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Helping abandoned and surrendered dogs fi nd their forever homes
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Hours: Fri-Tu 11am-6pm • Closed Wednesday & Thursday
www.facebook.com/WigglyTailsDogRescue
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THROUGH 10/15/16
SAVAGE
VULVA VA VOOM
BY DAN SAVAGE
LOVE
A question on your favorite topic, Dan. Just kidding, it’s a question about my vagina. I’m hav-
ing a problem with the microbiome of my vulva and vagina. I’ve been going to my gyno for the last
six months for recurrent bacterial vaginosis and yeast infections. She shrugs, gives me a script,
the symptoms go away for a week or so, then they come back. I understand the infections are like-
ly due to an imbalance in my vaginal pH, but I don’t know what to do to fix this. I’ve used probiotic
suppositories to boost the amount of lactobacillus and these help more than anything else, but
the problem remains. I also wear cotton, loose-fitting undies and practice good hygiene and nev-
er douche or use anything scented. The problem started when I stopped using condoms with my
partner, but it’s not an STI. We’ve both been tested. There’s tons of sites online talking about this
problem, but no one has a solution that I’ve found. How the hell can women with this problem fix
their pH?! Thanks a ton if you read this far, and thanks a million tons if you or one of your experts
has any ideas to help.
Vexed Und Lacking Vaginal Answers
“I love that she used the word ‘vulva,’” said Dr. Debby Herbenick, a research scientist at Indiana
University, a sexual health educator at the Kinsey Institute, and the author of Read My Lips: A
Complete Guide to the Vagina and Vulva and numerous other books. “Most people have no idea
what that even is!”
I know what that is! (Full disclosure: I know what that is now. I didn’t know what that was when I
started writing this column.) The vulva is (the vulva are?) the external genitalia of the female—the
labia, the clit, the vaginal opening, some other bits and pieces. (Fun fact: Vulva is Latin for wrapper.)
The vagina, aka “the muscular tube,” runs from the vulva to the uterus. (Fun fact: Vagina is Latin for the
sheath of a sword.) People tend to use “vagina” when referring to a woman’s junk generally, and while
meaning follows use and I’m inclined to give it a pass, saying “vagina” when you mean “vulva” makes
scientists like Dr. Herbenick rather teste. (Sad fact: Teste is not the singular form of testes.) Now back
to your vulva and vagina, VULVA…
Dr. Herbenick recommends seeing a “true vulvovaginal health expert” (TVHE) about your problem,
VULVA, and your gynecologist presumably qualifies as a TVHE… right?
“Not necessarily,” said Dr. Herbenick. “Gynecologists know far more about vaginal and vulvar
health issues than most health care providers, but many gynecologists haven’t received deep-dive
(pun not intended) specialized training in difficult-to-treat vulvovaginal health conditions. And if they
have, it was likely when they were in med school—so years ago. They might not be up to date in the
latest research, since not all doctors go to vulvovaginal-specific conferences.”
Is there a fix for that problem?
“Yes! If everyone lobbied for their doctors to go to events like the annual conference of the Inter-
national Society for the Study of Vulvovaginal Disease (ISSVD),” said Dr. Herbenick, “we would live in a
country with millions more happy, healthy, sex-interested women and others with vaginas and vulvas,
too, like trans men.”
As for your particular problem—a tough case of bacterial vaginosis—Dr. Herbenick, who isn’t a
medical doctor but qualifies as a TVHE, had some thoughts.
“There are many different forms of bacterial vaginosis (BV) and different kinds of yeast infections,”
said Dr. Herbenick. “These different kinds respond well to different kinds of treatment, which is one
reason home yeast meds don’t work well for many women. And all too often, health care providers
don’t have sufficient training to make fine-tuned diagnoses and end up treating the wrong thing. But if
VULVA’s recurrences are frequent, I think it’s a wise idea for her to see a true specialist.”
A TVHE is likelier to pinpoint the problem. Even so, Dr. Herbenick warns that it may take more than
one visit with a TVHE to solve the problem.
“I don’t want to over-promise, since BV remains a challenging diagnosis and often does come back
at some point,” said Dr. Herbenick. “There’s no one-size-fits-all approach to BV, which is also why I think
VULVA is best off meeting with a health care provider who lives and breathes vaginal health issues.
The ISSVD is full of health care providers like that—they’re the Sherlock Holmes of vaginas and vulvas,
none of this ‘shrug and here’s a script’ business. VULVA can check out ISSVD.org for more information.”
I have a question about biking and female genitalia. I’m a woman in my forties, and I love bik-
ing! My husband and I often go for long rides on the weekend. Unfortunately, this makes various
parts of my crotch sore, especially the clitoris. Certain bike seats are better, but none eliminate
the soreness. Two years ago, we had a baby, which not only made my crotch more prone to sore-
ness but makes it a lot less likely that we’ll have sex except on weekends, often after biking. The
sore clit makes sex more painful, but it also increases sensitivity, so the whole thing can be an
alternating experience of “Ow!” and “Wow!” Am I causing my clit any permanent damage by the
biking and/or the post-bike poking? Any suggestions for decreasing crotch soreness?
Bike Related Injury To Clit; Help Ease Soreness
“I love biking, I love vulvas, and I love babies (mine, and I’m sure I would adore BRITCHES’s baby,
too!),” said Dr. Herbenick, “so I appreciate being asked to chime in on this question. That said, there’s
not a ton of research on female genital health in connection with cycling.”
There’s far more research on men and cycling, due to the risks of bike-seat-related erectile dys-
function specifically and our society’s tendency to prioritize boners generally.
“The few studies that have been conducted on women and cycling—generally cisgender women
as far as I can tell—found that cutout seats are linked with a higher risk of genital symptoms, as are
handlebars that are lower than the saddle,” said Dr. Herbenick. “So broader saddles and higher han-
dlebars may be the way to go. Some of the research notes higher rates of genital symptoms among
people who go on longer rides, spending hours in the saddle.”
To decrease your risk of un-fun genital symptoms, BRITCHES, Dr. Herbenick recommends mixing
it up.
“Go biking some weekends and try other activities on other weekends—maybe hiking or swim-
ming? You might also take Dan’s ‘fuck first’ Valentine’s Day advice and apply it to your weekend rides.
And if you’re prone to post-intercourse semen leakage (and, really, who isn’t?) use a condom or have
him come elsewhere pre-ride so you don’t have the semen seepage issue to contend with on a long
ride. I hope this helps!”
Follow Dr. Debby Herbenick on Twitter @debbyherbenick.
YOU CAN HELP: Wherever you fall on the debate about sex work—it should be decriminalized, it
shouldn’t be decriminalized—everyone agrees that women who engage in sex work shouldn’t be pun-
ished. Yet thousands of women are incarcerated for prostitution or prostitution-related crimes. The Sex
Workers Outreach Project (SWOP) has launched a pilot program to help these women. Go to swopbe-
hindbars.org to send a book to an incarcerated sex worker (books are in great demand), become a pen
pal, or donate a book to a prison library. Since everyone agrees sex workers shouldn’t be punished,
everyone should be able to get behind SWOP Behind Bars. I donated a book to an incarcerated sex
worker today—it was easy!—and you can, too.
MAIL@SAVAGELOVE.NET • @FAKEDANSAVAGE • THE SAVAGE LOVECAST AT SAVAGELOVECAST.COM
eugeneweekly.com • October 6, 2016
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