September 2, 2021
Happy Vaginas, Fibroids & Discharge
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Board-certified gynecologic surgeon and author of This Is How You Vagina, Dr. Nicole Williams joins us to share her knowledge and wisdom on the following questions and more.
- What makes discharge normal? How can you tell if something is awry?
- What myths hold us back from loving our vaginas?
- Why might your vulva be itchy?
- How do fibroids affect sex and pleasure?
Follow Dr. Nicole on Instagram, Twitter, Facebook, and The Gynecology Institute of Chicago website.
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Rough Transcript:
This is a computer-generated rough transcript, so please excuse any typos. This podcast is an informational conversation and is not a substitute for medical, health or other professional advice, diagnosis or treatment. Always seek the services of an appropriate professional should you have individual questions or concerns.
Happy Vaginas, Fibroids & Discharge
00:00:05 – 00:05:04
You’re listening to the sax with dr jess podcast sacks and relationship advice. You can use tonight. Welcome to the second doctor. just podcast. i’m your co host brandon. Where here with my lovely other. Half dr jess hey. I’m ready to talk vaginas. Are you ready to talk vaginas. I’m ready to talk vaginas and learn about vaginas. Did you learn about vaginas. Growing up. In what i learned in school. Which which probably everyone learned that was about it. Okay what did you learn in school. Specifically about vaginas. What did you learn. I can’t remember what. I just remember basic sexual anatomy so what it was what its purpose was and we definitely didn’t learn about any pleasure. Okay so what did they teach. You was the purpose. Well there was babies. Which i know not in the vagina per se and then obviously other anatomical functioning. I mean if you had you know that you re thrown going p but that was a bit okay so they actually taught you that there was a separate whole to piazza. Yes i recall that. Yep because we didn’t. I don’t think i learned that. Like i think i kind of for longtime thought the vagina and the youth for with the same interesting. No i do remember it being separate. Because i remember you learning about the you. Re threat for penises as well okay. So let’s talk names. did you have like. What did your parents call the penis. I only remember it being called the penis. I can’t remember if i was a kid if it was called something else when i was a little little kid i mean maybe my pb or something like that. But i never. It was never called anything else and did your parents use the word penis freely. Like i can’t picture your dad’s saying penis. I definitely wouldn’t say that it was used freely but when we had to address it if there was something it was what it was. Which was the penis. Okay okay. now i’m thinking about my childhood. My parents call. I guess the vagina the pongy. So pongy i. I don’t know if it’s from the jamaican side. It could be the chinese side. Or probably some combo of chinese jamaican it was always called the pongy And i can’t for the life of me. Remember when i learned that it was actually called vagina or vulva volvo. I learned when i was in. I think university. But i did have a book called. Where do i come from. Which was this cartoon illustrated book out how babies are made so pongy was the word. I’m wondering if anybody else’s parents called it the pongy like i’m saying oh maybe it was for my jamaican side. Maybe it was chinese jamaican. Maybe my parents just made it up. I don’t know if your parents called it a pongy. Please let me know and if you have a story about how your parents taught you about your body parts kind of the good. The bad the ugly definitely send it our way so you can email us but also you can still leave a voice note for us to play on an upcoming podcast if you’re up for it i’d love that it’s on our podcast. Page at sex with dr jess dot com. And while you’re there check out our course all about pleasure for vaginas and actually really clitorises. It is mind blowing oral clitoral edition and it’s on sale this week. You can save twenty five percent with code podcast so podcast will get you twenty five percent off and i think it’s a pretty great course and a really good deal. Honestly if i do say so myself. Since i created and hosted. But he’s got a ton of info on sexual communication on toys on principles of pleasure and of course so many techniques for touching and petting caressing and licking and kissing and just giving pleasure to the clitoris and the surrounding area and having better saxon better orgasms and in the video course i walk you through each technique and our model ivory demonstrates on some really juicy fruit so you can learn from home and watch so there’s a series of videos willing to the course in the show notes or you can access it directly at happier. Couples dot com. All right let’s get into some vagina. Talk joining us now. is dr nicole. Williams author of this is how you regina a board certified gynecological surgeon and founder of the gynecology institute of chicago. Thanks so much for being here and congrats on the book. Thank you so much. Dr justice really great to be here with you hard to have to ask. What made you write a book about vaginas. Why did you go there. Great question i am. of course. i’m a gynecologist. I’ve been unpracticed for a little over fifteen years and what i’ve noticed over all of this time is at my patients still kept having the same questions and the same concerns over and over and over throughout the years even though it’s great for me to be able to explain it to them one on one i started thinking of my patients and we have seventeen thousand patients in the practice. If my patients have these questions what about other women are they still having these same insecurities about their anatomy that my patients are having and i thought you know with the pandemic. I had a lot of time on my hands and any major knows that when you give an english major too much time to do nothing like their brains go wild.
00:05:04 – 00:10:06
I started thinking. I start answering some of these questions and i was gonna just write a little e book to put on my side just frequently asked vagina questions but i just kept going and going and going. I realize oh my god. I have eighty seven pages. Nobody’s gonna read that unless it’s like an actual book and that’s just started to get it done and there. We go amazing. So what are some of those questions that people have been coming to you with over and over again in the thousands the biggest question i always get is odor. Everybody is so concerned about odor. And i explained to them for the most part. Yes your vagina is gonna have some type of owner odor considered your signature scent which is completely normal. Sometimes it’s a little tangy. It might actually depend on what you’re eating or drinking generally it’s normal but we are bred at to believe our vaginas. You’re supposed to smell like you know. Bath powder or chanel number five or you know. Some kind of special bath and body works all the time. But that’s actually the opposite of what you want what you really want. If you’re trying to attract a partner. I have research in my book about this is that you want your own signature. Sent to get onto your partner. Because he’s gonna remember or she for that matter is gonna remember or they or is going to remember that sense especially if it’s tied to pleasure is going to bond nut person to you so when i talked to my patients about their odor. Most of the time. It’s normal. I secondly you want this smell. Because it’s going to help with your relationship on a cellular level and thirdly we are not supposed to smell like betham body works so you’re you’re dispelling that information and i appreciate that so much. How do we get over the idea that the vagina should be one way because we even see this. You must see this in your practice where people come in and say oh. I’m sorry i didn’t have a chance to shave or they’re kind of holiday sizing for their vulva and vagina. Before you even get down there. Can you tell us how little you care about whether or not they’ve shaved or i don’t know what else they apologized for. Oh my god. They apologize for everything. Oh i just came from the gym. Oh i didn’t get a chance to share first of all. Let your bushby free like we talked about those glands. Come from the hair bearing follicles. So you do want you want a little bush. That’s gonna help. Lead the bush alone so my patients are is apologizing and i actually talk about the little section in the book. Where lysol you know. Lysol that we’ve been spraying on everything. Because of the pandemic. It was originally made as a vaginal disinfectant. There are textbooks from way. Back in the fifties where doctors would clean their hands and clean the vagina with a lysol solution and there were ads in newspapers. This has been going on for actually millennia way before nineteen fifties. But this is where it came from. And it’s been propagated ever since. Oh my goodness but of course you do not recommend lysol for the vagina. Absolutely not it’s been dispelled. But the fact that it was their explains a lot about why so many women have these insecurities And people with penises. I don’t know that they they have the same concerns. I don’t know brandon like. Is that something you ever really think about with your penis. I’m just sitting here in shock. Because no i don’t think about. I certainly don’t think about wiping my penis with lights. All that sounds like it could be very painful but there. Just isn’t the same sort of stigma i think for people penises for me to listen. I think you’re always a little bit self conscious if you have a partner you’ve been with somebody before but at the same time no absolutely lysol has never crossed my mind ever and i see in your book. You also talk about different types of vaginas right so the so called rejuvinated vagina. What are the different types. I imagine this is all in the name of having a normalizing conversation that all vaginas are good vaginas exactly so i wanted to break it down in different types quote unquote. So it’s easier to digest. Because when i started writing the book i’m like how am i going to approach. This and i looked at so many different other books in how they approached. It approached it by disease process. Like oh this. Is this disease that disease but my patients don’t think about it like that they think about it as okay. This is the thing that’s happening my vagina. What’s going on with it right now so. I have itchy vagina. What’s going on. There’s something coming out of my vagina. What’s going on there something on my vagina. I’m giving birth. that’s why i broke it down like that. So then when you read about each factor it makes a lot more sense that you can understand it somewhat better by going okay. This is what my vagina is going through right now. These are the things that it could possibly be now. Of course the book is not a complete repository of all of the things that it could be. These are just guidelines to kind of help. Guide your conversation with your practitioner. What are some reason. You could have an itchy. I guess it’s more the volvo right to get itchy or to china get to. Yeah what when. I talk about vagina in the book. I just made it the all encompassing vagina slash volva complex. Because most people don’t know the word volva meaning the external female genitalia cy disuse where vagina as a catch all.
00:10:06 – 00:15:02
Just make it easier to write the book but really the most common is just your run of the mill houston fiction however sometimes but china’s just my rich and if you have a male partner he might just adjust his balls and just not even think a second about it but if we have even just a tiniest little loose something might be. Oh i got a little scratch and then it’s done we. Oh oh my god. Something must be wrong. But i don’t know brandon. What do you think. I think i’m embarrassed to admit that. Yeah i’m i think i’m making a little adjustment right now and not even thinking about it so i never thought that you know having a vagina and scratching would be considered you to something that you you’d think about because guys people with penises are constantly touching their penis like constantly adjusting or moving. Or get your hand in your pocket. You know. there’s a little who yeah do. You think that’s because you treat your genitals like it’s just a regular part of your body whereas we’re taught to treat it like it’s this kind of mythical beasts. That’s not a part of us like listen if i have a scratch face. Scratch my face even in the meeting right. I’m not self conscious about it at all. I you can see me exactly. I have a little under my nose. I give it a little rub but with the whole genital area especially for people above us. It’s like oh we shouldn’t touch it. Something must be wrong. We have to sound the alarm. It must be affected by your cycle in your hormones. As well right like i noticed that things feel different ovulating versus right after my period and of course during my period oh sure of course you’re gonna have an easier all you’re gonna feel something different you’re out you’re month if you’re cycling. You’re not controlling your hormones absolutely but these things are all completely normal. I think one of the reasons doctor that women see anything going on with their vagina vulva as wrong if they have to each other. If there’s something going on because everything is hidden for us with men it’s kind of out there it’s hanging around it’s you can see it. It’s very easy to access. It’s like it’s right there in front of you for us. Everything is hidden. it’s tucked in and that actually goes to what you’re talking about with the whole mythical beast ancient peoples actually thought that the uterus vagina all that would move around to different parts of your body and wreak havoc so it really was a beast so if you are sick if you had sore throat or headache they thought your uterus actually moved to your head to cause you problems Now can i ask you about the uterus. Can i have some questions from some folks here. Somebody’s asking about a tilted cervix or a tilted uterus and whether or not you need to what they ask is specifically story what are the best sex positions for tilted cervix So if you’re talking about it’s called retro version of years it is a normal anatomic ovarian like how one ball might be lower than the other one on a dude. It’s nothing wrong. It’s just that the fact that the uterus normally the top of the uterus normally sits forward and if you have a tilted which is a misnomer to be retrofitted usually just sits in the opposite direction so if you’re talking about that actually probably. I had to guess educated. Guess knowing the position of the uterus. It’s actually gonna be rear vaginal injury. So hands and knees on female rear entry for the male because the angle at which the penis enters isn’t going to jostle a retrograded uterus as much as an anti verdy uterus so if you have an anti verdict uterus and they are basically hidden it from the back sometimes you might feel a little something buried deep inside. That’s when he’s actually hitting your uterus and you have to angle yourself a little bit more but if you have a retro averted uterus the angle is should already be in the correct position not gonna jostle your uterus around in ’cause you discomfort interesting and i imagine you kind of have to experiment for yourself absolutely find what feels good. Yeah has to do with the angle of the inserted objects to penis or a straw or whatever because they’re also curved right or they bend down side more than the other and that’s perfectly normal as well exactly and in the book we talk about the infamous duct ref avert so dr finger. Otherwise known as the g-spot he didn’t name it himself first of all he’s not like going around like i’m naming the g spot after myself. Because i’m just bad as no it was actually named in the nineteen seventies from a nineteen fifties urologist. Who found that this spot actually right in the anterior portion of the vagina. If you move your finger in like pump here motion you’ll find dr graefin gertz area and what they believe this to be is analogous to the corpus. Spongy oh some of the penis like the shaft portion of the penis which is still very pleasurable. Not quite as pleasurable as the head of the tip of the penis which is going to be our glance clitoris. The one the little bit that kind of peeks out that’s analogous to the tip but dr gothenburg’s analogous to the shop you’re talking about you know whether it’s vaginal rear entry or whether it’s missionary side the most superior all of these other positions you’re gonna wanna make sure that you’re stimulating dr g spot in.
00:15:02 – 00:20:03
There’s always been old cosmo in all these places like oh gee spot real not real okay people. It’s been around since nineteen fifties when dr g identified it. It is real it is real and the thing about the g spot. We’ve kind of like some of us have re rewarded our language to make it the zone because it’s not like a hot button. I think sometimes people think it’s just a little button but the thing about it is some people find it intensively pleasurable and some people. Don’t it’s like even when we think about the head of the taurus like we always talk about the function of being simply for sexual pleasure. It doesn’t mean that everybody likes their head tickled or poked or sucked on or vibrated. Right right everybody. The so that area exists. And it’s there for your for your experimentation for your exploration and another piece around that. And i don’t know if you’ve talked about this in your book. Is the fact that the way we interpret or enjoy pleasure changes during our site. Call right so lake pressure against that. Jesus might feel really good during one period of your cycle and then two weeks later it might not have the same effect. It could be uncomfortable. It could be neutral. You must see that. Even more with the cervix because the cervix really changes position throughout the cycle doesn’t it. Yeah the starbucks is gonna be closer to the entry of the vagina at ovulation on purpose because the cervix releases the mucus that is going to help the sperm to stick to it and at ovulation. You’re gonna want that closer to where the sperm is going to be released so it might be down and this is millimeters. This is not inches or centimeters. You know it. Does it make this giant move all the way down and back up. This is just a little bit because you know. We’re talking about cells here but millimeters out when it comes to sell so and you’re going to feel a little bit different throughout the cycle. You’re gonna wanna feel a little bit more at ovulation and maybe not just before ministration because we know that the egg has already been released and it’s already on its way out. You may not have as much response. Sexual response immediately prior to menzies. You may not but some women do. And that’s the beauty of being female interesting interesting. And so the cervix eat you mentioned mucus and positioning does the texture or anything to the does the feeling of the cervix change throughout the cycle as well. Yeah so we talked about in the book. We kinda talk about things that are coming out of my vagina. There’s something coming out of my vagina. And i have so many of my patients and this is why eighth grade sex. Ed needs to be completely retooled. The whole year becoming a woman now that that’s done for but during ovulation. You’re going to release a thicker mucus. That mucus almost looks like egg whites. And it’s very very viscous. It’s called spin bar fight that if you’re interested in patients who are very interested in natural fertility they discharge and if you can stretch it it becomes very stretchy and it doesn’t break then you know that you have oscillated so you don’t necessarily always need you can count your days. You can also check your discharge in my patients. Actually think when they’re coming to me like oh my god two weeks after my period i had this terrible discharge and i explain that. Is your natural discharge to help sperm stick and they go. Whoa whoa. nobody ever told me that. Like yes what. I just did. Not you know. Tell your friends exactly. Tell all of your friends i. It’s interesting. I remember when i was probably in a boat. Read seven or so and i’d see the charge in my underwear. I was freaked out. Because i had already learned that it was going to get my period. I don’t think i had gotten my period yet. Because i got mine a little bit late and so i knew that what that was gonna look like. This didn’t look like a period. Obviously and i seriously thought like when is this gonna stop. Is this part puberty. But of course it’s continued throughout my life and it’s something we don’t really talk about the fact that we exist charge all the time we discharge all the time every day and it kind of depends on what you take in. So if you’re well hydrated you expect your this tarred unless you’re ovulating to be relatively thin yellow clear and very easy to pass if you’re dehydrated for it’s gonna be sicker. It might actually be irritating. So i tell my patients if you feel like you’re having irritative discharge drink some water because we expect to have this completely normal genitalia and be able to eat like crap and do whatever the heck we please and expect everything to just work like clockwork and i have to give the body. The things that it needs and it needs so water and sunshine. Hurry soap water and sunshine but no soap inside right no soap inside just so full of external vulgar area. Just a very mild soap. I like an ivory or a dove. You know. I don’t pay by any of these people but just a milder types of soaps you don’t need to specially please don’t use anything that has heavy perfume because remember. Don’t wanna mask your signature said so any potential level be like well. You just like the woman. I was just nice. Personnel was just. We had china last week. You want your own sense so plain soap water meaning use plain water and drink a lot of water. That’s something that. I know brands very good about well i mean. He doesn’t have vaginal discharge. Does the penis have regular discharge at all. Oh to my knowledge. W what’s that dave.
00:20:03 – 00:25:07
I was just joking around. Because i think people penises. There’s a lot of discharge when you’re early teenagers through maybe mid to late teenage years and then joking kind of depending. How much continue. Yeah yeah so. If opposed discharge. You’re creating the discharge out. So i have one more question about discharged. Because i get this often. What makes discharge normal like. How can somebody know that. My discharges normal and housi- for me or something’s up. Maybe i should get checked out by my healthcare professional. So if you’re discharged like we said if it’s pretty thin yellow clear now even if it gets on your underrate turns your underwear crunchy. That’s okay. it just dried it’s fine. don’t use a panty liner. Because what’s on the back of a penny line of plastic. I don’t care how breathable they say it is. It is genuinely some type of polymer on the other side of that so cotton underpants is going to be your best friend. They last a really long time. And you’re not spending money. Even i did a little math in book and if about ten percent of patients use a daily panty liner. If these women all stop buying henny laced where every day we will have saved landfills. I secondarily we will have robbed all of these companies that are selling us the fact that our vaginas need a panty line to protect our underwear from discharge when the whole idea of underwear is to catch the discharge. Let’s saved i forgot. It was like maybe about fifteen billion. Or maybe it’s almost like a billion dollars or something like that. It’s a huge amount. Big money about it’s it’s it’s a huge amount so let’s not give them money because even know what the average woman you saved them like fifty five bucks a year still for several problems we have you know hot underwear to wear catcher discharge. So that’s normal normal discharge abnormal if it is now sometimes you’ll get a little bloody discharge at the middle of your cycle. That’s also normal because at its associated with ovulation so no that too but if it is malodorous meaning if it is a strong strong odor if it be clumpy than we start to think of yeast if it’s green. We start to think of things. Like bacterial geneticist or genetic. It’s pretty easy for your practitioner to check out quick swab. Everything comes out. Okay then know that you probably need to be a little bit better hydrated and then keep a note mentally okay. This is my range of warmer. So then you’ll know that for next time and when you say a little bit of blood in the discharge it is it discharge carrying a little bit of blood or just blood on its own at the middle of ovulation. Your estrogen levels might drop a little bit. Your body thinks it might be time for the period so you bleed a little but then is optimize up not time for the period. The estrogen levels increase again. So right at cycle anywhere between into seventeen. You might get a little tinge of blood. So that’s not part of the discharge. That’s actually coming from the uterus herself. Okay and so do polyps and fibroids affect that like i know i have polyps and probably talked about this before and i’ve been very lazy about going and having them removed because they’re not bothering me too much but i do get. I do believe spot between periods and i realized that you do you remove fibroids right i remember fibroids we also remove polyps too because if they are bothering you so if it’s just a little spot or two and they’ve monitored and they biopsy if find that it’s completely normal that it’s not pre-cancer anything like that. It’s not necessary to remove it unless you know if it starts with your life if you’re bleeding every day you’re bleeding after sex with that. Little vacuum suction at the penis might make if you have. You know a person who has sex with a penis then you might get that little vacuum. You might actually get bleeding after sex then you do to remove those polyps yeah same thing with fibroids so you might get bleeding that outside of menstruation. I’m not talking about like the one day of little bit of spotting that you might get. That is normal. We’re talking about abnormal when you start spotting multiple days through the month that you cannot track with ovulation when we go. You’re looking at your calendar while that doesn’t make any sense this outside of what my normal is and that’s why when i talked my patients i explained. It’s really important for you to know what your cycle might feel like and yes might change somewhat drought a life for the most part you kind of stick to some basic rules now. I want to ask you about fibroids. Because i have. I received a bunch of questions. So i know you do surgeries for fibroid removal. I think i’ve seen some post on your g. Can you just tell us what fibroids are. And what we should know about the way they can affect lifestyle and sex. I know that’s a huge question. But i hear from so many people with fibroids for whom it’s it’s debilitating. So what are they. What are their options. What can we do so first of all. Thanks for asking that question because its passionate. I’m passionate about helping women who have fibroids to live their lives especially sexually fibers are usually benign tumors. They can range anywhere in size between a p. and a watermelon the largest one. I’ve ever removed as a ton of knocked. The melon esque size now. They grow over a period of years and unfortunately african american women or black women do tend to start growing vibrates in their twenties.
00:25:08 – 00:29:25
And for some reason we don’t know why we’re still trying to look at gene signaling and the like why those fibroids are getting bigger faster. But not everybody’s does but those patients who do grow these large like orange size tumors. Of course it can affect your sex life because when if you have a toy or a penis or finger anything that goes into the vagina you can actually touch the uterus and like we talked about you jostle the uterus around it can be incredibly incredibly painful and that’s a deeper kind of pain sensation that you wouldn’t get if you say had vaginal muscle spasm. Which is a very very different type of pain. So those patients who do have vibrates it can be incredibly debilitating options for fibroids. Include anything between medication or surgery or combination of the two. I’ve had patients tell me. They become vegan for a whole year. They had no dairy products and did everything they thought would help. The fibroids not grow. Unfortunately there just hasn’t been enough data and the patients who have told me that okay. I was vegan for a year. They’re fibroids still grew. Unfortunately so when. I’m looking on itchy and other social media sites about these people who are saying. Oh well if you do this particular diet than your vibrates gonna shrink. I’m gonna call. Bs on all of that because there has yet to be any diet or anything that can shrink a now. Of course we want you to live a healthy lifestyle. That’s still incredibly important for your overall health. When it comes to shrinkage we have medications. You’ll not wanna talk to your physician practitioner about or surgeries which might include larry scott surgery surgery very tiny holes. Or maybe you have to do an open surgery like that of a c section either of these things it kind of depends on the size of the fibroid and what your goals are with the uterus. How do you diagnose the fibroid if somebody’s worried like i have fibroid how do they know a lot of times you’ll have family members with fibroids. Ask aunt your mum older sisters. They’re a little bit older. You know but for yourself if you have no relatives of fiber if your periods come very very heavy if you’re changing your sanitary protection every hour. Or if you get really tired. Help patients fatigue. You’re staining through your clothing. That’s abnormal uterine bleeding and that should be easiest way to diagnose fibroids is suspicion so if you’re period changes the to a practitioner at an ultrasound ultrasound even a united states with our terrible health system go canada. It’s still pretty cheap tests and can give you a lot of information. Okay great and i know people can learn so much more about you your work the vagina healthy sexuality in your in your book. This is how you vagina available anywhere. Books are sold really really appreciate you sharing your expertise your insights today. I any last thoughts on what you’d like people to take away from your work and from this is how you vagina. Let’s see so from this is how you vagina most of the time. Your vagina is normal. Embrace her in all of her vagina. Glory have questioned talked practitioner and for fibroids heavy bleeding. Don’t wait don’t wait because if you are in your late twenties early thirties and your periods changed. Just don’t go okay and just do nothing about it. If you feel like something is not right. Go get checked out really appreciate that. Thank you so much for your work. Thank you for your time today. All the best and congrats with this is how you vagina. I’m looking forward to reading it. I just got my copy yesterday. And i’m sure other folks are going to go out there and get this book. Dr nicole williams board-certified gynecologic surgeon and founder of the gynecology institute of chicago will make sure to leave. All your handles and links in the show notes. Thanks so much for being here. Thank you so much. Dr jess and thank you for listening once again. We’re running a twenty five percent off sale on the mind blowing oral courses this week at happier couples dot com. I said it was the clitoral one in the beginning. But it’s both of them the clitoris and the pena. So we’ve all got something to learn. Check him out. Use discount code podcast to save. I hope you are having a great one wherever you’re please keep your questions coming. We’ll be back next. Friday and every friday with a brand new episode. You’re listening to the sex with dr jazz podcast. Improve your sex life improve your life.
