Great Sex, Naturally (15 page)

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Goldenseal root.
Also known as
hydrastis
, goldenseal can be used as a douche, as a sitz bath, or as vaginal suppositories to treat vaginal infections. It’s antibacterial, antifungal (which means it kills yeast), and gentle on your tissues. You can find goldenseal root at most herbal dispensaries, often as a powder, capsule, or pill. If you purchase capsules, you can open them and use the contents to make the mixture for your douche or sitz bath.

For a douche or sitz bath, bring four cups of water to a boil, add a tablespoon of goldenseal root, simmer for 15 minutes, strain, and let cool until it’s at a warm temperature, comfortable to douche with or sit in. For douching, use this mixture to douche twice daily for a week. For sitz baths, warm the mixture, pour it into a large pan, and sit in the pan for 10 minutes twice daily for two days.

To use goldenseal vaginal suppositories, place one in your vagina twice daily for a week. You may need to obtain goldenseal suppositories through your naturopathic physician; the ones I recommend, which are in a base of cocoa butter, are well tolerated by most women.

—
Chinese herbal wash.
You can treat vaginitis caused by bacteria or yeast, and nurture this sensitive yin area of your body with an antipathogenic herbal remedy from a Chinese-herb store. The product Yin-care combines a number of organic Chinese herbs, and makes an effective douche; for information on obtaining it, see
Appendix C
. Yin-care is recommended for chronic vaginal imbalances, known as “damp heat” conditions in the terminology of traditional Chinese medicine.

For douching, dilute the herbal wash in warm water, following the directions on the product label, and douche twice daily for five days. If you have a chronic or severe infection, mix the herbal wash with an equal amount of water, soak a tampon in the solution, place the tampon in your vagina, and leave it there for three hours; do this twice daily for six days.

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Friendly bacteria vaginal suppositories.
If you suffer from bacterial vaginitis, you need to restore your vagina’s bacterial balance with friendly bacteria. Your vagina is healthiest when your friendly bacteria keep the unfriendly elements in check and help maintain your vaginal pH at the right level.

You can purchase over-the-counter suppositories containing friendly vaginal bacteria, known as
Lactobacillus acidophilus
, but it’s important not to overuse them; you don’t want an overgrowth of friendly bacteria. For most chronic or acute vaginal infections, use one suppository a week for seven weeks. (see
Appendix C
for information on purchasing friendly bacteria vaginal suppositories.)

To help determine whether vaginitis is caused by bacteria, examine any discharge you may have. If it’s yellow-green with a slightly fishy odor, you most likely have a bacterial infection; if it’s white and curd-like, you probably have a vaginal yeast infection. For a definitive diagnosis, however, you’ll need to see a doctor.

—
Cleansing.
You can have chronic vaginitis from bacteria or yeast if your immune system isn’t in peak form and your overall health is compromised. Many women with chronic vaginitis also have excessive yeast or unfriendly bacteria in their intestines, the result of an overwhelmed immune system that can’t rally to restore balance between friendly and unfriendly bacteria and yeast. With your Great Sex Detox, the cleanse outlined in
Chapter 2
, you can recharge the health of your entire body and effectively eradicate vaginitis.

Facilitating Sex: Solutions for Vaginal Dryness and VAD

Vaginal dryness is one of the most disconcerting sexual-health challenges you may face. Most women experience it to one degree or another at some time in their lives. If you have vaginal dryness, there’s no mistaking the symptoms, especially if you experience it during sex; insufficient lubrication can be debilitating to your sex life. One woman graphically described the condition to me as “a sensation that my vaginal walls are lined with sandpaper.” Another summed it up as “feeling like I have dust bunnies in my vagina.” Solving vaginal dryness can be one of the most sex-enhancing steps you ever take.

If you experience vaginal dryness at any time in your life, you can benefit immeasurably by using natural lubricants as needed for sex. We’ll cover many of your options for sexual lubricants in detail later in this book.

When vaginal dryness is accompanied by the thinning of the tissue of the vulva and vagina known as
atrophy
, which often happens during midlife, the condition is referred to as
vulvovaginal atrophy
or
vaginal atrophy and dryness
(which we call
VAD
). The name may sound clinical, but it describes an experience that for many women is all too real. VAD is a silent epidemic that affects millions of women, including up to 60 percent of those in their postmenopausal years.

Your vaginal and vulvar tissues naturally secrete sex-enhancing lubrication, and the secret to your secretions often lies in your estrogen level. VAD is caused by the natural reduction of estrogen throughout your body as you approach midlife; the tissues of your vulva and vagina are uniquely sensitive to this decrease because they’re estrogen-dependent. The drop in estrogen can decrease blood flow to these tissues, and lower their collagen content, and since collagen makes up your connective tissue, this means more tissue breakdown and atrophy. In addition to atrophy, the most noticeable effect of VAD is the reduction of your natural lubrication, and vulvar or vaginal pain that can last for months, or years.

If you have VAD, you may also experience vaginal irritation, itching, tenderness, urinary incontinence, and pain or bleeding during sex. Your symptoms can range from uncomfortable to excruciating, and sex may be out of the question. You may visit a number of gynecologists who prescribe topical steroid creams and vaginal anti-yeast creams—all to no avail. You may conclude that nothing can be done, and resolve to live with your symptoms.

Although both vaginal dryness and VAD are among the most common challenges women experience, VAD is one of the least recognized. There has been a tendency to downplay or ignore it in conventional medicine, which provides no clear explanation for why some women have the condition and some don’t. Since VAD often begins when a woman is in her 40s and continues into postmenopause, conventional doctors sometimes consider it just another unpleasant change that comes with the territory of midlife, a “minor” affliction requiring no special medical attention.

If untreated, VAD can lead to numerous other conditions, including vaginitis. Low estrogen in your vaginal tissues can make you more vulnerable to pH shifts and vaginal infections from unwanted bacteria and yeast. This happens because your vagina and urethra are lined with
mucosa
—the protective, moist outer barrier that lubricates your tissues and helps prevent vaginal infections from bacteria and yeast, as well as urinary tract infections. When the estrogen level in these tissues drops and your urethral and vaginal tissues become thinner and more fragile with atrophy, your protective mucosal barrier can break down, increasing the potential for bacteria or yeast invasion.

If you suffer from vaginal dryness or VAD, the good news is that there are many ways you can alleviate your symptoms, and you may be able to make them disappear completely. Treating VAD often means mitigating its effects by nourishing and supporting your vulvar and vaginal tissues.

From the perspective of traditional Chinese medicine, the symptoms of vaginal dryness and VAD are by no means an inevitable part of your life; they’re seen as the result of an imbalance in your chi, and inadequate circulation of chi through your pelvis. The underlying causes can be treated with herbs, some blended in ancient formulas that give them synergistic effects—which means they’re more effective in combination than alone. Two of these formulas, included below, can be used to balance your chi, enhance your overall health, and nurture your vulvar and vaginal tissues.

For many women—especially those with severe dryness and great discomfort—using any one treatment alone may not provide the entire solution to VAD. Some find that combining Western methods, such as topical estrogen cream and vitamin E, works best, while others find a blend of Western and Chinese methods most effective. And for many, combining treatments with the lifestyle changes we’ve covered earlier in this book, along with Kegels or other exercises for increasing blood flow to their vaginal tissues, helps treat the underlying deficiency and create change on a deeper level. If you suffer from vaginal dryness or VAD, a multifaceted approach that incorporates lifestyle changes will not only enhance your sexuality by nurturing the tissues of your vulva and vagina, but also build your libido by boosting your overall health.

Let’s look at the most effective natural methods you can use to reduce or eliminate the effects of vaginal dryness and VAD, including three treatments from Chinese medicine. (Note: If you have vaginal dryness but you don’t have VAD, the first two methods—estrogen creams and DHEA suppositories—aren’t recommended, but the others are.)

—
Natural estrogen creams.
By using a low-dose natural estrogen cream on your vulva and in your vagina, you can rehydrate your tissues, enhance their integrity, and support your urethra. It’s recommended that you use the lowest possible dose of the cream needed. If you have a history of breast cancer or other cancer linked to estrogen, you shouldn’t use an estrogen cream, since even a low dose can stimulate estrogen-related cancer growth.

The best natural estrogen cream to use contains
estriol
, a type of estrogen that’s much weaker than estradiol and other estrogens commonly used in hormone replacement therapy. As the primary estrogen produced by the body during pregnancy, estriol is “friendlier” than estradiol, and can’t convert in your body into stronger forms of estrogen.

Not only can estriol make an enormous difference in VAD by enhancing the integrity of your protective mucosa and allowing for more lubrication during sex, but it can also help prevent urinary tract infections, which can be common during the years leading up to menopause. In addition, by strengthening the tissues of your urethra, estriol can help prevent urinary incontinence—a common condition in menopausal women who experience VAD.

To use estriol vaginal cream, apply a dose of 2 mg nightly before bed for ten nights by placing a small amount on your fingertip; gently spread the cream on your vulva and in your vagina. After ten nights, taper to 1 mg nightly three times a week. (You can also apply it with a vaginal applicator, if the cream you use comes with one.) After following this protocol for as little as a few weeks, many women report that they no longer experience vulvar or vaginal discomfort, and can have pain-free sex once again.

As an alternative, you can use estriol in the form of vaginal suppositories, which are used much like the cream and in similar doses, except that you insert the suppositories into your vagina. Neither the cream nor the suppositories are available over-the-counter; they’re by prescription only, and should be used under the direction of a licensed naturopathic physician or other qualified holistic doctor.

Since some of the estriol you apply will be absorbed into your system, it’s highly recommended that you use a small amount of natural progesterone simultaneously. This helps to balance the effect of the estriol and prevent the unwanted buildup of the
endometrium
, or inner lining of your uterus. (If you’ve had a hysterectomy, this isn’t applicable.) In the next chapter, we’ll explore in detail what you need to know about taking progesterone.

—
DHEA suppositories.
If you can’t use estrogen, you can use the hormone DHEA in the form of vaginal suppositories. This can effectively increase your vaginal moisture and resolve symptoms of VAD, especially if you have vaginal atrophy, without increasing your risk of tissue overgrowth in the inner lining of your uterus that could lead to endometrial cancer.

A 2009 study published in the journal
Menopause
found that menopausal women with vaginal atrophy who used DHEA vaginal suppositories showed significant improvements in their vaginal symptoms, which included pain during sex, dryness, irritation, and itching. And after three months of using the suppositories, they had no increase in endometrial growth.

To use DHEA vaginal suppositories, insert a 5 mg suppository into your vagina every night before you go to bed. DHEA vaginal suppositories are available by prescription only. (Note: Women with a history of estrogen-related cancer shouldn’t use DHEA.)

—
Black-cohosh and wild-yam suppositories.
A gentler way to enhance your vulvar and vaginal integrity is with vaginal suppositories containing both black cohosh and wild yam in a natural cocoa-butter base. These can be the answer for vaginal dryness, and a wonderful solution to VAD if you’d rather not use estriol, or any kind of hormone. (They can also be an effective add-on if you use estriol or DHEA, but they don’t completely solve VAD.) Typically, these suppositories also contain some vitamin E.

Although the herb black cohosh doesn’t contain any estrogen, it has active constituents that may have estrogen-like effects on your tissues and can help increase vulvar and vaginal lubrication. Black cohosh has been used by naturopathic doctors for decades to help women through the changes they experience in the years leading up to and beyond midlife. It’s often taken as a pill to help with hot flashes and other symptoms associated with low estrogen.

Wild yam contains active compounds that have progesterone-like effects—and also contains ingredients that have estrogen-like effects. Like black cohosh, it contains no hormones but can give you many of the same benefits.

To use the suppositories, insert one into your vagina every night at bedtime; after two weeks, taper use to two or three times a week to enhance lubrication. For many women, the suppositories are helpful within one or two weeks of use. (see
Appendix C
for supplier information.) If you have a history of breast cancer, you may be able to use black-cohosh and wild-yam suppositories, but you should check with your doctor first.