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The Empowered Woman’s Guide to HSV

Oh herpes. No one wants you. But with 2/3 of people under age 50 having some form of herpes, a lot of women are dealing with this unwanted guest in their lady garden. And herpes isn’t going anywhere – once you have the herpes virus, you always have the herpes virus. Herpes is one of the types of virus that is able to remain in a hidden state in our bodies (called “latent” infection) and pop out when we least want it to.

Types of Herpes

There are two types of herpes simplex virus – HSV-1 and HSV-2. HSV-1 is the virus associated with most cold sores. HSV-2 is the one associated with genital herpes. However their location doesn’t really matter – you can have HSV-1 on your genitals, and while relatively rare, you can also have HSV-2 around your mouth.

How to Get Herpes

Now no one wants to get herpes, but honestly it is hard to avoid. HSV-1 and -2 are transmitted by physical contact, kissing or sexual intimacy. As one of the most common sexually transmitted infections, exposure rates are very high. To avoid exposure to HSV use condoms or dental dams when having sexual contact, and avoid direct contact during known outbreaks in a partner.

While HSV-2 is commonly transmitted sexually, it can infect the mouth as well through oral sex. Most cases of HSV-1 are contracted during childhood, but can also occur sexually. HSV-1 and -2 can both also be passed along to infants during childbirth.

Symptoms of HSV

Many people recognize the symptoms of cold sores – a watery blister near the lip (or sometimes the nose) or in the mucous membranes of the mouth. As the blister heals it forms a characteristic scab.

But herpes can also be completely silent – many people have HSV infections and never know it. This contributes to the high rates of exposure to HSV – it can be passed on even if no active blisters or sores are present.

Symptoms of an outbreak can also cause some symptoms such as tingling, burning or flu-like symptoms before the blisters appear. It is important to avoid direct contact with a partner during these times (use a condom or dental dam).

The first contact with the virus will cause the primary outbreak – usually with symptoms showing up between 2-21 days after contact. Typically this outbreak is more severe and can last longer than subsequent outbreaks.

Triggering Future Outbreaks

Any number of different triggers can lead to the resurgence of the herpes virus. Things that compromise your immune function – like lack of sleep, stress, poor diet and alcohol consumption are common triggers. Other triggers may be sun exposure, excessive heat, skin irritation or other local infections.

Diagnosing HSV

The best test is a simple swab, done in your doctor’s office soon after the onset of the blisters. It can take up to a week for results to come back, so treatment is often started if the symptoms and appearance are consistent with a herpes infection.

There are blood tests available as well that can be used if HSV is suspected.

An Empowered Approach to Treating HSV

My first step in treating HSV in women is to offer assurance. You are practically a unicorn if you have never had HSV – most people in Canada do have it (and remember, once you’ve had it you always have it). It is a virus like any other and we need to let go of some of the negative connotations around contracting HSV.

Second, there are antiviral medications available that can help to lessen the severity of an outbreak and lower the chances of passing HSV to a partner. While I don’t advocate for on going use of these medications, they can be used judiciously in women who are looking for short term support.

Of course, as a naturopathic doctor, my focus is on empowering women to make choices for their health based on knowledge and informed by science. So I like to emphasize what we, as women, can do to help control HSV and prevent outbreaks.

St. John’s Wort – most commonly known as a treatment for depression, Hypericum perforatum (St. John’s Wort) also has powerful antiviral properties that are effective against herpes viruses. Typically taken at higher doses for 1-2 weeks, then decreasing to a lower or maintenance dose.

Lysine – one of the more well-known treatments for HSV, lysine is an amino acid that helps to stabilize the virus and prevent reactivation. It is most often taken daily to prevent outbreaks. Many doctors also suggest consuming more lysine in the diet, and avoiding arginine – this balance supports the immune system in it’s work. Below you’ll find a list of foods high in lysine (enjoy lots of these!) and foods high in arginine (limit these).

Lemon Balm – topical lemon balm is stellar at soothing and supporting the healing of cold sores and genital herpes. It is applied directly to the lesions once or twice per day during an outbreak.

Coriolus Mushrooms – mushrooms pack one hell of a punch when it comes to optimizing our immune system. Coriolus mushrooms in particular have been found to optimize immune function and support the immune system in it’s battle against viruses. I suggest taking mushrooms regularly to support your immune function.

Empowered Steps

If you are struggling with recurrent HSV outbreaks, or this is your first outbreak, I hope that you feel more knowledgeable after reading this article. As always, I suggest that you work with a qualified Naturopathic Doctor to put together a plan that approaches all aspects of your health, and the health of your lady garden. If you’d like to work with me, I am happily taking new patients in my women’s health focused practice in Toronto. You can book here.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

The Empowered Woman’s Guide to Vaginal pH Testing

In teaching my patients to provide empowered care for their lady garden, I have emphasized the importance of a healthy vaginal pH. So how do you know if your pH is optimal? You test it of course!

The Importance of Balance

Your vaginal pH is one of the most important factors contributing to the health and comfort of your lady garden. The pH of the vaginal tract is maintained by the healthy bacteria that live there – mostly Lactobacillus species. When the pH is out of balance this can lead to bacterial vaginosis (BV), yeast infections, and urinary tract infections.

If you are experiencing symptoms of itching, burning, discomfort or an unpleasant odour from your lady garden, a pH test can help you to determine the cause. And once you know the cause, an empowered woman can find the appropriate solution!

How to Test Vaginal pH

Testing your vaginal pH couldn’t be simpler. You purchase a pH test kit – it has to have a pretty narrow range to accurately assess the pH of the vaginal tract. This one is the one I recommend most – you can purchase it easily on Amazon.

To test the pH simply part the outer labia then apply a piece of the pH paper to the vaginal walls for a few seconds. You can then compare the colour of the pH paper to the packaging to determine your pH balance.  Choose the colour that most closely resembles the colour of the paper – it doesn’t have to be a perfect match, just a close match.

What the Results Mean

The pH of a healthy vaginal tract is slightly acidic – typically between 3.8 and 4.5.

A higher number (above 4.5) suggests a more alkaline environment – and is one of the most accurate ways of diagnosing BV. If your pH is high, you should skip the yeast infection treatments and instead start on the PATH to treating BV.

Yeast infections don’t typically change the pH of the lady garden. So if your pH is normal and you still have itching or discomfort, then a yeast infection is more likely your issue. If you don’t have typical symptoms of a yeast infection, speak with your Naturopathic Doctor about whether it may be cytolytic vaginosis, a condition associated with an overgrowth of Lactobacillus that can sometimes mimic a yeast infection.

Monitoring with pH

One of the best things you can do when you are learning to expertly tend to your lady garden is test your pH. If you have had a history of bacterial vaginosis in the past, using pH to monitor your balance, or to assess the impact of treatments, can be incredibly empowering. I suggest you try testing your vaginal pH at different times through your cycle, I recommend weekly, to get a sense of your pH balance throughout your hormonal cycle.

Seeking Support

If you test your vaginal pH and it is out of balance, I suggest you work with a qualified Naturopathic Doctor to regain your balance. The health of your lady garden is a reflection of your hormonal and bacterial health, and I want your health to be vibrant and amazing!

Selected Resources

Hemalatha R, Ramalaxmi BA, Sweta E, Balakrisna N, Mastromarino P. Evaluation of vaginal pH for detection of bacterial vaginosis. Indian J Med Res. 2013; 138(3):354-359

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Bitch Redux

In my work in women’s health I see a lot of conditions impacting the lady garden, endometriosis, PCOS, fibroids, cervical dysplasia, yeast infections and UTIs. But the one issue a lot of the women in my practice complain about is bitchiness. It might not be a medical diagnosis, but it impacts up to 80% of women at some point during their monthly cycle.

Women’s Emotions

Women have evolved to have immense sensitivity, and their emotional variations allow them to be more responsive to the environment, people and connections important to them.

Women are naturally more empathic and intuitive than men (of course acknowledging the great diversity of individual personalities). Women have always been the caretakers, the gatherers, the life-givers. Women rely more on social relationships for their survival, and the survival of their children and communities. Women have great emotional intelligence, because they need to be able to intuit and empathize with those around them – their children’s needs, their community’s goals, their partner’s intentions.

Women’s Brains

Women’s brains develop different to men, hardwiring us to feel more deeply, be more attuned to the emotional states of others, and be more reactive to the needs of those around us. At 8 weeks gestation, the testes become functional and the resulting surge of testosterone kills neurons in the communication centre of the brain. The testosterone instead develops more neurons for action, aggression and sexual drive – ultimately taking up about 2.5 times the space in men’s brains than women’s.

In women’s brains more space is allotted for language, hearing and memory. The memory center, the hippocampus, is larger in women, allowing those early female gatherers to remember where to find the food. The insula, thought to be the seat of self awareness, empathy, and interpersonal relationships, is also noticeably larger in women. This may lead to an increased intuition, or gut feeling, in women.

Women’s Hormones

Women’s hormones DO make them more moody. For women being fixed and rigid doesn’t lend itself to survival. Our emotionality is our strength – we may not be as physically strong as men, we rely more on our emotional connections and strength of connections, community and family.

Unlike men, whose hormone production spikes at puberty and remains fairly stable across their lifetime, women’s hormones ebb and flow over a monthly cycle and wax and wane over their reproductive years.

At the beginning of our menstrual cycle, at the onset of our bleeding, estrogen levels climb to prepare an egg for ovulation at midcycle. Estrogen production is strongly linked to serotonin production – and as estrogen goes up, so too does serotonin.

As estrogen continues to climb to the midcycle peak, most women note a positive mood state. During this time our biology encourages us to be more social, to connect to our tribe, more confident, to meet people and more alluring, to try to find a mate to conceive a baby with.

Estrogen acts as a stress hormone, or an anti-stress hormone. Making us more likely to brush off things that at other points in our cycle may provoke a significant response.

At midcycle estrogen levels are at their highest, along with dopamine and oxytocin. This encourages pro-social, trusting behaviour, and we are more generous and connected to others in our social network. We also talk more and are more interested in intimacy than at any other time of the monthly cycle.

Immediately after ovulation, our estrogen levels start to decline, but the rise in progesterone catches us before our moods crash. Progesterone doesn’t increase serotonin levels like estrogen does, but it supports GABA production, leading to a sense of calm and low anxiety that persists for about 10 days while progesterone levels are high.

All hell breaks loose during the final 3-7 days of the menstrual cycle however, with estrogen levels at a low, and progesterone levels steeply declining. Women during this time are more depressive, more cautious – a way for nature to keep us from harm during a time when we may be pregnant without knowing it.

The low estrogen also makes us less resilient, experience more physical pain, more emotionally sensitivity, and makes us more likely to react or respond to triggers that we would ignore during our high estrogen first half of the cycle. It’s not that we have more stress – we’re just way more likely to call it what it is and not stand for any shit.

Estrogen is essentially the “whatever you want honey” hormone – you are so much more willing to give to others and sacrifice your own needs when estrogen levels are high. But when those levels drop we are more likely to react and share our opinions – good or bad. It is not that we are reacting to things that aren’t really there – we’re reacting to things that upset or anger us – we just might ignore them at other times. If you feel underappreciated, overworked, or overwhelmed, or that you’re not in balance with your partner – it’s probably all true.

Bitch Redux

I want to encourage women to recognize the power in our hormonal fluctuations – our mood changes are adaptive – they help us seek out relationships, build connections, and preserve our energy. The mood changes that occur during our premenstrual phase are normal, and temporary. I want women to reclaim our natural hormone and mood fluctations, and be empowered by our emotions, rather than struggling against them.

My recommendation is to learn your natural fluctations and use your bitchiness as a superpower. Track your cycle – using any number of excellent free apps – and plan your month accordingly. Plan for presentations, meetings, anything requiring verbal skills for your first half of the cycle (the closer to ovulation the better! Your personality is magnetic when you’re near ovulation!) Have a task that requires fine motor skills – an intricate art project or rewiring your house? Keep that to the first half of the month as well.

Leave the tasks best left for your OCD-self for the last month of the cycle. I think most women probably read The Life-Changing Magic of Tidying Up during the last week of their cycle. So put “clean out the kitchen cupboards” on your list for the premenstrual week (maybe stay out of your closet though – many women feel less appealing during their premenstrual week and this could be a disastrous task.) Your pain tolerance is also lowest during your premenstrual phase – so skip the dentist or your tattoo appointment and get a mani-pedi or skin care facial instead.

Think of your PMS as a time to spend in reflection and personal contemplation. Your intuition is at its peak in the week before your period, so take time to do a mental health inventory – are you doing what you want? Are you where you want to be? Pay attention to the things you are critical about during your premenstrual phase – these thoughts are probably a lot more valid than you might want them to be. Write down the things that upset you/ anger you/ send you into a whirling passion of emotions and act on them in the beginning of the next cycle when you’re feeling energized and empowered again. Harness your bitchiness, it could end up being your greatest power.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.