Episode 60: Hot girl summer…and vaginal health?

Dr. Sophia:
Hello everyone. Welcome to the Dr. Sophia ObGyn podcast. I'm an obgyn practicing for over 15 years in my native New York City. And I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more. Disclaimer, this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician.

Hello everyone, and welcome to the doctor Sophia ObGyn podcast. Today I am joined as I always am with my co-host and good friend Touseef Mirza.

Touseef Mirza:
Hello everybody.

Dr. Sophia:
And as always, we talk and chat and we are so excited that it's summer. We are so excited that it's summer.

Touseef Mirza:
It's so nice right now in New York. Like we went through a little bit of a, a hot couple of days a few weeks ago, but now it's just so pleasant and people are just outside flaunting their stuff, just

Dr. Sophia:
Flaunting their stuff.

Touseef Mirza:
And it is just so, such an amazing energy in New York when the first few weeks of summer starts.

Dr. Sophia:
Exactly. And what else happens? When we have the first few days of summer, I get an influx of calls from
women who say they have infections, irritations, just all kinds of things going on, quote unquote down there.

Touseef Mirza:
Does it usually happen at the beginning or that's really the most, you see it and then it dies down, or that's the beginning of summer and then you keep seeing that for the rest of the summer issues?

Dr. Sophia:
I feel like the calls around, like I think I have a vaginal infection or I just have a lot of irritation. It's kind of like two times around the year that I really see it, but for sure around summer, just the heat alone. Right. So people are just so much more humid, like, you know, if, especially if you're wearing clothes that stick to you or very tight and then it's hot outside, so you're just more sweaty. I think it's also happening because people are enjoying themselves. They're going to pools and beaches and hot tubs and, you know, things.

Touseef Mirza:
Getting into public waters.

Dr. Sophia:
Getting into public waters. Which we want you to enjoy.

Touseef Mirza:
Of course. Or else it's not summer.

Dr. Sophia:
It’s not summer if we're not doing those things.

Touseef Mirza:
Yes.

Dr. Sophia:
But first of all, are they actually having infections or vulvar irritation? Yeah, sometimes they are. I mean, if you are wearing clothes that are not breathable, then what that does is keeps humidity on the skin and then that allows for bacteria to overgrow, fungus to overgrow things like Candida or yeast to overgrow on the skin. And that could be in the groin, that could be on the vagina, on the vulva itself, in between the folds. And they come back and they're like, I just feel itchy. I feel uncomfortable. I don't like, you know, it's weird for me to sit down. I just don't feel right.

Touseef Mirza:
So basically what you're saying is because of all these different activities and also because of the temperature from a vaginal and vulva area perspective, it affects us in a different way than the rest of the year?

Dr. Sophia:
Yeah, and like I was saying, there's like another part of the year when I tend to see a tiny bit of like what, what feels like a little bit of a spike is actually like after January when everybody's on their health kick and going back to the gym. Things that can be sometimes related to things like pH balance changes just because we are either trying to stay really dry or over washing or, or putting in more fragrances or things that have way more chemicals on our skin During this time people are using maybe more wipes or more, you know, like wiping with things that have chemicals on them.

Touseef Mirza:
Well, number one, I don't understand that concept. Like I don't know, maybe it's because I'm from Canada originally, I don't know. But for me, like the whole, like trying to be more fresh down there. I mean, I just like to take showers and use water to wash myself and that's it. You know, like me, I've never understood other things that we need to put because I always felt that it's such a sensitive area that if anything it's gonna irritate it. So I've never, ever tried to do any of those things.

Dr. Sophia:
Like less is definitely more, but you'd be surprised. I mean, at the end of the day, people wanna feel like, you know, spring flowers and it's the concept. I think we're kind of, unfortunately just even as a society, like there's such a big industry in the fragrance industry. So for example, the bath and bodies of the world and all the different creams and potions and lotions and body washes and making women feel like they're supposed to have this perfume smell as opposed to their just normal odor, what their bodies are like just all the time.

Touseef Mirza:
Are you talking specifically from a vulva perspective or just in general in terms of the body?

Dr. Sophia:
I mean in, in terms of the body, yes. But from a vulvar perspective, I feel like women are a little bit more fed this notion that their genital area is supposed to have this, like we're in a garden, because it's like the way that women come into my office when there is a bath and body work sale, and I don't mean to signal 'em out, I'm just saying like, when there is a sale on some stuff, I always have to be like, please don't buy the latest and greatest. Please, please don't do it. And so the summertime I feel like it's more, I feel like, because again, women are doing things like going to the beach and going to the pools. And it's important to just not stay in your wet clothes because that actually can lead to, you know, smells or odors that you don't like per say.
And so getting out of wet clothes whenever you're out of the activity as soon as possible and changing into something dry, or making sure that you're drying yourself very, very well, it seems so common sense. But then at the same time, if you're not thinking about it, then you're onto the next activity or you're onto the next thing. And it does become easy to just wanna stay in, well, I'm gonna go back to the pool, or I'm gonna go back to the water. Why am I changing? Or why am I making it such a big deal without realizing that that actually can be creating other, like, changes in terms of holding that moisture there.

Touseef Mirza:
So let's start there. Like in terms of going to, in the summer, we have a tendency to be more, either we go to the beach or either we're going more to the swimming pool and then we do activities. But that doesn't happen to all women because I don't recall that being really, for example, an issue with me. Like if I just stay in my bathing suit all day or I go in and out, whatever it is. I haven't really seen any difference. So I guess it depends what type of water you're submerged in and, and how your vulva is actually reacting to that.

Dr. Sophia:
I think it just means that A, you've done a great job keeping good bacteria in your vulva.

Touseef Mirza:
Yay.

Dr. Sophia:
Okay. It means that you haven't stripped your skin of the good things that should be there to protect you when you're in that kind of an environment. And moreover, we are all different. And definitely the vulvar and vagina area are sensitive areas. And it's not the same for everyone. Also, some of us are more sensitive to different, even just materials in your clothing, you know, some people actually like things that hold spandex that hold moisture, it doesn't really whisk away like cotton would for example. You know, in terms of drying, those are some of the things that can, in someone who is sensitive, make them have irritation and the irritation doesn't have to be bacterial or fungal. It could just be what we call a contact dermatitis from different, even materials and clothing. It's important to pay attention to that, especially under the hot and humid conditions. I think we just take it for granted. And I'm happy for you that you've never had experiences but it can happen. I know that I definitely see a spike. During the summertime. And I wanted to be clear to address it and to talk about it and to let women know this is not the time to be over washing your body.

Touseef Mirza:
What do you mean by over washing?

Dr. Sophia:
Well, again, because we are hot. And we are sweating, like it doesn't mean that you need to every single time you use some type of strong soap to clean yourself. Something gentle and mild in order to just make you feel fresh. And just water. Just water and just water. As opposed to, like I said, sometimes we feel like if we do feel like we have an odor then there's like, oh, let me use something like antibacterial. You know, because you're like, oh, maybe I have an infection. Not realizing that the antibacterial can actually be the thing that–

Touseef Mirza:
That makes it worse.

Dr. Sophia:
It makes it worse. Right. Exactly. The thing that makes it worse.

Touseef Mirza:
And let's be clear, when we say an odor, there is a natural odor of the vulva.

Dr. Sophia:
I wanna tell people when it comes to odor is to pay attention to their body. We're talking about a foul odor, right? Exactly. A foul odor should be evaluated. And I've even had this before where people think that, oh, okay, if I start to feel like I'm at, I might start to have a little infection. I'm sure by going to the beach it's going to cure it because they're in the salt water. Or I'm sure by going into the chlorine or going into a pool that's going to cure it. No. If you feel like you're truly having an infection because your discharge has made you now feel very uncomfortable, vaginal discharge, vaginal discharge has made you feel very uncomfortable. It's become super heavy. Oh, itchy. And it's itchy and it smells bad. That requires a trip to your doctor. . On the flip side, what I'm talking about is we all sweat and in summertime what happens in terms of why people tend to feel like they may have more odor is simply from dehydration. . Because they're not drinking enough water in order to clear out their system. And so one of the easiest things to do is to start to drink a lot more water when you feel like you may be experiencing a shift in your normal body scent.

Touseef Mirza:
So it seems to me like there's three levels here. I'm a systems thinker, so that's just how I roll. So there's one level which is like your natural scent. Okay. Which is not a bad scent. Not, maybe you don't like the scent, but it's like, it's, it's just what your body smells. No Right. Smell. And, and that's or no smell or a little smell, whatever. I mean it's, it's just a constant that's there and that's just what it is. There's nothing to worry about. That's just what it is. That's one. Number two is if you're starting to smell something, maybe not the foul smell, but, but you know, in the summer where it maybe it's musty.

So, that's level two. And level three is when not only is it foul smelling, but also you have a discharge or you have other symptoms associated with that. So that's like a different level. So you have these different types of smells and there's different ways of considering each?

Dr. Sophia:
Yeah. And addressing it. So that's one thing. In terms of complaints, concerns, what's bothering people in the summertime. I also get a lot more women come in with things like UTIs, like urinary tract infections. They tell me they have more burning, more frequency, more urgency, more pain when they urinate, whether it's before the urinate, after the urinate, they feel a burning sensation with their every time they void or what have you. And undeniably they're coming in with actual urinary tract infections. You know, we test them and, and their cultures become positive. And I think in terms of summer, I feel like people are just a lot more engaged. Like social, they're out more, they're out with friends more. They may be out with their partners more. They may be just more, become more sexually active during summertime. I think there is something to be said about just being in the sun that makes people feel good and feel better and wanna be more connected.

Touseef Mirza:
And more and more uninhibited.

Dr. Sophia:
Uninhibited. Yeah. Maybe we're drinking more because we're more social. Right. So we're having a little bit more alcohol. So a couple of different things that could actually be adding layers to why women tend to come in with a, what seems like a, a spike for me in UTIs. So just some clear, easy kind of guidelines or recommendations, let's put it that way. Recommendation is if you are drinking remember to hydrate, hydrate, hydrate at the same time.

Touseef Mirza:
So drinking alcohol?

Dr. Sophia:
So if we're talking about alcohol, to always continue to balance that with water, because alcohol does dehydrate you.

Touseef Mirza:
And so what happens when you dehydrate.

Dr. Sophia:
It increases it. That can increase your chance of having urinary tract infections.

Touseef Mirza:
And why is that? Just

Dr. Sophia:
Because you're not fluid. You're not flushing out your kidneys. Flushing out the system. Two is just peeing after sex as a way of decreasing bacteria from sticking to the walls of the vagina, from sticking to the walls of the urethra very specifically, so that you are just clearing and flushing that out after sex. And so you then therefore will decrease your chances again of developing a urinary tract infection.

Touseef Mirza:
And by the way, you know, we're, we're talking about urinary tract infection, you should always go pee after sex. It just so happens that during summer people have a tendency to have more sex. It's not like, don't do it the rest of the time of the year. You know, it just so happens that in summer people usually have more sex. So we're just specifically talking about that. But yes, please do that every single time you're having sex. Same thing with drinking. It's not just in summer. Mind you, the sun will probably dehydrate you more, but that's another story,

Dr. Sophia:
Both of them really, honestly. Right, right. So it, we're in the heat, so we have to be mindful of the fact that we're in the heat and our bodies love water and need water. And three, the other thing is that in summer, a lot of times we're traveling. We're, we're on the go, we're moving.

Touseef Mirza:
We're in the car for a few hours.

Dr. Sophia:
For hours because we're taking a road trip or we're taking a flight or what have you. And I know I'm actually a culprit. I, I have to say that I'm a little bit guilty of this, but when I'm on a plane, sometimes I actually do limit how much I drink because I don't wanna have to get up through the seats or what have you in order to get up every, you know, five minutes what it is, what it could feel like to go to the bathroom or going to the bathroom on the plane kind of skives me a little bit.

Touseef Mirza:
Why?

Dr. Sophia:
I don't know. It just does.

Touseef Mirza:
For me it's an excuse to get up and I don't mind if I'm bothering people.

Dr. Sophia:
And though I agree with you because it's super important to move when you're on a plane and stretch and get the fluids moving and you know your circulation. But I'm guilty.

Touseef Mirza:
That's okay.

Dr. Sophia:
But I'm going to practice what I preach. When we're on long travel, we need to constantly be drinking.

Touseef Mirza:
Drinking water in this situation. Water, not alcohol.

Dr. Sophia:
Alcohol, drinking water.

Touseef Mirza:
Yes. So why, if we're on long trips and we don't go to the bathroom on those long trips, why does that increase UTIs?

Dr. Sophia:
Because we have what we call urinary retention. So we're holding onto that urine longer than we really should.

Touseef Mirza:
And so there's a greater tendency for bacteria,

Dr. Sophia:
Bacteria develop. So there was bacteria there. We've now made a nice little breeding home for it. By holding it there in the bladder, in the urine.

Touseef Mirza:
See, I didn't know this. I didn't know that by not going to the bathroom, that it could increase your chances of getting a UTI but I, I mean, knock on wood, I haven't had many UTIs in my life. So I'm very happy with my vaginal vulva and urinary bacteria system. Thank you very much. But also, like, I just don't like to have a full bladder. Like I wanna be comfortable.

Dr. Sophia:
Listen, the brain will accommodate. So sometimes it gives you that signal, it's time to go to the bathroom, and then you start doing something else. You walk around or whatever the case may be, and then that is, that signal kind of goes away for a little while before it comes back. You know, and for some people, whether it's because of their jobs, their lifestyles, what have you, they have trained, they, their bodies are almost trained to hold their urine. That is definitely not what we recommend. We want you to be going to the bathroom when you get that first signal and say, oh, okay, it's time for me to go to the bathroom and replenish what you've lost by drinking. And especially under these conditions, because you're just at such a higher chance of having dehydration.

Touseef Mirza:
Hmm. You know, so when you're like, I'm just thinking about, you know, those times where you just, you can't go because there's no bathroom around or whatever the situation is. And your bladder literally hurts. You know, like when it's painful. Oh, that's painful.
Sometimes it is just hard sometimes. Maybe you just have to pull the car over, go in the ditch.

Dr. Sophia:
I've done that many times. Yes, I have. So, summer behaviors that are just gonna keep us healthier is, again, I can't stress this point enough, drinking enough water, not using, you know, highly chemical fragrances, soaps, body washes, lotions, et cetera. Especially in our genital area, getting as soon as we can out of wet clothes or humid clothes because of a workout, or, you know, from going to the pools or wherever we go that we enjoy, but remembering to change when we can and to dry clothes.

Touseef Mirza:
Right. Or like if it is a humid day to try to wear clothes that are breathable.

Dr. Sophia:
Cotton's great.

Touseef Mirza:
Or linen.

Dr. Sophia:
Yeah, exactly.

Touseef Mirza:
And we're gonna pee.

Dr. Sophia:
We’re gonna pee after sex.

Touseef Mirza:
Yes.

Dr. Sophia:
Yeah. We've gotta pee after sex. But enjoy it, girl. Yeah. Get out there.

Touseef Mirza:
Enjoy the sex, and then enjoy the peeing. Enjoy all of it.

Dr. Sophia:
Enjoy all of it.

Touseef Mirza:
The good news is, these are not serious issues.

Dr. Sophia:
No, they're not. Like I said, oftentimes women are coming in, they think they have a yeast infection, a BV type of infection, which is really a change in your pH balance. But at the end of the day, there are things we can do to help our bodies to help try to avoid us from getting those things. And let's differentiate if we do have a like, smell, discharge, itchiness, discomfort, see your provider in order to confirm what is going on. Again, with our little extra sexy time, we wanna make sure that we're preventing STIs and STDs. So we're wearing our condoms, we're doing barrier protection, because those things are still there. They're still out there. We're having a good time, but it doesn't make it not happen. But yeah, enjoy the summer, man.

Touseef Mirza:
We love the summer. We wait for it all year, and then it's finally here.

Dr. Sophia:
We have to be outside, you know, at the end of the day, I think it's good to just keep hearing it over and over and over again, how we care for ourselves. And I really just thought that now is a good time to talk about this.

Touseef Mirza:
Well, I am going to embrace my bladder because I didn't realize that I was putting unnecessary strain. It's not like I wanna hold my pee, but aside from being uncomfortable, I didn't even realize that that has-

Dr. Sophia:
An impact.

Touseef Mirza:

A potential influence. Yeah. On a urinary urinary tract infection. So now when I'm on the computer, the first signal comes.

Dr. Sophia:
Boom girl.

Touseef Mirza:
Go to the bathroom.

Dr. Sophia:
Empty your bladder. Replace those fluids you've lost.

Touseef Mirza:
Summer, autumn, winter, spring.

Dr. Sophia:
All the time.

Touseef Mirza:
All the time.

Dr. Sophia:
I hope you ladies have had as much fun as we have talking about our summer and how we're going to embrace our bodies and embrace ourselves. Thank you so much for listening to the Dr. Sophia ObGyn podcast. Bye for now.

Touseef Mirza:
Bye.

Dr. Sophia:
This is General medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.