- 3 years ago
Nicole Michalik and Marisa Magnatta speak with Theresa Adeliyi, MD Medical Director, Virtua Center for Women. They discuss UTIs, Vagina issues, Sex and Sweat
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00:00Hi, it's Nicole from 92.5 XTU.
00:03And I'm Marissa from the Preston and Steve Show on 93.3 WMMR.
00:07And I'm so excited to have this incredible doctor who I like to say she's like my friend
00:14on Zoom, medical director from Virtua Center for Women, Dr. Teresa Adele-E.
00:21You got it.
00:22Welcome.
00:22See you again.
00:23Welcome.
00:24Thank you for having me again.
00:25It was so fun last time.
00:27It was.
00:27It was so fun.
00:28And Virtua is amazing.
00:29And you were just so open and incredible and made all the women feel so comfortable.
00:34So this Zoom is just going to be an extension of that.
00:37And so here's the thing.
00:39We're just going to get right into it because this is 10 things to ask your OBGYN.
00:45So many women are so embarrassed.
00:49You know, they're like, we can't talk about vagina.
00:51We can't talk about, you know, you grew up in your, they call it an area.
00:55No, it's a vagina.
00:56Right.
00:57So let's just go into it.
00:59Is vagina itching normal?
01:02The short answer is no.
01:03Okay.
01:04But for the most part, the reason why people have vaginal itching is mostly benign problems.
01:10Right.
01:10So it can be anywhere from irritation.
01:13You know, if you're a sweaty girl down there, you work out, you have a lot of moisture, combination
01:18of that can cause irritation.
01:19It can also be the things that you use, like the soap, the detergent that you use, it can
01:24cause that kind of irritation and itching down there.
01:26Now, there can also be for menopausal women.
01:29If you have dry vagina, because your estrogen is decreasing, it can cause the lining of the
01:35vagina to thin out.
01:36And so it can cause irritation and therefore itching.
01:38But typically, if you have a persistent of all this itching issue, especially if you remove
01:44the moisture problem, the irritation problem, especially if it's after you take a shower
01:48and you're noticing it more.
01:49And if you're over 60 years old, it could be something else like a vaginal vulva problems,
01:56but also vulva cancer can be very common in women over 60.
02:00So if you feel like this itching is not going away and it's particularly in one area of your
02:04vagina or vulva, it's definitely worth looking into by your GYN provider for sure.
02:10All right.
02:11I'm jumping in with the next one.
02:13How do you relieve UTI symptoms or even more important, how do you just prevent them completely?
02:19Well, I would first say UTI is a sexually active woman's problem in general.
02:24So anyone is sexually active can really have UTIs anywhere from once to twice a year, which
02:30is normal.
02:31So in order to prevent that, if you're sexually active, things you can do to prevent it can
02:35be anywhere from using condoms consistently because it decreases your chances of introducing
02:40bacteria in the vagina, drinking lots and lots of water because water helps flush out bacteria
02:45that might be introduced into the urethra.
02:47Um, you can also make sure you are avoiding foods that can cause more predisposition to
02:53infection, spicy, all the things I love, spicy foods, alcohol, acidic foods, drinks and stuff
03:01like that.
03:02They can increase your likelihood of having a UTI.
03:04Now, um, if you already have a UTI and you're already having the symptoms of UTI, ultimately
03:11what's going to get rid of it is an antibiotic.
03:13So you do need to see a doctor for it.
03:14But in the meantime, you know, you can do cranberry juice, real cranberry juice, not the
03:19sweetened one, like the one you get from, you know, uh, Trader Joe's, uh, you can do
03:23cranberry juice, um, voiding as frequently as you can, especially after intercourse can definitely
03:29help decrease the pain, uh, but also, um, peridium or azo over the counter, the things that people
03:34can get over the counter to kind of decrease the spasming of your bladder so that by the
03:39time you get to your doctor's office, at least you're not, so you're not dying of UTI and
03:43people should avoid fingering, you know, that kind of things also causes, um, um, can we
03:47be explicit, explicit?
03:49Yeah.
03:50Fingers in the vagina just creates bacteria.
03:53So you want to avoid that from your, I have your partner avoid that part.
03:55Yes.
03:56So you're burning everything.
03:57And what are the symptoms of UTI just in case somebody isn't aware?
04:01Yeah.
04:01So a lot of times you feel this urge to go to the bathroom, even though you don't have
04:05anything to avoid, you go, you go to the bathroom, only trinkles come out two hours
04:09later.
04:09I mean, 20 minutes later, you go back in, you, you feel like you have to avoid again.
04:13There's actually pain in the lower part of the, uh, your, um, your belly is because
04:17your bladder is contracting and spasming, um, odor, your urine can have a really, really
04:22strong smell to it and concentrated smell.
04:25Those are all signs of UTI.
04:27Okay.
04:27Well, this leads us perfectly into the next question.
04:30How much vaginal discharge is normal and what could cause an odor down there?
04:36Yeah.
04:36So patients come to me and like, it's normal to have a vaginal discharge.
04:40Okay.
04:41Like your vagina is a living, breathing vessel.
04:43Like it's supposed to have discharge.
04:45It's normal.
04:46So normal can be very scant to like a lot, maybe like, you know, you're having to wear a
04:52panty liner.
04:52It all depends on your hormonal status, right?
04:55And it changes based on where you are in your menstrual cycle.
04:58If you're in the first half of your menstrual cycle, it can be more of a white pasty, um,
05:04discharge.
05:05In the second half of your menstrual cycle, it's more like a clear, um, slippery, mucousy
05:11discharge.
05:11So those are all normal.
05:13Um, when you're menopausal, you may not have any discharge or maybe a clear with a yellow
05:18tinge to it can also be normal.
05:19So any of that is range of normal.
05:22What is not normal is if you have white clumpy, like cottage cheese, like discharge, maybe
05:28also associated with itching.
05:30If you have a green, that could be more of a, I mean, yeast infection.
05:34If you have more of like a green yellowish discharge, that might be an STD.
05:39Um, if you have more of a gray foul smelling odor discharge, that most, that might be a, uh,
05:44bacterial vaginosis.
05:45So you do need an exam to decide whether or not this is an actual infection, but the point
05:50is, vaginal discharge is normal.
05:52It can be, it can vary.
05:54It's just not supposed to have a significant fishy odor to it.
05:57Got it.
06:00Hope that helps.
06:01It is.
06:02It is.
06:02We're going to keep going because the list of questions, the most common questions just
06:06keeps going.
06:07Um, what is something that might cause a lot of cramping, discomfort, or sharp pelvic pain
06:12down there?
06:14Yeah.
06:14Yeah.
06:14So overall, you know, women in reproductive age, I believe maybe 40% of women at some point
06:22in their entire life have had some pain and that can be sharp pain from their menstrual
06:26cycle.
06:27It can be just pelvic pressure.
06:28So it's, it can be normal once in a while to have pressure or pain, but the pain that
06:33you're talking about can be based on your menstrual, where you are in your menstrual cycle.
06:36So if you're in the middle of your cycle where, where you're ovulating, you can have a really
06:41sharp pain, it usually can be on one side or the other that typically reflects which
06:45side of your ovary you're ovulating from.
06:47If you're actually on the start of your menstrual cycle and you're having some cramping, a lot
06:52of women have cramping with their periods.
06:53That's because your uterus is trying to make sure you're not bleeding too much.
06:56Now you can have fibroids.
06:58If you have fibroids, it makes that cramping and pain worse.
07:02If you have constant pain all the time, even in between your menstrual cycle, and then it
07:07gets worse when your menstrual cycle starts, that can indicate endometriosis.
07:11And so those are all the things that might be normal or abnormal.
07:15What I usually tell patients is just make sure you write these things down.
07:18Like when is the pain happening?
07:19Timing of it?
07:20You know, how long does it last?
07:22What else is happening around the same time?
07:24So that when you come to me and you tell me all these are happening, these are the questions
07:27I'm going to ask to try to figure out which is the cause of your pain.
07:30So in general, pain is not normal, but it can also be a normal association of your menstrual
07:36cycle.
07:37Keep a diary, take notes.
07:39What's that?
07:40Keep a diary, take notes.
07:42Yes, yes.
07:43We are detectives.
07:44Doctors are detectives, right?
07:45We really want to know like, when did it happen?
07:48When did it start?
07:49Like, give me some details because patients get annoyed about that, but it's really to kind of
07:53help me figure out the timing determines is it endometriosis or is it, is a pelvic, I
07:58mean, is it fibroids or is it something else like a pelvic floor problem?
08:02Yeah.
08:03So what does it mean when someone leaks, when they sneeze, laugh or cough?
08:08It means that you have incontinence.
08:10That's stress incontinence.
08:11We call it specifically.
08:12There are three different types, but the one you're talking about specifically is stress
08:17incontinence.
08:17That's essentially when you sneeze, you're increasing your pelvic pressure, right?
08:22And the normal pelvic anatomy in your pelvis is supposed to kind of kink, like create a
08:27hammock around the opening of your urethra, right?
08:30And cause you from not, prevent you from, you know, leaking.
08:33But when you, when you, when that's off, that definitely removes the anatomy to keep you
08:38continent.
08:39That can happen if you have big babies or if you have multiple babies, right?
08:42Or if you have a genetic predisposition to that, that means every woman in your family
08:46has had some kind of incontinence.
08:48Those are all the reasons why you can have that.
08:51And what can you do about it?
08:52It just depends.
08:53You know, it can be pelvic floor therapy, like Kegel exercises.
08:58It can be medication.
08:59If you have overactive bladder, because you can have stress incontinence, but also overactive
09:03bladder.
09:04That's usually when your bladder is doing this.
09:07So that might mean you need a medication for that as well.
09:09But overall, leaking when you sneeze is what we call stress incontinence.
09:14All right.
09:15So we should all be like looking at ourselves down there and used to what we see, but could
09:20potentially cause like a new lump or a different bump that we're not used to.
09:25Yeah.
09:26I have a patient come to me and tell me, I have this lump down there.
09:28This is where it's herpes.
09:29Like, you know, it's like a herpes outbreak.
09:31It's most of the time it's not.
09:33Okay.
09:34So a new bump down there can be like anything from like stress.
09:38Like when we get stressful, you know, stressed out the creases in our area, there's lump,
09:43there's lymph nodes there.
09:44So that can be a lymph node, like just a bump from that.
09:47Right.
09:48Um, ingrown hairs, you know, we, people that shave a lot, if you don't really have a good
09:52shaving habits, you can create a nick in your skin, deposit bacteria in that follicle.
09:58And then it just starts to create an inflammation, right?
10:01And so when the inflammation starts, your body walls it off and that prevents your hair from
10:06coming out through the follicle.
10:07And then it just starts to grow and curl in.
10:09So that's an ingrown hair.
10:10It can be, um, genital, it could be warts or a skin tag.
10:14Right.
10:14Um, but also herpes, it could be herpes, but it's mostly not herpes, but usually herpes
10:21looks like small pimple.
10:23It looks like a clear vesicles, like very small dots that come in clusters and they start
10:28off as irritation and itching and tingling.
10:31And then maybe three or four days later, then you notice that crusty, that the bumps, and
10:36then later on it becomes crusted over.
10:38So that is, if you have that, that's for sure herpes, but most of everything else is
10:42usually benign stuff.
10:44Is it common for women to experience pain while having sex occasionally or regularly?
10:51I would say occasionally it's common.
10:54It's not normal to regularly have pain during sex.
10:57It's just, it just, it's not supposed to be painful.
11:00So I would say, and unfortunately a lot of women, they're, they suffer in silence, right?
11:04They don't usually say anything until I ask them.
11:06It's usually part of my question when they come for an annual exam, like, do you have
11:10pain with sex?
11:10And then they're surprised I asked them about a question and then it's like, wow, they
11:15just like reveal everything.
11:16So it's not common, but psychologically it can be because, you know, a woman has grown
11:22up in a household that is restrictive, right?
11:24It can be because they had a traumatic experience, rape or something like that, that, you know,
11:28mentally has affected their ability to, to really relax during sex and therefore it becomes
11:33painful.
11:33Um, if, if you have infrequent sex, I usually say the vagina is a muscle, you use it or you
11:39lose it, right?
11:40So you have to exercise it.
11:41So if you have sex once a month, that's going to hurt every time you have sex.
11:47It's just well, um, menopausal women, again, because they don't have estrogen.
11:51So their vagina is thinner.
11:53They, it hurts.
11:54It feels like something, someone's cutting in their vagina.
11:56So that definitely causes pain.
11:57Um, women that have endometriosis, they, they, they have chronic pelvic pain.
12:02And so sex can be, um, be uncomfortable for them, especially when we, what we call deep
12:06penetration.
12:07That's position such as like doggy style or stuff like that.
12:11They would say that there's usually pain around that time.
12:14Um, let's not forget size, you know, it matters.
12:18So I usually ask them, is it pain on penetration or is it pain and thrusting?
12:23So usually size is a problem with pain with penetration.
12:26And then what is not commonly known, depending on which size, which way your uterus is facing,
12:32pain can be, I mean, sex can be painful.
12:34Most women's uterus is facing forward.
12:36Some women like 20, 30%, they face backwards.
12:38And so when you're in a deep penetrative position, sex can be painful as well.
12:43Yeah.
12:44All right.
12:45I mean, that's all very helpful.
12:46I mean, is there any other things?
12:48We talked about some mental things and the pain, but are there any specific reasons why
12:53women could lose interest in sex and be changed?
12:57Yes.
12:57So like I said, if pain is sex is painful, every single time I have sex, I'm not, I'm
13:02not going to have sex.
13:03Right.
13:03And so that can be a reason why it decreases their libido because you're just so distracted
13:08with the pain.
13:09You don't want to have sex anymore.
13:10So that decreases your libido.
13:12Um, what was stress relationship, stress, or personal stress.
13:16If my mind is, you know, conceive, like conceiving everything else and my relationship is not
13:21healthy.
13:22I don't trust my partner or we have financial issues.
13:25Sex is a function of a relationship.
13:27It's the first thing that goes away.
13:29Right.
13:29And so that can decrease a woman's libido.
13:32What's not talked about more frequently is depression.
13:34You know, when you're depressed and you're sad, in addition to everything else that you
13:39like to do.
13:39And if sex is one of those things that is enjoyable for you in the past, it becomes less enjoyable
13:44when you're depressed.
13:45Um, medical conditions such as low thyroid, it kind of masks depression as well.
13:50You know, it's like a low energy situation.
13:52So again, it's, it looks like depression.
13:55You don't really have the energy to want to have sex.
13:57Um, finally, if you're menopausal, for sure, you know, your hormone levels going down, everything
14:02goes down with it with desire as well goes down with it.
14:05Yeah.
14:06And these are all things that you can address as a doctor or patient.
14:10Oh yes, absolutely.
14:11I would say 90% of those issues can be addressed.
14:13I think about it more of, is it organic or inorganic?
14:17Like, you know, organic is what we talked about, you know, family history, trauma, that,
14:21that, that aspect, you have to address it with like mental therapy, sexual sex therapy.
14:27You have to address that.
14:28But if it's organic issues, like you don't have time, you're just so busy.
14:32I tell patients like, listen, you just have to schedule sex.
14:35Sometimes they think, is that really something to do?
14:38Yes.
14:38Yes.
14:39Because if you're averaging once a month, scheduling sex once a week, definitely make
14:43increase your frequency.
14:45And I find that patients find that they start looking forward to having sex because now every
14:49Wednesday, no, no matter what, we're doing something either foreplay or having sex or
14:54something that the couple can come together to do.
14:57Right.
14:57So I find that that's useful to get the libido back for, if it's just a dryness problem,
15:02because it's painful, lubrication, coconut oil, I say you can use three times a week.
15:08Uber Lube is my favorite.
15:10You can use it for vagina and hair.
15:13Astroglide is great as well.
15:17So those are all things you can do.
15:19Um, but let's not forget estrogen.
15:20It doesn't have to be estrogen you should take as a pill, estrogen for especially post-menopausal
15:25women who have vaginal lining that's thin.
15:27You can do estrogen, vaginal estrogen so they can help thicken the lining of the vagina and
15:31make sex more comfortable.
15:32Those are all things that we can talk about in our GYN visits.
15:35And don't be afraid to talk about sex stuff with the GYN.
15:38It's really important.
15:39It's not supposed to be painful, period.
15:42Just do it with you in a room.
15:44You're there to talk and that's what you're there for.
15:46Contraception and sex stuff is my favorite thing to talk about.
15:49Yeah.
15:50And it goes back to like, I think women for so long were told that like, you know, sex
15:55isn't about pleasure for them.
15:57Right.
15:57And for changing that narrative, like women should feel good having sex.
16:02It should feel good.
16:03It should feel good.
16:04You should want to as many times as you can.
16:06And, and, um, there's things we can do if really, we just have to talk about it.
16:11And even with yourself too.
16:13Yes.
16:14Yes.
16:14Yeah.
16:16That's it.
16:16If you're single and you don't have, you don't have a man, use, use, uh, go to sex
16:20stores, stores.
16:22They love, they love talking about sexual things that you can use for yourself.
16:26I strongly recommend it.
16:27It's like, it's great for your skin too.
16:29Yeah.
16:30It really is.
16:32I know all of this is so helpful and whatever you choose, wherever you choose to live in,
16:37you know, just make sure you take care of yourself.
16:39That's the most, I hope you guys were all taking notes.
16:41Cause I definitely was here.
16:42Um, anybody who watched this video and found something, share it with a couple of friends
16:46because they probably need to hear all of this as well too.
16:50And if you would like to schedule an appointment with one of Virtua's women's health experts,
16:54they make it really easy.
16:56There's two ways.
16:56You can call 833-VH-WOMEN, or you can visit Virtua.org slash women.
17:02It's right here on the page as well too.
17:04You're just doing this for yourself.
17:06So please, please, please take care of yourself.
17:08Please, please let us know what's going on.
17:10We can, we can address almost everything you have.
17:14Great.
17:15Thank you so much.
17:16Thank you for having me.
17:18Pleasure.
17:18Thank you so much.
17:19Until next time.