vagina or vulva?

Hi Christine

I too have wondered why they talk about dry vagina so much. I have always found that my vagina is moist, more or less according to the time of the month, more mucous in the first half running up to ovulation of course, but that the vulva gets dry, almost all the time these days. And I'm not even quite at menopause yet! I figured that the dry vagina would come eventually, but maybe it won't? I just figured I was a bit different, as usual, and put some more balm on. I think your theory has some legs. Is it purely coincidence that the two conditions in women occur at exactly the same time of a woman's life, and in adjacent body parts? Maybe they are the same, just differing in degrees?

Other menopausal members, what are your experiences? Dry vagina or dry vulva, or both? And do you have LS as well?

Maybe we have all been tricked, and there was more to Thierry Vancaillie's comment about "You can't change long-standing traditions overnight", than meets the eye. It was like an 'admission under interrogation', that doctors do have secret language codes, and purposefully use anatomical language selectively, depending on whether they are talking factually and accurately with peers, or trying to kind of protect women from the real words that describe women's anatomy (as if women's genitals and the words used to describe them were dirty, and that women should be protected from all this). Noble intentions, but totally irrational!

I could get really Freudian here, but I won't.

Vancaillie really did seem to be apologising for doctors using inaccurate terms, but I gleaned from his explanation that this habit is deeply ingrained in doctor-culture; also that doctors had to be pretty careful in negotiating cultural issues and boundaries. Perhaps it is another aspect of balancing watching their ass against clear discussion with their patient, a difficult balance.

It is as if there is a very uncomfortable line between dealing with a woman's genitals in the professional arena, and dealing with a woman's genitals in a sexual, personal arena. every male doctor probably lives on both sides of that line in different parts of his life, but jumps high when traversing the boundary. ;-)

I get the feeling that in general doctors just don't feel confident talking medical language to women about the genitals of women. Perhaps they don't think we would understand so they tell us lies instead. Go figure. They can get away culturally with talking about her vulva as 'vagina', because the possibility of offending by using the correct term is too confronting for him, and he is assuming that the woman can decode the message (which probably we can't, as we don't know it is in code!). No doubt there are also women who would be offended by the real terms. I'm probably reading far too much into this, and I think Thierry Vancaillie did a good job, answering very simply a question ("Why do doctors use the term 'vagina' when they mean 'vulva'?") which had a very complicated answer; a question that badly needs resolving.

I would encourage all our Members to ask their gynaecologist or family doctor to clarify every time they use a word that doesn't make sense, eg using "vagina" when you think they should be using introitus, vulva, vestibule, or some other term. Get to know the correct terms. Pin labelled diagrams of female genitals, both external and internal to the back of the toilet door if you have to. Repeat the exercise with the male organs as well. The blokes are even more ignorant than we are about how their genitals work, and they need to know, particularly as they get older!

Treat the real terms like Times Tables, and learn them until you understand their names and functions backwards. Only then will you be able to understand what a doctor is talking about with your genitals or your kids' genitals, or your partner's genitals. These organs need to be brought out of the closet. There is too much at stake for the patient if the patient doesn't really understand what the doctor is talking about.

It also may explain why so many women undergo pelvic surgery after a short, general description of the procedure, then come out the other end wondering why they wasn't told what would/could happen, after an unexpected result. Maybe they were told everything in code at the consultation, and didn't know it was code; couldn't make sense of it, instead choosing to trust the nice doctor, ie the doctor did tell them ... but didn't tell them.

Protecting patients by using the wrong terms is simply lying to patients, nothing less. If they know that you are trying to understand, they can use the proper terms and have the person understand, rather than sitting there with a glazed expression wondering what the hell the guy is talking about.

Members, please let us know about the dryness of your vulva and vagina, and whether you have LS. Doctors are not going to clarify it, so we might as well find out from each other!

Cheers

Louise

Mae
Hi Christine and Louise,

I do not have Lichen Sclerosis, as far as I know, but about a year and a half ago, about two years into my bladder prolapse, my new gynecologist, who was insisting I HAD to have surgery (I did NOT thanks to you Christine), said my vagina was dry and gave me a sample of Replens, which, in my opinion, is the best thing since sliced bread! It so helps my bladder prolapse, which I suspect is Stage 3. I use it every 4 or 5 days and I can tell by how bad my prolapse is when I need to use the Replens again. I can't say enough good about it.

Thank you for this wonder site. It has been a God send for me and I've been following it for quite some time now, although this is the first time I have written. I have read Christine's book and have the video. I am 60 years old and have had two very large babies in my lifetime. I am in good shape and manage my prolapse with diet, exercise, a positive attitude and Replens! I am always looking for new non surgical things that might help. I was recently in touch with Gaynor Morgan, who was kind enough to send me an Incostress to try. Unfortunately, it did not work for me. I was fitted for a pessary about 2 years ago, but I find that very uncomfortable.

I have ordered the Sea Pearl sponges on the internet and am hoping that might help me on my "bad" days. One of the earlier posts by MeMySelfandI caught my eye about Incostress and also Sea Sponges. I e-mailed her and she has been extremely helpful.

Back to vaginal dryness. Give the Replens a try. It can't hurt and just might the answer.

Warm regards,

Mae

Hi Mae

Is yours vulval or vaginal dryness, or both? Do you use the Replens high in the vagina or around the vulva. Given the self-draining design of the vagina I guess it would find its way to the vulva without any help?

Cheers

Louise

Mae

Hi Louise,

Thanks for responding to me. I have just now, with my former reply to you and Christine, opened up to my POP with my response. I think I kept hoping that if i didn't say it was a problem, it would go away. Of course, it didn't and with people like you, and, of course Christine, I have gathered strength from your knowledge and support.

I have no idea how Replens works for me, but some how it does. A lot of what I insert, as deeply as I can, ends up on the mini pad that I wear after inserting. After that, I am good to go for 4-5 days. Then my prolapse become obvious (protruding) and I use the Replens once again. From there I repeat the cycle. I would be crushed if I couldn't use Replens. Granted there are days that I blow the whole thing by lifting things too heavy for me, or eating a too large a meal (although the lifting seems to be the biggest culprit for me), but for the most part, if I wake up and do the things I need to do, I am pretty much O.K.

The Dr. said my vagina was dry..Could be she meant vulva..I am not sure they have any clue! But, at any rate, Replens works for me (along with never forcing a BM).

Thanks again for responding to me Louise. It's not easy..but it helps to have such wonderful support.

Kindest regards,

Mae

Thanks for that Mae

Your comment about the doctor is exactly what Christine and I have been talking about. I wonder if they do discriminate between vagina and vulva when talking with patients? That's why I am always going to clarify with the health professional in question in future.

I am so glad Replens is working for you. I have seen it advertised and came across a couple of research papers about how it works. In theory it should be helpful. Obviously it is working for you. That's great to hear, in case I ever need it.

I notice that you have not mentioned refining your posture amongst the things you are doing. Have you not tried that yet? Or was it just an omission? I have found amendment of my posture to be be essential, and it has enabled me to continue to do things that I could not otherwise do. I don't bust my guts over lifting heavy stuff any more. I tend to use my brain to figure out another way, and usually there is one! But I can still lift heavy things, as long as I keep my butt out, my lumbar curve intact and use my leg muscles to do the heaviest bit. If I don't do all these things, I feel 'the bulge', which is my barometer. As soon as I feel 'the bulge' at all, I stop. I also find that if I do feel 'the bulge', I don't repeat the exercise and shift the whole pile. My body can often do a heavy job once, but doing it a lot of times, or for a long while is what brings me down. If I do overdo it, it may take a day or so to go back to feeling OK again. If I can see that it is a stupidly big job, I get one of my big family males to do it, or just pay somebody else to do it.

Cheers

Louise

Hi Louise,

I try to keep good posture, but I am never convinced I am in the posture Christine suggests. It feels extremely awkward, so I am sure I am not doing it correctly.

Getting back to the doctors, one really does have to clarify what is said and ask a lot of questions. In addition to that, I think it's important to take the information home that they give you, research it and come to a decision you feel is right for you. The gynecologist who insisted I had to have surgery for my bladder prolapse (which would include removing my uterus) made it sound like I had no other choice. She even followed up with a certified letter when I told her office that I decided against the surgery, stating that she had determined surgery was necessary for my condition. If I did not have the knowledge that I did about POP (my previous gynecologist, who no longer was on my insurance plan worked with me for managing it without surgery and I spent a lot of time researching it on the internet), I probably would have believed her. Pretty scary in my opinion. I wonder how many women get talked into surgeries that they might not have chosen had they known all they needed to know about their situation.

I am happy to report that this year, my previous gynecologist is back on my insurance plan! I have an appointment to see her next month. While she says, "surgery is where I make my money" she never pushes elective surgery and is happy to work with patients who want to try alternative things. I was thrilled to hear she was back on the plan.

And that's pretty much my story. Again, I am so thankful for this website and for people like you, Sue and Christine. My story might be very different if I had not found this website and read Christine's book.

Warm regards,

Mae

I definately wonder how much more common LS is...your idea Christine of a continuum makes complete sense.

re dryness....I often have inner dryness with a flareup, and with this bad flareup I had terrible dryness for the first few weeks till we managed to shift it with herbs--and I'm no where near menopause, so it is definately connected.

Mae

HMMM. I expected a reply and encouragement here. Some what surprised..guess I shouldn'd be.. but I am... Expect the worst, as they say, and you'll never be disappointed!

Hi Mae

You do certainly have a thorough approach to knowing what your doctor was on about. I wish more women did this. It is, after all, another person's body they are talking about rearranging when they are selling women surgical procedures. Yet somehow the woman treats it as if it is Tupperware she is buying! (Never mind, if I don't end up perfect again, there is always the lifetime guarantee on the product - WRONG!)

The scary bit is the registered letter, as if this gyno had some sort of authority like the Tax Office or the Police. As you say, how would the normal woman in the street take that? We are all brought up to 'follow doctor's orders'. This is probably because the medicine is always bitter, and may not do any good, but if the medicine you take makes you suffer then it must be worthwhile in the end. No pain, no gain? A registered letter is a bit over the top. If any other sales type person tried that sort of intimidatory tactic they would be hauled over the coals by consumer law.

So glad you have your old gyno back.

Re the posture, there are a few reason why it might feel awkward. It could be that you are already using it, and don't realise it? :-) Or there might be something that you don't have quite right, or an old injury or something. If you want to explore it further, post again, and we'll endeavour to help you work out what is happening. In the meantime it sounds like you are going really well.

Cheers

Louise

EDIT:
I just read your "Hi Mae, Mmmm ..." post when I posted this. Hey, give us time. I am not on the Staff of Wholewoman. I just fit this Forum in with all the other stuff happening in my life. Sometimes we all just have to be a little patient. The right person will reply, in her time. Also we are all over the world, and in different time zones, so it does take time sometimes. ;-) L.

Sorry Louise. I think I was just impatient to hear back about what someone else thought about what had happen with my situation. I think I got myself all worked up reading what I had written. I've never put all this in writing before and I have to admit, it somewhat stressed me out to do so. Almost like reliving that terrible experience with the doctor. Not every day is a good day with POP as we all well know. Thanks for understanding.

Warm regards,

Mae

That's OK.

Anyone else got any responses to offer Mae?

L

Interesting discussion about vaginal/vulvar dryness. Mae's testifying to the positive effects of Replens got me thinking. I've been aware that using Bliss Balm on and around the bulge at the base of my vagina (cystocele) helps it move more freely and retract more easily. Mae's comments led me to feel inside to test how dry my vagina is farther up, and I was really surprised that it felt so dry. I've needed extra lubrication for sex for several years (I'm 60 now and went through menopause at 45) but I had not thought about the vagina just being dry throughout the day. I think there is enough moisture and snugness in there that I can't really feel it being dry. But I now have the idea that when that dryness exists it might help CAUSE a prolapse, because when the organs do not move freely by one another couldn't this put extra stress and pull on the fascia? If dryness has helped to cause a prolapse might not lubrication enable some healing? I'm trying Replens now to help relubricate the deeper parts of the vagina in addition to Bliss Balm throughout the day to protect the tissue that is at the opening.

Thanks for your insight, Mae, about the strong link between vaginal dryness and your prolapse symptoms. It may be another piece of the puzzle for me.

On the other matters under discussion, I don't suffer from LS. I would imagine that the skin inside the vagina and the skin of the vulva may have a lot in common and that it could indeed be a continuum. I wonder too whether women with LS do not feel the dryness of the vagina just as I don't feel its being dry in there even though it is. Maybe the sensation of dryness depends on the skin being exposed to air.

I found menopause to be very easy. I knew at the time that having it so early in life was not a happy indicator, though, and that's proving to be true.

Ellen

Hi Ellen

I too have had these thoughts about the importance of reducing vaginal and vulval friction, and the degree of difference lubrication makes. Logically the use of lubricants could stop stresses and potential further damage to the pelvic supports and the surfaces of the vagina, urethral opening, perineum and vulva.

DS2 is a mechanic and is always raving about the importance of lubrication (For machines, silly! Discussion of any other sort of lubrication is still TMI for him, at the tender age of 21).

However, the human body *is* a machine, so of course lubrication will help to prevent wear, and prolong the machine's active life. So will improving the properties of the surfaces in contact. Yes?

This research paper, "The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry", published in the Journal of Clinical Pathology 2002;55:446-451 indicated "a positive effect of Replens on the maturation of vaginal epithelium". Full article available from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1769660 . I guess the manufacturers of Replens had some part in the sponsorship of this research (I came to a maze of information in Dutch at the website of the University Medical Centre, Radboud, but it would be pretty hard to falsify a "positive effect of Replens on the maturation of vaginal epithelium", so I guess the improvement is not Mae's imagination at work. I'm going to give it a try myself, and use DH as a vaginal dryness assessor That will really rock his boat! ;-)

Here is another one. Replens versus dienoestrol cream in the sympomatic treatment of vaginal atrophy in postmenopausal women. Could only find an Objectives and conclusion of this, not even an Abstract, cos the journal is an Elsevier publication (no free full text). Published in Maturitas. 1996 Apr;23(3):259-63. Somebody with access to Elsevier full text might be able to access it and report on it for us. The Conclusion was a little unclear about the degree of practical difference between the two treatments. I guess sponsorship may have a part in what the researchers conclude.

I think we could benefit in more conversations about Replens.

Anyone have any experiences with it, positive or negative?

Cheers

Louise

Hi fellow-women

Just letting you know about an amazing documentary I watched with DH and DS1 last night. It is called The Clitoris. This is it, http://www.dfgdocs.com/Directory/Titles/1259.aspx .

There was a lot in it about doctors' and educators' limited attitudes towards female genital organs, and the 'joy' part of sex. It would seem that still, many of them don't want to talk about it. One of the doctors interviewed commented on the way attitudes towards female sexuality throughout history have coloured what is, and is not, included in medical text books, right back to Gray's anatomy and Vesalaeus (sp?). The medical textbooks have also ignored female sexuality. Historically, art and literature have said and shown what was really happening in women's minds and bodies!

If you get the chance, watch it. It was released in 2003. It also has some very funny and playful European television advertisements scattered through it.

Cheers

Louise

I hope the Replens works as well for you Ellen as it does for me. My cystocele is much more in my control if I stay lubricated. I did not think I was dry either, but a doctor said I was so I tried the Replens sample she gave me. I immediately noticed a difference in the severity of my prolapse and my ability to "hold things in" better.

I too am 60 years old and have been "managing" my prolapse for three years. Finding this website kept me from having surgery to repair the cystocele. However, I am always looking for alternative ways, as we all seem to be, to better manage my prolapse.

Wishing you well.

Mae

I just wanted to share with everyone something I tried today. I decided to buy Replens, as Mae suggested, and used it this morning. After inserting the applicator full of the product as directed (high up) I also manually inserted some KY jelly (lower down)

Well, I drove to the nursery to buy plants, stopped at the post office, went grocery shopping, came home and ate lunch, made the beds, did the dishes, went to my office for 1 hour to do some work, stopped on the way home to pick up bread (forgot that at the first grocery stop) all the while staying in posture as much as I could, and I DID NOT feel my proplase at all. It's now almost 3:00 EST and I feel GREAT! As Louise said, it is so important to stay lubricated, and she is so right. My vagina is very dry, and what a difference these 2 products together made today. The Replens says it works for 2-3 days, so we'll see how it goes tomorrow when I'll just re-apply some KY jelly.

Goldfinch

'Life is not holding a good hand; Life is playing a poor hand well'

Hi Goldfinch,

I am so glad you tried Replens and it worked so well for you! It sounds like it works better for you, since you didn't even feel your prolapse all day, than it does for me. I usually feel mine (stage 3), even with Replens, but the Replens certainly makes a huge difference in how bad the prolapse is. I haven't tried the Ky jelly lower down (I only use the Replens), but I will. Thanks for the idea. Just wondering what stage your prolapse is and if it is cystocele like mine?

Thanks for posting. It thrills me that I may have helped someone. I know how excited and thankful I am when I find something that helps me!

Warm regards,
Mae

Hi Mae

Gee, isn't it funny how we compare prolapses? It is interesting to find out how others are doing, and whether they are addressing the same degree as we are.

Trouble is we are all so different in so many ways, so it's hard to make meaningful comparisons. Also, be aware that there are a couple of different grading systems that doctors use, so make sure you are talking the same language before drawing conclusions.

Cheers

Louise

The rest of my day yesterday was as great as the beginning. Today will be a different challenge since I'll be spending most of it with my 2 1/2 year old granddaughter - lots of playing on the floor and bending over to pick up toys, etc. But so far, so good.

I'll be 60 in December of this year (yikes!). I have a uterine prolapse that presented itself in July of 2007, so it hasn't even been 1 year. I went to see a uro-gyn at that time, and he diagnosed it as a stage 2. That number is meaningless to me now. My goal is to use the WW techniques so that I can manage it, feel good, and live a happy and normal life. I also have a slight cystocele which stays hidden because of the UP getting in it's way.

I think that regardless of whether you have one prolapse or all three, lubrication will help you to feel more comfortable. Christine sells some wonderful balms that many members swear by. You might want to go to the WW store to check them out.

Thank you again for letting us know about the Replens! It also thrills me when I can help someone. That's what's so great about this forum. We can touch each others lives in such positive ways - even the littlest thing shared might make a hugh difference in someone else's life. Your tip made a hugh difference in mine. Thank you again.

Goldfinch

'Life is not holding a good hand; Life is playing a poor hand well'

May,

Thanks so much for offering the information on Replens. It's a really good product.

I was having trouble with my prolapse annoying me, and I decided to try the Replens as well. I tried it at night first. It burned like a house on fire for about 15 minutes. I thought that it was just another thing "I can't use!" But then the burning quit, and I was much more comfortable the next day. I think it's a great product. Thanks so much.

Judy

Mae and Goldfinch --

I use Bliss Balm from WW at the opening of my vagina and on and around the cystocele bulge, in addition to Replens for deeper tissues.

Bliss Balm is effective and I like it very much AND like the idea of its being all natural and organic.

Be sure to use a minipad with it as it's oil based and it's a good idea to guard against smudges!

I still keep KY on hand for lubrication for sex as I really need the extra slipperiness then. Replens makes a product for that purpose too but I haven't tried it.

But for daily use I prefer Bliss Balm. I put a small amount in a tiny travel jar for my purse.

Ellen

Hi Louise,

I know there are different grading scales and that makes it kind of hard. I wish there was a definite "rule of thumb". I suspect the less the prolapse the more the Replens is going to help. I pretty much determined I am at a Stage 3, but on better days I think I can be a Stage 2, at least for a good part of the day. Maybe that's why it's so hard to say what stage someone is in...there are so many variables to consider.

Thanks for the advice. I'll remember that when thinking about, and trying still, to find ways to make things as good as possible. I've been trying again, after you mentioned it, to keep myself in the posture. It does help. I just have to keep thinking about it though, because it's easy to fall back into old habits.

Have a great day!

Warm regards,
Mae

Thanks Ellen. I am going to order that Bliss Balm that everyone seems to like so much. I never use anything but Replens, and while it works well, there is always room for improvement! I am so glad I responded to Christine's post on vaginal dryness. All this help and support is wonderful.

Warm regards,
Mae

Glad it's working for you Judy. Everyone seems to be pleased with it. Maybe we should all buy stock in the company! LOL

Have a great day!

Warm regards,
Mae

Ellen:
I use the most wonderful pad. It's called Kotex Lightdays Incredibly Thin Regular Unscented pantiliners. They are so thin, you can not feel them...I don't even know I have one on. It's just enough protection for any lubrication that escapes. Regular panty liners were too thick and actually were causing me some irritation. I know some of the ladies make their own - maybe I'll try that someday when I have more time.

Until then, just thought I would share this. I usually buy them when they're on sale, and the Sunday supplements very frequently have Kotex coupons. I bought them last week - 2 boxes (60 in a box) for $4.00 - then used my $1 coupon. Good deal!

Goldfinch

'Life is not holding a good hand; Life is playing a poor hand well'

Hi Goldfinch,

Glad the Replens kept working for you. I do find though, that I still have to be careful when I lift something heavy or do too much. Even the Replens can't stop the prolapse if I don't take care. I am going to order some of Christine's Balms that everyone seems to like so much. I've just been using the Replens and I'm hoping the Balms will help even more.

I turned 60 last May and have 2 grandsons ages 7 and 10, so I know what you mean about playing with them and having that be a factor in how well your prolapse will do that day. Maybe you'll see a difference from other times with her since you are using the Replens.

Have fun! Grandbabies are simply the best!

Warm regards,
Mae

Goldfinch --

Thanks for the tip about pantiliners and coupons, I'll make a note of it and try those when it's time to buy them again.

Appreciatively,
Ellen

You're so right, Mae - I never get to lift my granddaughter anymore, because I'm trying to be so careful. Sometimes she'll climb up onto the sofa or a chair, then I'll do a deep Kegal and pick her up from there. But I'm always VERY careful!!

I also have a 9 year old grandson. Grandkids are the best!

Goldfinch

'Life is not holding a good hand; Life is playing a poor hand well'

i to have searched the net re vulva pain..and i came across the following information..

St Johns Wort:

Actions: Anti-inflammatory, astringent, vulnerary, nervine, anti-microbial.

Indications: Taken internally, St. John's Wort has a sedative and pain reducing effect, which gives it a place in the treatment of neuralgia, anxiety, tension and similar problems. It is especially regarded as an herb to use where there are menopausal changes triggering irritability and anxiety. It is increasingly recommended the treatment of depression. In addition to neuralgic pain, it will ease fibrositis, sciatica and rheumatic pain. Externally it is a valuable healing and anti-inflammatory remedys.

i have started taking this today to try and see if this will allieviate my symptoms of severe vulva pain ...the only thing to be aware of is that you have to be careful of what other drugs you are taking as st johns wort can interact with them...