A recent article in the American Journal of Obstetrics and Gynecology(AJOG) found that compared to white women, women of color had higher levels of beauty product–related environmental chemicals in their bodies. “Racial discrimination based on European beauty norms can lead to internalized racism, body shame, and skin tone dissatisfaction, factors that can influence product use to achieve straighter hair or lighter skin” and use of vaginal hygiene products, researchers wrote in the study. Theses chemicals included phthalates, mercury and parabans which can impact fertility, the endocrine system, unborn children and cause cancer.
Skin lightening agents may contain mercury which can cause central nervous system and kidney damage. They may also have “bootleg” ingredients not found on the label. Some contain high potency steroids like clobetasol that should never be used on the face. Steroids can cause stretch marks and if large amounts absorbed can cause elevated blood sugar and pressure. Other products have prescription hydroquinone that used incorrectly can cause a blue/black discoloration.
A new trend is IV ( yes, intravenous!) glutathione to lighten skin tone. This therapy is popular in Asia and despite no large studies to prove effectiveness, is taking hold in the US. There have been reports of serious side effects including thyroid and kidney problems. The treatments can cost as much as $400 and 10-30 treatments are often suggested. If treatments are discontinued, the darker pigment returns.
These hair products can contain parabans and estrogenic chemicals from placentas. According to the study by AJOG, they can cause uterine fibroids, premature puberty, and endocrine disruption.
According to the article, advertisers used targeted marketing towards African American women with messages that encouraged self-consciousness of potential vaginal odors.
Douching is unnecessary. It increases the risk of bacterial vaginitis, pelvic inflammatory disease as well as exposes woman to phthalates that may adversely affect pregnancy and offspring.
Use of talc powder on the genitals is also more common for African American women. Talc-based powder used on the vulvar vaginal area may increase risk of ovarian cancer by 24%.
Reference: Zota,Ami ScD,MS, Shamasunder, Bhavna, PhD,MES. The environmental injustice of beauty: framing chemical exposures from beauty products as a health disparities concern. AJOG.2017 http://dx.doi.org/10.1016/j.ajog.2017.07.020
Many woman need vaginal moisturizers or sexual lubricants regardless of age. Needing a lubricant does not mean you have a problem or inadequacy. The need for lubricants or moisturizers increases with age especially after menopause.
Medications like antihistamines, oral contraceptive pills, chemotherapies can cause vaginal dryness as well as breast feeding and menopause.
Latex safe lubricants can help prevent breakage of condoms or dental dams for safer sex.
Which one is right for you?
- Water Based: least irritation, latex safe may dry out with extended time
Good Clean Love, K-Y, Sylk (all natural) , Yes
- Silicone based: longer lasting, staining, usually non irritating, waterproof, do not use with silicone dilators, toys or gynecologic products like pessaries
AstroglideX, Pjur, Silky, Uberlube
- Oil Based: staining, non irritating, latex safe. Some people can be allergic and there are concerns that they can cause bacterial or yeast infections so I do not recommend
avocado, olive, peanut, corn or coconut(best)
- Hoping to conceive? lubricants can decrease sperm mobility but there are several safe products
Pre-Seed, Conceive Plus,Yes Baby, Astroglide TTC
Moisturizers: longer acting to help with daily dryness, chafing and may decrease risk recurrent infections. Used 1-3 times per week.
Replens, Refresh,Yes VM
Hybrids: lubricant plus moisturizer, a combo of water based plus silicone product. Good for people with sensitivities or allergies.
Lubrigyn (great for menopausal woman), Luvena
Stay away from petroleum based products (mineral oil, baby oil, petroleum jelly) they are not latex safe and should not be used with condoms, dental dams or diaphragms and can cause irritation. Also avoid parabens or glycerin. Glycerin(often found in water soluble lube) may cause yeast infections and parabens (to extend self life) may have estrogen like properties so best to avoid especially if you have had breast or other hormone sensitive cancer.
Want to try some out? MiddlesexMD.com sells a low cost sampler!
Menopausal women, or women with low estrogen levels, may need more than a topical lubricant or moisturizer. If the over the counter products don’t seem to be enough, see your gynecologist as you may want to try prescription vaginal estrogen or steroid.
Krychman M, Dweck A,Kingsberg S, Larkin L,OBG Manag, 2017 (special section SS2-10)
In OBGYN news around the web this month:
Study disproves the concept of “pregnancy brain fog” or “period brain“. In 88 women studied, cognition was not decreased in pregnancy or during menstruation (articles run in Time http://Health.com).
In another article “Is it me or my hormones?”, J Clin Endocrinology Metab, women’s brains did respond differently to visual food cues during the premenstrual or luteal phase of their cycle versus the beginning half of the cycle. But hey we knew that already!
Flibanserin (Addyi) is the first medication approved by the FDA to treat low libido (sex drive) or hypoactive sexual desire in premenopausal woman. Although dubbed the “female Viagra” low libido is hard to treat. Many things cause low libido including stress, relationship issues, how one views their partner or themselves. Medical/mental health issues and medications can also affect libido.
When other reasons for low libido have been excluded flibanserin can be considered. Flibanserin, first approved in 2015, has been shown to improve sex drive in 50% of women with an increase of 2.5 to 4 sexual encounters per month. Twenty five percent of woman saw an increase of 6 sexual encounters per month .
Downsides and risks:
MULTIPLE DRUG INTERACTIONS: many medications, including, but not limited to, some antibiotics, antifungals (yeast treatments), heart medications can also cause low blood pressure and fainting with flibanserin use.
Must be used daily and long term
Most common side effects are sleepiness and dizziness
Can lower blood pressure
Must see a flibanserin certified gynecologist or other provider for prescription
Interested in trying?
You can see me, Dr Beth Roland, as I am a certified prescriber since 2016
Ask your pharmacist about drug interactions.
Taking at night may decrease side effects
Although approved for premenopausal women, postmenopausal women may benefit too (off label use).
If no response by 8 weeks discontinue use.
Marijuana is not safe for use in pregnancy or while breast feeding!
THC, the chemical in marijuana, crosses the placenta and is also found in breast milk. Smoking marijuana has the added risk from harmful smoke but all forms of marijuana expose your baby to harmful THC . THC exposure at this early stage of life has been shown to decreased academic ability/cognitive function and increase attention deficits. There is no safe time or levels regarding marijuana in pregnancy.
Is it illegal to use marijuana in pregnancy in CO?
Perhaps! Some hospitals test babies after birth for drugs including marijuana. If your baby tests positive for THC child protective services must be notified.
What about medical marijuana? Use for Nausea in pregnancy?
Marijuana is not a safe choice for nausea in pregnancy!
Is it safe to use marijuana while breast feeding?
The answer is NO!
THC crosses into breast milk.
THC is stored in body fat. Infants brains and bodies have a lot of fat so THC can be stored in their bodies for a long time.
Can I pump and dump?
There is limited data on how long it takes THC to clear from breast milk so pumping and dumping is not recommended.