Feeds:
Posts
Comments

What you describe is an unpleasant (you said “putrid”) odor, almost like ammonia. The odor is worse after intercourse. You wonder if it could be related to an ablation you had over a year ago. Tests for yeast infections and trichinosis have been negative.

Your symptoms don’t sound consistent with an effect of the ablation. A much more rare possibility might be an intrauterine infection following the surgery that is chronic and causing these symptoms, but I rule it out because it would most likely lead to other physical symptoms. An endometrial biopsy would be needed to assess that possibility.

What it sounds like is bacterial vaginosis (BV), which is an overgrowth of bacteria in the vagina resulting in a discharge and odor. It is treated with antibiotics (oral or vaginal). Some women are prone to recurrences; if you are one of them, you may be helped by a product like Balance Moisturizing Personal Wash. You could also consider using ProB, a daily oral probiotic for vaginal health, available over the counter. It contains lactobacilli which are important in maintaining a healthy bacterial balance.

Here’s an overview of vaginal health, which you could consider when you’ve recovered for other ways to keep your pH in balance: Vaginal Health Begins with Bugs.

The Intensity, which we call a “pelvic tone vibrator,” would certainly not be harmful in any way. There is some clinical evidence that increasing pelvic floor muscle strength and tone may improve prolapse a bit, and it is very possible it may reduce the progression or the prolapse to some extent.

The Intensity adjusts for a perfect fit and then uses electrodes to stimulate muscle contractions to increase tone. It has an additional vibration function, because that, too, increases circulation in surrounding tissues and orgasm is, in itself, great pelvic floor muscle development. (Read more here about how to use the Intensity.) The makers of the Intensity recommend that you be able to insert the Intensity shaft at least four inches for effective use.

Good luck!

Summer has finally arrived, along with the opportunity (and energy) for different kinds of date nights. My date night strategy in the summer is driven by the climate where I live: Summer is a short season, but the days themselves are blissfully long, with daylight that extends until 10 p.m. That makes it easier to plan date nights that are active. It’s a great time to change things up with your partner to keep things interesting. Here are a few ideas to get you started.

Couple walking beachPush a favorite activity in a new direction. If you already enjoy taking a leisurely evening bike ride together, that’s great! Your body thanks you and your relationship is likely stronger because of it. You already know that biking is something that works for both of you. Now just add a twist, perhaps by trying tandem biking, or by planning a daylong (or even overnight) bike trip. If you like to walk, consider doing more strenuous hikes. You might be surprised by how much tackling something that’s familiar yet challenging invigorates your relationship.

Get competitive! You and your partner might not think of yourselves as competitive. But competition has some things to offer a relationship. First, it gives you a common goal. Second, preparing for the competition—whether that’s a 5K or a chili cook-off—automatically carves out “couple time.” Finally, struggling together—the frustration, hardship, mutual support, and laughter that are all part of it—can strengthen the bond between you.

Walk—or foster—a dog. Sometimes seeing your partner in a new light can make you swoon all over again, almost as hard as you did when you first fell in love. The Humane Society has lots of opportunities for volunteers, including playing with and walking dogs. What better way to enjoy each other’s company than spending quality time with small fluffy animals? (Just make sure you know where you both stand on actual adoption.)

Be a tourist in your own town. This is something you can do even if—perhaps especially if!—your town is not a true vacation destination. Put together a short list of the best places in your area, and then spend a date night visiting them. Maybe it’s a museum, or a small park that has rare flowers, or a kitschy attraction just off the nearest expressway. You may have to get creative and keep a sense of humor, but that’s part of the fun. Miniature golf, a river that’s great for tubing, or a pick-your-own farm—all are fair game. You may develop a whole new appreciation for where you live, but at minimum you’ll have fun trying together to achieve that appreciation.

Intercourses CookbookPack a picnic that feeds your relationship. What would a summer date night list be without this old chestnut? Incomplete! What can make this traditional summer date night special is what you choose to talk about while sitting on a blanket nibbling on cheese and grapes. Choose something romantic, like how you met. Or something important, like what keeps you awake at night or what impractical thing you still dream of doing. Or work together to create a list of where you’ve celebrated every anniversary since you first got together. All of these topics feed your relationship. They open you to insight about each other and reminding you why you were attracted to each other.

If you forget everything here, I hope you’ll remember the underlying premise: Get out together! Get moving together! Both are sure to bring you together emotionally, and that is where intimacy begins.

Re-engaging in intimacy is a bit different for each individual, just as everyone’s first experience of intercourse is unique. Some of the “preparation” can depend on the partner, the scenario, the amount of foreplay, and so on, so it’s a bit tough to know exactly when “you are ready.” I hope you can move into this slowly and gently to determine your readiness as you move forward.

An exam by your provider can tell a great deal. How comfortable was your last pelvic exam with speculum placement? I tell women that when I do a pelvic exam and place two fingertips into the vagina comfortably, it is quite likely they will be comfortable with intercourse. Because there are variations in male size and female elasticity, that may not always be 100 percent accurate.

Vaginal lubricantsYou say you’re taking vaginal estrogen, and that should be very helpful to your tissue health. This is a time using an intravaginal vibrator (like the Liv2 or Celesse) may be helpful. Can you insert and use these without discomfort? Having a good lubricant is very important as well. Most menopausal women benefit from a silicone or hybrid lubricant (and this article describes the variety of lubes and how you might select and use one). Some women need to use vaginal dilators to do some stretching of the vagina in advance of intercourse.

I’m so glad to hear you have found someone special to share intimacy!

Walk into any drug store and confront the aisles of skincare products: cosmetics, conditioners, lubricants, lotions, potions, and creams. If you’re looking for the safest, least allergenic product for your particular skin—good luck.

You walk up to a counter and how do you begin? How do you interpret the labels; how do you cross-reference which products might have been the irritant? It’s an impossible task to do as an individual.

You could read the teensy print on dozens of bottles and attempt to identify which unpronounceable ingredient might be causing your itchy rash. You could try to find products without parabens or Methyldibromo Glutaronitrile (yeah, that’s a thing). You could buy something expensive because the label says it’s “dermatologist tested” or “hypoallergenic.”

Or, you could go to the SkinSAFE website where that analysis has already been done on tens of thousands of products that touch your skin, from shampoo to cosmetics to sexual lubricants. There you can find products with the “TOP Allergen Free” designation, meaning that they contain none of the ingredients that have been identified as highly allergenic. You could also scan your favorite product into the SkinSAFE app on your smartphone to find out how that product ranks on the TOP Free scale and what allergens it might contain. Both the app and the website are intuitive, easy to use, and give you information that was impossible to find before.

 

You just need to know. Information is power.

This gargantuan effort is the result of decades of patient data painstakingly collected by dermatologists at Mayo Clinic and compiled in a user-friendly internet platform by Michelle Robson, creator of EmpowHER, a website dedicated to providing credible health information for women. (Michelle describes her journey in my podcast series, Fullness of Midlife.)

According to its clinicians, the number one complaint that brings patients to Mayo Clinic is skin conditions. Research also suggests that up to 45 percent of contact skin allergies could be avoided by using allergen-free products like those with the TOP Free designation on the SkinSAFE website. This kind of scientifically sound, third-party ranking of everyday products according to their allergenic properties is a huge public service, not to mention one that could avoid many trips to the dermatologist.

Top Free Uberlube LubricantSkinSAFE is a significant tool empowering consumers to make informed buying choices in an industry that’s been confusing at best and misleading at worst. It creates a meaningful designation—Top Allergen Free— based on science rather than marketing hype; it eliminates price from the equation. Neither price nor labels like “organic” or “hypoallergenic” are indicators of a product’s allergenic properties. Maybelline products, for example, are just as likely to receive the TOP Free designation as more exclusive brands. (And Uberlube is among the TOP Free products you’ll find in our shop.)

“There are a lot of myths about skin-care products,” says Dr. James Yiannias, a dermatologist at Mayo Clinic and co-developer of SkinSAFE, “so if you choose a product that says ‘hypoallergenic’ or ‘dermatologist-tested’, unfortunately, it doesn’t really mean a whole lot.”

For example, we often think of botanical ingredients as “natural” and thus harmless. We’d rather put something natural on our skin than a product laced with unpronounceable chemicals, right? But botanicals can be just as allergenic as synthetic ingredients. One of the major allergy-causing ingredients in skin-care products is fragrance. And “fragrance” can include natural botanicals, such as balsam of Peru, which is highly allergenic.

For most of us, this information just helps us make better choices in skincare products. But for those of us who truly suffer from skin sensitivities or allergies (which often only become more severe with age), it’s critically important information. The SkinSAFE website has a special section for those with very sensitive skin that allows you, presumably along with your doctor, to create a “personal allergy code” (PAC) that filters out products with your specific allergens and only shows you products that are safe for you to use based on your individual profile.

The SkinSAFE app and website are a tremendous resource intended to empower consumers and clinicians alike with current, credible, and badly needed information. And we’re adding SkinSAFE ratings to our product pages and submitting not-yet-rated products for SkinSAFE review. Because as Michelle Robson says, “You just need to know. Information is power.”

 

You describe two issues, one of which is painful sex and the other is embarrassing sound effects when your partner withdraws. You’re wondering why that happens and whether you can change it.

Vaginal DilatorsI don’t have an absolute solution for your dilemma, but I do have a suggestion that I hope will be helpful. We consider the vagina to be a “potential space”; in other words, the walls of the vagina are usually collapsed but can create “space” when needed – when you insert a tampon, for example, or during intercourse. When the space is created, air can, as you describe, enter and be trapped; the entering object (a penis, during intercourse) forces the air out. If the space is tight, there’s likely to be that sound effect you’ve noticed.

You may consider using vaginal dilators, which gently stretch the vagina, giving it greater capacity in both width and depth. This should both reduce the painful sensation of tightness you experience and the likelihood that air escaping will cause the embarrassing sounds.

I think this is definitely worth trying. Good luck! And in the meantime, remember that sex for everyone includes at least some messiness or awkwardness – and one of the joys of midlife intimacy can be the playfulness of laughing together.

You say you’ve tested negative for herpes 1 and 2 antibodies, while your partner has tested positive for the herpes 2 virus, though he has not shown symptoms. I don’t find your situation unusual, and it does pose a bit of a conundrum. The reality is that using condoms is the most reliable way to prevent transmission, but in a long-term relationship, I understand that it’s not desirable.

I find that the most up to date and reliable information regarding HSV (and other STIs) is the Centers for Disease Control and Prevention (CDC), which is what I use to counsel patients:

  • HSV can be transmitted when lesions are not present.
  • Anyone with a HSV diagnosis is encouraged to inform current and future intimate partners, and to abstain from sex when lesions or their precursor symptoms are present.
  • Correct and consistent use of latex condoms might reduce the risk of transmission.
  • “Daily treatment with valacyclovir 500 mg decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences. Episodic therapy does not reduce the risk for transmission and its use should be discouraged for this purpose among persons whose partners might be at risk for HSV-2 acquisition.”

What that last point means is that ongoing daily treatment with a prescription for an antiviral therapy by the affected partner can be effective protection to reduce the chances of transmission; “episodic therapy,” meaning the antiviral is taken only in cases of an outbreak of lesions, will not provide that protection.

I hope this is clear! You can have intimacy confidently, and I’m glad you’re researching the steps to take!

%d bloggers like this: