exam and makes us all wonder what ding-dong is writing this stuff. Again, nothing in your vagina unless it's specifically made for that (like yeast creams, lubricants, etc). It's just odd.

Foreign bodies. OK let me be straight-forward here. Some women like toys. A lot. And some like to experiment with all manner of objects. Whatever. Just make sure it comes out again. Keep tabs on what goes up there so you can get it out. If you cannot get it out, this is not an emergency but come in when you can and we will fish it (whatever IT is) out.  It's not going to go into your abdomen or migrate up out of your vagina, so relax. We can and do this all the time, however an ounce of prevention is worth a pound of sitting on a gyn table, legs in the air. Try to keep an eye on what's up there.

Cleaning. OK let's say you just can't get over the whole "it's dirty I have to clean it" thing. Fine. Water ONLY. No soap, special washes, gels, douches, wipes etc. Just...plain...water. Use your hand, it's the most gentle. The vagina is a self-cleaning organ that doesn't really need your help. Have fun with the shower head if you have to, but water is all you need. I really can't elaborate more than that.

That's all for today! Please post any questions you may have and I will be happy to answer them, since we all deserve happy healthy va-jay-jays. -The Doc