The Brain-Gut-Vagina Connection

Introduction to Vaginal Health 0:00

Hi, everyone. Welcome back to Mastering the Menopause Transition Summit. I'm your host, doctor Sharon Stills. I got another redhead here with me today. And we are going to have a talk about vaginal health. And so that is not something you hear talked about often. But it is super important. And so we're here to take away the stigma of it and just let you understand how the health of your vagina is really important, but also how it connects to your brain and your gut. And like, this is a whole body thing we're talking about here.

And so I have my dear friend and colleague, Doctor Betsy Greenleaf, with me. She's a premier women's health expert. She's a bestselling author and entrepreneur and inventor, business leader specializing in female pelvic health and reconstructive surgery for over 20 years. She's a trailblazer as the first female in the United States to become board certified in Euro gynecology. She possesses a professional reputation that has led to being sought after by medical societies, associations and corporations to provide lectures, teaching advanced training.

She is she's got just a laundry list of accolades. And I'll let you tell I'll let her tell you about herself. And she's also funny. So we're probably going to chuckle a little in this talk, too. So welcome, Betsy, I am I'm thrilled you're here. And we finally got this to work through all our technical difficulties. Oh, I'm so excited to be here. So thank you so much, Sharon, for for, you know, inviting me. I always love talking to you. This this is a fun topic, even though I know a lot of people are like, what? No.

So is there anything else about you before we dive in that you want the ladies to know your story, how you ended up doing what you're doing? Okay. Now, I'm an they can always read that stuff online. But, you know, I, I definitely did not, like, want to grow up and be a gynecologist. I was definitely not on my list of things to do as a five year old. You know, I always joke about that. And in fact, when I went to medical school, I was like, oh my God, why would anybody look at that all day long? And patients always asked me that.

And I actually, in fact, one of my good friends, she's such a diarist. And I remember during residency we were sitting across the table from each other eating lunch, and I was like, you, how do you look at people's nasty feet all day long? And she, like, almost choked on her sandwich and she's like, are you serious? And I was like, oh yeah, yeah, you know what?

Why Vaginal Health Matters 2:37

You just become desensitized. You know, when you're going into the medical field about what you're looking at it. And really, it was just that I wanted to help women in women's health. So, you know, and the vagina is it's such a beautiful part of our anatomy and so unique and has so many magical qualities. And, you know, so let's like, let's dive in because you are like America's vagina doctor. And, you know, I think the biggest thing is really tough is that there was a study that came out not too long ago that said that 65% of women are uncomfortable saying the word vagina.

And I really think that that's kind of sad. And but I realize that there's a lot of shame and embarrassment. But if we can't talk about it, then how if we're having problems with that area of our body, how do we ask for help? And 80% of women will have a pelvic health condition at some point in their lives. So I think that we just need to get used to saying the words that go with the parts. And and even though I say vagina all the time, vagina is actually just the tube, the inner tube, when really the vulva is the outer outer part here, the labia, which are the outer lips.

But I'm just happy people say the word vagina. And if you use the vagina just to refer to everything down there, I'm perfectly happy that with that. So as long as we're talking about that area, I'm happy. And I think eventually we'll get to the point where we can use that word and people won't, like, get kicked off Instagram like somebody I know or or, you know, get blocked by social media, you know, because vagina goes against community standards. But, well, and so if you're, you're listening and you want to say the word vagina with us, we'll do it on three, 123.

Vagina China. And if and if you feel triggered by that word, then you know, there's a little exploration to do there. We're not trying to make you feel bad or anything, but it's just a name for body part. And somehow it got so, like you said, censored. You know, we can say elbow or we can say lung, we can say heart, but vagina is not okay to say. And so, you know, it's just part of your body. Yeah. If you're if you're a woman listening, you have one. There's a lot that goes on down there. A lot of good stuff to a lot of, you know, pleasure can happen there.

Babies come through there. You know, there's a lot of there's a lot going on there. So it's an important part of our, our anatomy. And I know in my practice, especially when I had my brick and mortar, I was so surprised at how many of my patients had never seen their vagina. And I had my handy dandy mirror where I could actually show them their vagina and get them intimate with it. Because, you know, I guess it's not the easiest thing to see, or we don't think about seeing it, but like having a relationship with our vagina is is important.

Yeah, I think a lot of people don't even think about that area until they have a problem. And then when you have a problem, that's all you think about. That is, oh, that's I kind of see they see my job is not only just normalizing the conversation, but I want to get you to the point where you kind of forget about it, but not forget about it. Like ignore it, but forget about it where it's not running your life so that you can just get on with your life and and live your life. Not have to think about it.

Burning pain or whatever is the problem. So and I agree with the with the mirror. That is key. I always tell patients like your body parts are with you all the time,

Microbiome, Brain, and Gut Connections 6:29

and so you're going to trust your doctor to just look at something once a year. And now some of the recommendations, pap smears especially, are not even to do pap smears until like every three years. And then even after the age of 70, they're saying you don't need to do them anymore. And so women are interpreting this like, oh, I just don't need to go to the gynecologist. Or you see women, they go because they're having babies and they've had their babies, and then they just stop going. And so first of all, you need to have those areas checked.

And second of all, what better way to check it to like, look at it yourself. You know, I say vaginal exams are mirrors to make sure things look, you know, figure out what it looks like normally so that something's a little out of whack. You can be like, oh, wait, that's something different. And same thing. I tell people seeing their breasts and my breasts are with you all the time. You know, you're more likely to find lumps and bumps than your doctor. That's just checking once a year. So. Exactly.

I was just thinking the same thing. So you took the words right out of my mouth. Exactly. We we check our breasts, we get to know them. We we need to know our vagina. Because what you said, I mean, we are we we need guides and doctors and teams, but we are with ourselves 24 seven and we should know ourselves the best. And by inspecting and getting acquainted, that's a good way to start. So, so gosh, there's a lot to talk about. Where do we start? Let's talk about first how the vagina is connected to the brain, to the gut.

So we can kind of get this holistic perspective, and then we can go into issues that are happening. Yeah, this is just fascinating. And I think being like as an osteopathic physician and you would know also as a like a natural path, we come from a natural world. We tend to like connect everything. And so this is nice, you know, to realize that actually traditional medicine is actually catching up with this idea. And we're starting to see more studies where everything is connected. I think the biggest thing that they're finding out is that we have a microbiome.

And, you know, if you haven't heard about what a microbiome is, it's just the little kind of universes of bacteria that live on our body and within our body in each of our areas have different microbiome. So like our skin has different bacteria living on it than our mouth and our gut than our vagina. And so it's when that bacteria goes out of balance that we tend to have problems. So starting this is where when you get the brain, the gut and the vagina connected, we can actually start from any one of those organs and connect it to each other.

So, a lot of times we'll start with the vagina since we're talking about the vagina. So if the microbiome of the vagina is off, it's usually because we have we should have lactobacillus, which is a type of bacteria that lives within our vagina that keeps us healthy. We need it there because it it does is when it's there and it's growing, it produces hydrogen peroxide. And the hydrogen peroxide chases away the bad bacteria, chases away the yeast. And the reason why the lactobacillus wants to live there is when we're younger and our tissue is nice and thick and healthy, it's it's actively growing.

And as it's actively growing, those old cells are sloughing off. And those old cells contain glycogen. And glycogen is the food source for the lactobacillus. So our old cells are feeding the lactobacillus. And in return the lactobacillus produces hydrogen peroxide. It acidified our vagina. The vagina's pretty bad. It's like like acid level. It's like 3.5 to 4.5 as a normal acidity for the vagina, like water is seven. So, and and the scale. So when everything's in balance, that is great. What happens is many things throw off that balance and basically kill off our healthy bacteria.

Anything from stress to being on antibiotics to as we get older, that tissue starts to thin out and we're not actively producing new cells. So basically the bacteria starts to starve to death unless we do things to rejuvenate or regenerate the vaginal tissue. And so when the balance of that bacteria is off now, now, because the way we're built as women, you have the rectum and the vagina so close together, bacteria from the rectum can now get into the vagina. And so this is gut bacteria. The gut bacteria is off.

Now we also have bacteria or yeast from the gut getting into the vagina and causing these issues. And I think, you know, one of the thing that's super interesting, I find super interesting is, you know, in the past in traditional medicine, we'd be like, oh, that's just a yeast infection or that's BV bacterial vaginosis. And we're like, oh, that's just an infection. And didn't think it had any other connection to anything else in our bodies. But now they're finding out that it's the microbiome with a vagina is off.

There's a feedback loop to the brain telling the brain that this is not an ideal time to be reproducing, because the body, you know, as humans, we're supposed to be reproducing and making more humans. And if our systems are not perfectly imbalanced, the body's going to be like, oh, that's not a great time. To be reproducing the body is going to sense it as a stress, and the brain is going to then shut down our hormones, which may show up in some people that are younger, having babies, it may show up as infertility.

And in anybody at any age, it actually can show up as a decrease in sex drive. So when a lot of women and including myself, you know, periods of my life before I knew any better about this, this information thinking like, oh, I'm having a low sex drive, I must need more hormones. And so then you go to the doctor and you ask for hormones when the hormones aren't are just a tool. They're not always the answer. It could be that there's something going on in the vagina, and your brain is telling everything like, okay, let's shut everything down because we're sensing that things aren't right.

So, I think that in in science, the scientists are actually studying this now, and it's just incredibly fascinating. Really puts it all together. It's like one big circuit, and we are always feeding back

Vaginal Dryness and Tissue Changes 13:01

to each other on our different systems and our bodies. So, so a big thing we see is vaginal dryness. So can you speak to that because so many women I mean, having sex is such a beautiful part of being a human being alive. And so many women I see come to me who just stopped having sex because it hurt and which is so sad to me. So can you speak to that? Yeah. So, fortunately, you know, as we get older, our estrogen levels start going down. And what happens is the estrogen is one of the hormones that feeds the vaginal tissue and tells it to grow thicker and, and, you know, very full and actively growing and, you know, well, you said before, it's feeding the, female lactobacillus.

But the other thing is when we start, when that tissue starts thin out, it also loses its elasticity. And so we start losing our collagen and elastin. These are the these are the chemicals in our skin or in our in our vaginal tissue that makes things like stretchy. So what happens is not only is the vagina very becomes very dry, but also when it stretches, you actually can get cracks and tears in the tissue. And this is why some people complain. It feels like cut glass when they're having sex, because basically the tissue is stretching and ripping.

And so this is true. Like and some women will come in and say like, I feel like I'm getting ripped open and it's kind of true. Like the tissue is tearing and, you know, becomes very, very uncomfortable. We also start losing the blood vessels that feed, that tease. You start to retract. So this is another reason why if women are on systemic hormones, like they're taking hormone replacement, whether it's a pill or a patch or palate, and they're like, well, it's not. So still not helping my vagina.

Yeah. Because you don't have the blood vessels that are if you can take those hormones to the vagina to feed that tissue, to make it grow nice and thick and healthy. So, you know, it's kind of like trying to grow a plant, but not having any fertilizer or any nutrients in your soil, like nothing's going to grow. So, then there are tons and tons of different things now to help rejuvenate the vagina. And I mean, just ten years ago, all we had were topical hormones and some of the and the ones that we had on them that were prescription on the market weren't always the best options, because a lot of the prescription ones, and I'm going to throw some under the bus here, but it's like Premier and Estuaries, if you look at the ingredients of those creams, a lot of them contain propylene glycol as a filler agent, as a thickening agent.

Well, unfortunately, propylene glycol can be, irritating to mucosal membranes, so they can actually be using it and actually causing more irritation. Or women will use, vaginal lubricant. So we'll use lubricants like KY jelly when they're having sex. Well, that's going to make things better. Well, they've done a lot of research on the balance of the key and something called osmolarity. And osmolarity has to do with like them to get scientists to think. It's like the solute concentration is basically how moisturizing or how drying something is to a tissue to tissue.

And, k almost gets to the point where it's almost like pouring salt on your tissue, you know, like, imagine pairing salt on a slug and it, like, shrivels up. So you're using K-Y because you want the lubricant in, but it's actually drying out your tissue more. So you need to use more. So the science behind lubrication has gotten so much better. And now there are lubricants, two that just come to mind. And I know there's more. So, the companies that I haven't mentioned, and I apologize if I'm forgetting them, but companies like Good Clean Love or Uber Lube, those are some really good companies that are really put invested in doing them.

Research and finding lubricants that are paged and osmolarity balanced for the vagina so that it doesn't affect your age. It also doesn't dry you out like a, like a, like a salt on a slug. So and then now from rejuvenation standpoint, we have so many more options. I mean, anywhere from like let's okay, there's bio, you know, there's bioidentical or I like to call them bio equivalent because I think bioidentical has gotten a little bit of a bad rap just that term. It's the same thing. But bio equivalent meaning like what's in your body.

So there's bio equivalent hormones that can be compounded. There's a description, bioidentical obviously that can be purchased called Vecsey. There are DHEA prescription suppositories, which, DHEA is a precursor hormone to estrogen, testosterone. And so we have also testosterone receptors in the vaginal area. So when you apply that topically it can it can help. And then I think what's fascinating is from an esthetic standpoint from so from the beauty world, they've been doing things to rejuvenate our face and our skin elsewhere in our bodies for years, like lasers.

And then obviously, I mean, since the 1980s, they've used lasers for skin rejuvenation. And then all of a sudden in about the late like, like to 2014, the first laser came to the United States. It's been used in Europe for a lot longer. All of a sudden they're like, well, wait a minute, we can do it to the face. Why can't we do it to the vagina? And then that just exploded the world of vaginal rejuvenation because they realized, wait a minute, anything that we can rejuvenate skin with by, you know, doing to like, a cosmetic treatment, we can just now apply it to the vagina.

So then you have laser and you have radiofrequency. So, just to go back and look, why does laser work. So laser uses light energy to penetrate the tissue and it makes a microscopic injury, which sounds terrible, but it's it's actually the ultimate in biohacking because if we make a tiny microscopic injury, the body goes, oh wait, I need to fix that. And so what will happen is your cells will come in and flood that area with growth factors to heal the injury, but in turn, it turns on your tissue to regrow.

So now we can regrow vaginal tissue without having to use topical hormones.

Treatment Options and Rejuvenation Therapies 19:38

So this is like really important for people who have breast cancer who are like nervous about using hormones or just, you know, anybody who's nervous about using hormones. So then they were like, okay, well, what other things can do that radiofrequency, which is using sound wave to generate heat and that heat causes an injury that then is perceived by the body and causes regeneration. Then we have red light therapy and red light therapy, something that you can actually do at home with these red light wands that you can buy.

She plug off my website, the pelvic floor store. But the other places do and then things like something called carboxy therapy. So carboxy therapy is using carbon dioxide too, which is a gas. But they were able to figure out how to put it in a gel form. And you're like, wait a minute. We breathe out carbon dioxide. How does that regenerate the vagina? Well, when you apply it or inject it into tissues, like in this instance of applied and injected, it attracts oxygen into that tissue. And so that attraction of the oxygen will actually help stimulate growth of blood vessels.

So now you get more blood vessels in the tissue, and the more it can grow. And yeah, I think that's about it that I know of right now. They're still working on tons of things, but it's just so exciting that there's so many different options for people. Anything from things that could be done at home to things that, you know, you can go to a doctor and have done, or even actually in some states there, like I would warn people against going to just anybody to have some of these laser treatments done.

I mean, you got to look, it's actually some of the laws are kind of scary. Like, for example, in New York State, anybody that has enough money to buy a laser can own and operate a laser. That I think is a little, you know, little scary. But, yeah, you have to make sure you go to somebody who's been trained and been doing it for a while. Oh, I know something else. PRP, platelet rich plasma. So that's something where you take your own blood and they spin it down and they pull off the platelet rich plasma, which has growth factors.

And that can be injected into, around the, the vagina. And some people have heard it called the O-Shot. That's, that's actually a licensable name that people can get trained in. But, it may be caused called other things elsewhere that's injecting, does your own blood back into your body with growth factors to trigger the, the vagina to regrow. So, so that's that's a very extensive list. I know there's a lot of stuff, which is amazing. So for someone listening like how do they navigate. How do they know am I I'm dry.

Can I just use some estradiol or DHEA internally or do I need lasers? How do how do we know how to navigate? Yeah. You know, I think on your own sometimes it's not that easy to tell yourself. I think it's also comfort level. I think it's comfort level. How, how much you want to get involved with doing things because some of these procedures can be slightly uncomfortable. Not not very much. Usually just, that day. And it also is going to be budget because some of the therapies run anywhere from, you know, you can buy a bottle of lubricant for 12 bucks all the way.

You can spend a couple thousand dollars for laser treatments. So I think one of the things that we're looking at now is in the past or up until recently, everybody was waiting and letting that tissue age and then treating it well. Once you treat something that's already kind of gone through the process, it takes more effort to try to get it back to where it needs to be. So I would actually challenge women to start thinking, in maybe late 30s, 40 years, to actually start doing these treatments almost as preventative.

I know, because if we can keep it the way it's supposed to be or the way it's healthy and keep it that way all the time, it's less effort. And in the long run it's less money that you're going to have to, to do. And so when you're younger you might just want to do like get a red light wand, which, I'm surprised I don't have one hand, usually have them like handy like next to me, like show and tell, but I don't right now. And and these are just, well, little ones. They almost they almost look like vibrators.

And just you put them in the vagina, like, 20 minutes, 2 or 3 times a week just to keep that tissue healthy. They found, and then people are like, well, why red light? What what is about a red light that works? They found that the wavelength of the red light actually stimulates our mitochondria, which are basically the powerhouse and the portion of our cells that that support, aging. So all of our aging is happening in our mitochondria. And if we can keep our mitochondria healthy, our tissue doesn't age.

So that would be like an easier thing. Now, if you're finding that you're having a little bit more dryness or even it doesn't even have to be women or menopausal, some menopausal, but even women who've been on birth control will experience these issues. Or someone who is pregnant and breastfeeding the pregnancy don't don't be messing with any lasers or anything. But, but if you've already kind of gone through some changes and are having a lot of symptoms, then laser is probably your better option because it's going to be one of the quicker things that's going to get things back to where it needs to be.

And then in combination, then you can add either topical hormones or red light or, or you know what? Or your your budget may just be like, all right, well, let me just I just want to do the topical hormones and put some creams in there, you know, kind of like we put creams on our face all the time. That's the thing I always laugh at. People will be like, putting, like, tons and tons of creams on their face. Yeah, you have them put a cream in the vagina and they're like, you, I don't want to do that.

I'm like, you're just like, you're moisturizing your vagina. We're just doing the same thing, just trying to keep things healthy. There you go. And can you just speak to because you mentioned lubrication. But lubrication doesn't fix the solution. So just to add the problem. So if you could just speak to that for the women. Yeah. So when we use like lubricant a lot of times, a lot of times people are using it during sex. Sometimes people are using them daily almost to try to keep the tissue moist.

It's really just going to kind of put like, like a layer of moisture on. It's not going to actually go into the tissue and actually fix it. But I know that there are a lot of companies that sell like hyaluronic acid. And actually hyaluronic acid, vaginal suppositories. And that's going to be I mean, that's good, but it's it's no more good than just putting a moisturizer on things that can actually going to change. That is just going to get the tissue to regrow. But using a lubricant during sex is great.

Just make sure it's a make sure it's one that's compatible with the vagina. Like a good clean lover. Uber lube. You know, there is a portion of, the population that I've talked to that looks at vaginal lubrication almost as a sign of their sexual arousal, and they judge themselves if they're not wet enough. And I always say like, that's like, that's it's a physiological thing that it's going to dry up as we get older. That just it doesn't mean that you're like less of a woman if you're not getting as wet or, there's a lot of things that play into into the factors of why, the vagina gets self lubricated and, and one of the things is some people think that that's like, it's like mucus coming out.

It's actually blood. So our natural lubrication is actually from blood.

Lubrication, Blood Flow, and Sexual Health 28:08

It's what's called a trans you date. So when we become sexually aroused, the idea is that our genital areas gets blood and engorged with blood, just like a man. It's engorged blood, but he gets an erection. When the blood comes into that area, the pressure of the blood coming in. Well, actually, like some, some of what the, the the fluid from that blood will actually leak through the vagina. And that's what causes the lubrication. It's what's called a transient. So once again, we've talked about as we get older we lose a lot of the blood vessels in that area.

So if we lose blood vessels we can't get as much blood in the area. So this is actually really important because if you don't use it, you lose it. And so this is where if you want to actually continue to have sex. So it's kind of a catch 22 because it hurts have sex. But the more you have sex the healthier your vagina will be. So, it's important that I think, you know, getting it helps getting it to the point where it's healthy from all these rejuvenating things. But also the more blood flow you can get into the area, the better.

And that whether that be having sex with a partner or even just self satisfying, you know, masturbation. Because think of it as your your physical therapy for your vagina. Because the more you can get blood flow in there, the more you keep those blood vessels healthy, the more blood vessels you make, and the better it'll be over time. So, you know, so whatever you got to do is I, I've seen women, unfortunately, over time of, like, maybe their partners have died and, they're no longer sexually active, or they, they think that, you know, that that's a part that it's over in their life.

No, you got to keep using it because at no joke, I have seen two women to the vagina will shrink if you don't use it. No, it will dry, but it'll shrink. I've had women where you can barely get a pinky inside of it. Because it will. It will shrink up, but doesn't mean you can't reverse it, because just think maybe babies can come out of there. So if we can pass a baby through the the vagina can stretch back out. It just sometimes takes a little bit of physical therapy and sometimes actually that's something you need to do is actually go for physical therapy.

There are pelvic physical therapists whose sole job is to help you keep your vagina healthy. You know, whether that's just, you know, from an aging standpoint or unfortunately, if you develop some sort of, you know, condition or pelvic pain, kind of, issue with the vagina there, there are pelvic physical therapists, I always think of orgasms as good medicine. So. Yes. Well, and yeah. And then you have also the wonderful hormones and oxytocin and all these hormones that are released during an orgasm.

So yes, you exercise if you about it as your regular exercise, which actually brings up another subject about exercise. So we start losing 8% of our muscle mass every year of our life or every decade of our life, starting at age 30. And people think about working out and like, you know, doing things for our arms and our legs. Nobody ever thinks about the vagina. And so we have pelvic muscles that basically are in charge of our whole pelvic floor that keeps everything in our body. And so that's like doing your key goals.

And if we don't do that, we can lose, like our muscles can thin out and atrophy. And now we're at much higher risk for leaking of urine, having difficulty holding in bowel movement and gas, and then even losing the ability to have strong orgasms because those muscles are just floppy. So strengthening those muscles and doing those exercises are going to help with keeping our pelvic organs in place. To a degree. There's some other conditions where ligaments get damaged, but it's a whole nother story.

But, you know, keeping our pelvic organs in place, helping us with leaking of urine, helping with, you know, strength in the pelvis and even helping with orgasms. So we've got to think about working out there, too. Good. Good points. So key goals is bad enough. And how should you what should the listeners should they start doing them now? Yeah. You always hear do your Kegels at the red lights, right? Or at the stop sign. So what do you that you know, what's the one problem with key goals is, is there's a good number of people who don't do them properly.

So I think it's hard to figure out where those muscles are. And I'll hear a lot of women that'll come in and they'll say, well, I do them every time I urinate because it was like printed someplace to do these. Why urinate? Tighten up those muscles? Well, you don't want to be doing it while you're urinating, because you're going to stop the flow of your urine, and your bladder is going to keep pushing in. The urine is going to go where the least amount of pressure is. It could be back up to your kidneys and then increase your risk of kidney infection.

Now, the reason I say to do it when you're urinating is just so you can figure out where those muscles are. So they are the muscles that help you stop your urine flow. Just figure out what those muscles are and then once you know where they are, then you can do that anywhere that you need to. But I've had other people explain it to like it. Tightening those muscles is similar to like the muscles you'd be using if you're trying to hold in your gas or holding in stool, or some people like said, well, it's like if you were trying to pick up and stuff something into your vagina, like think your picture your vagina like a straw and you're trying to suck up a drink through a straw and you're going to like, lift.

So the heat, those are great. Those are those are, what a lot of people think of with pelvic floor. But also there's exercises where you could just be sitting in a chair with, you know, your legs on the floor and stick a ball between your weight, between your knees and just squeeze, squeeze your knees together or take a pillow and, put opportunities and squeeze together that act of squeezing the legs together will also strengthen the pelvic floor. Or if you go to a gym, they have those abductor, adductor add adding your legs together.

Doctor machines that, will also strengthen the pelvic floor. So those are things that you can do. So, Awesome. So what about you mentioned bv bacterial vaginosis. So what what about infections and women having urinary tract and you know post-menopausal. Can you speak to that. So unfortunately after menopause our risk of vaginal infection and bladder infection skyrockets. And it all has to do with the microbiome of the vagina. So it's a microbiome. The vagina is off. Then we're more likely to get yeast infections, bacterial infections.

And a lot of times people automatically go reach an itch or burner discharge. The first thing that a lot of women will do is reach for the over-the-counter yeast medication, when in fact only 12% of itching burning discharge is yeast and 80 something percent is actually bacteria. So I always tell people, you're better off reaching for boric acid and bork acid. You can get over the counter. And there's many different companies out there.

Pelvic Floor Strength and Kegels 35:40

My favorite is PhD feminine health. They make one that you can find in most, most supermarkets or chain, pharmacies and doing a Bork acid. It depends on the symptoms. You can, if you really want to clear things out, rebalance the vagina. It's one suppository twice a day for two weeks. And that'll really that'll really just take care of things. But sometimes people just need to put one in, just, you know, if they just kind of feeling a little off, it helps, with odor. But basically it's going to help balance too.

So whether it's yeast or bacteria, it's going to help either way. Now the other thing is because the vagina is so close to the urethra, which is a two week throw, that bacteria can easily get up into the bladder and cause urinary tract infections. So if you're traditional medicine, if you get a urinary tract infection, the treatment is 3 to 5 day course of antibiotics. But let's say you're a person who's getting them over and over and over again. Then it's a matter of there's an issue with the the vaginal microbiome.

And then even further and maybe a problem with the gut microbiome, because I've seen that especially with yeast where women have yeast, they get treated, the yeast in the vagina goes away and then comes back, and then they get treated and it goes away and it comes back. Well, I can tell you, with no uncertainty, that a majority of those cases are people that are having yeast in their gut. And then we look back and look what causes yeast and and that diets high and sugar and even inflammatory foods, a glute in and dairy can throw off the microbiome of our gut, which then causes an overgrowth of yeast.

And then if we have a great thing in the gut and it gets near the vagina and then becomes this whole circular thing, and like we talked before, now you don't have any sex drive because you've thrown off the microbiome of the vagina. And that's going back to the brain. So it's all yeah, it's all connected. And I could do that circularly for hours. So, the knee bends connected to the shin bone. Exactly, exactly. Oh, wow. Such amazing and important information. What? Is there anything else that I didn't ask that you think's important to share for just overall vaginal health?

You know, I think when it comes to just health in general, I always tell people that total health is like a three legged stool with body, mind and spirit. And if all three legs are not even that, stool tips over. So when we talk about agile, how we can't just look at the agile house, we need to look at what is your diet because that's affecting your gut health, that's affecting your vagina, what is your stress level if you're stressed because, you know, work or life or family or just, you know, anything that's going to throw off not only your hormones, but that can throw off and start making too much cortisol that makes you more susceptible to infections, especially with yeast.

So, we really need to be looking at what can we do for the brain, what can we do for the spirit? I mean, that may be just, you know, spending time with family and friends. So we need to look at all aspects, not just for total wellness, but also for for pelvic and vaginal wellness. And then I think other than, you know, decreasing stress levels and eating healthy and being healthy, the two things we always forget are sleep and hydration. 75% of Americans are chronically dehydrated. If we don't drink enough fluids, then that affects our bladder health.

And also, well, you know, if we're having issues of vaginal dryness, we're dehydrated, then our tissues not getting moisturized from basically the inside. So we need to be drinking a lot more fluid. And you know, you're drinking enough when your pee is clear. Pee clear because always everyone's always asking how much water. And I'm like, pee clear. You're drinking enough. So, And sleep. You know, as Americans, we don't get enough sleep in anything. Under eight hours of sleep not only decreases lifespan, but increases our risk of obesity and also increases our risk of not not healing and affecting our immune system.

So, you know, you gotta we gotta put all those things together not only to keep our vagina healthy, but to keep everything healthy. And sometimes the vagina is the first sign that something more serious is going on. And it may be the vagina having problems because it's your body's screaming for help saying, like, you're not feeding me, right, you're not sleeping right. You're you're too stressed.

Infections, BV, and UTIs 40:38

It might not show up anywhere else. I mean, the vagina may be the first place that shows up and then we ignore it. And then next thing you know, we're having other health problems. So basically, listen to your vagina trying to tell you something. Your vagina is speaking. Don't the word. So I also want to just ask because you mentioned in it's a very important point about the vagina being acidic, because a lot of times we think we need to be alkaline to be healthy. And there are parts of the body that, like the stomach and so and the vagina.

So how could someone figure out if they're a vagina is the right page? Yes. So interestingly enough, you can get p paper and actually tests. And so, we actually go over this and I have a vagina reboot course and we go over how to test this and how to evaluate it. But it's really simple. I mean, you could even just take a tiny Q-Tip and just put it into the vagina, and you want to get in a specific range. It's usually a range of 3.5 to 5.5. So, we have it on our website. You can find it elsewhere because any the normal page of the vagina should be between 3.5 and 4.5.

So anything higher than that is there's something out of balance. Now, the only thing that gets a little tricky about that is yeast can survive in lower lower acid environments. So like the more like it can be in a low I mean, a lower, more acidic environment. So if you're still having symptoms in the peach is normal, doesn't mean that things are fine. You need always check, you know, check out what the symptoms are. And, you know, from a standpoint of at home, you can always try because I know sometimes it's these things always happen on a Friday night at 5:00 when all your doctors are closed and then you got to wait until Monday to get to see what I know.

It happens all the time, so I would reach more for the boric acid. Before you go for anything else, an important thing is stay away from Duchenne. A lot of people want to feel fresh. And, you know, first of all, the Duchenne and the soaps, you know, a vagina wasn't ever meant to smell like roses. We don't need, you know, floral spring scented vaginas. Because a lot of these products do contain irritants to the tissue that can further throw off the page. And the microbiome, inducing the we have an open system.

So the vagina is connected to the cervix in the uterus. And then coming out the university of the fallopian tube, the fallopian tubes are open to our abdominal cavity. So the problem with doing that, when you you squeeze this water in this fluid into the vagina, if we're squeezing too hard and we don't know how hard we're squeezing, we could be flushing things back into our abdominal cavity. You don't want to be flushing yeast and bacteria that shouldn't be there into our abdominal cavity. Then you get really sick.

So stay away from the in the washing altogether. And honestly, water is your best friend when it comes to washing. Without using anything else, though, I have to say I am actually really excited. So I said about the PhD feminine health company that I love, they just came out with a balk acid wash. Oh, so I find that that one is more is more balanced. If you feel like you need some kind of like soap, I would go for more of the balk acid wash. But in general, water is all you really need. Well, a lot of the soaps and detergents are more irritating, and they're than they're worth. So, which actually also is one of the problems some people with toilet paper, because toilet paper is often bleached to make it white and to some people that bleached toilet paper can be very irritating.

So nowadays you can find unbleached if you're finding problems, especially with as we get into menopause, that which is more dry can be more, sensitive. There are companies that make unbleached, toilet paper, bamboo toilet paper. So those are some things. If you're having a problem, if you're not having a problem, you can use those. But you know, things you got to like think about like if you're irritated, like, okay, what could be causing it with the detergent? You wash your clothes in? I always tell people, especially underwear wash in like, dye free, fragrance, not unscented.

Unscented because unscented, laundry detergents actually contain scents to cover up the chemical scent of the the soap or the detergent you want, like, fragranced undyed soaps to wash your underwear. Because anything that's touching that skin is going to make you irritated. This is why, if you're using any kind of pads or even like pads for incontinence, you're getting a little leaking.

Whole-Body Wellness and Vaginal Care 45:48

You want it. Sometimes those pads are bleached. So lots of different things that can be causing irritation down there. Yeah, I'm glad we I'm glad we went there because that's super important. And I'm, you know, I'm a fan of bamboo organic, natural whether you're struggling or not. Like, you know, prevention you were saying, is is the best cure. And so let it breathe. Two at night like either don't wear anything or wear very thick things that are very loose because, you know, when we're wearing lightweight and constrictive clothing, we're holding in moisture.

And yeast especially likes a warm, wet, dark environment. Well, that's the vagina, especially in clothing. So let her out. Yeah, I tell you, I'm wearing a dress right now and I got no underwear on, so yeah, actually, I'm wearing sweatpants with no underwear. That's why nighttime when I come home, I like fashion from the doctors. Yes. And then to to. It's all off air. Absolutely. Yeah. Let it breathe. That was that was fantastic. I think we covered a lot of ground and ended on a on some important good notes.

So, thank you for, you know, it's funny, as you were talking for a minute, I was thinking about, like, the mouth and how we we've so been taught that the mouth and oral health and the teeth are separate from our body, and we just go to the dentist for a cleaning and our mouth is such a breeding ground for disease processes that we experience. And so it's kind of like the forgotten mouth, the forgotten vagina, like these orifices are, are part part of full body health. And so I hope that from being here and listening to Doctor Betsy's wisdom, you can bring your vagina home to being part of your body and embracing it and not being not buying into any of the weird stigma.

It's it's part of your body. It needs TLC, it needs love. It needs attention, it needs prevention, it needs treatments. And so I hope that, you you have a lot to take away from this talk that's super important as you are mastering your transition and your hormonal journey and aging and growing and being a woman and being a sexual being, and all of these wonderful things that we get to experience. So thank you for for bringing the juice and bringing the conversation session and for all that you do.

And, where can people find you? Sure. So first of all, I'm all over social media as long as I don't get kicked off again using the word vagina. But come follow me, especially on Instagram at Doctor Betsy Greenleaf currently is Doctor Betsy Greenleaf underscore. But if you look me up at anywhere, Doctor Greenleaf or Doctor Greenleaf underscore or doctor, I think it's doctor B Greenleaf on Twitter. You can find me on there. I have a website, doctor Betsy greenleaf.com. And, there's also the pelvic floor stalker.

And so we'll be putting some information on those sites about different courses and programs we're doing. So yeah, come, come find me there. So again, her least her Instagram videos are a lot of fun. So highly recommend. Yeah. And I'm working on TikTok. That's my my next thing I'm trying not to I got I got so many ideas for videos up here and not enough time to do them. I just, I promise, we'll look forward to that. So thank you for for being here and sharing with us. And, to all of you and love to love to integrate and think about, but, you know, really, really important.

That's why I wanted it to be a part of the summit. So we will.