INQUIRING MINDS BY DR. SHERRY ROSS

Last month we introduced our readers to Santa Monica based and Celebrity OB/GYN, Dr. Sherry Ross. Like a girlfriend that we have known for years, she talked with us about how she got into her practice and the depth of her career, the difficulty that women have in talking about their vagina, the importance of knowing how to take care of this area - especially as it pertains to an athleisure lifestyle, her partnership with Summer's Eve, what she is up to this summer and more.

Dr. Ross shared so much information with us, we thought that we would spread out more of her knowledge in additional issues. If you missed last month, you can read it here and in this
month's issue we are focusing on some of the common questions that she is asked by her patients and of course, she shares answers.

• What are some of the changes that occur with our vagina throughout the years.

The effect of aging on our body, including our vagina, is inevitable. Your vagina is as young and beautiful as you think it is in its appearance. Your personal attitude and vaginal confidence is the most important factor in how others perceive an aging vagina.

Just like any other part of your body with skin, glands and hair follicles, the appearance of the vagina is affected by the aging process and how well you care of it.

There are known offenders, such as childbirth and menopause, which leave battle scars that can be permanent, but there are things you can do to avoid needing a vaginal “face-lift’ also known as vaginal rejuvenation, in the future.

Hormonal changes over the decades also influence the integrity and elasticity of the vagina. First let’s be clear what we are talking about regarding the vagina. The “vagina” actually includes the lips, vulva or labia-minora and majora, the opening to the vagina and the clitoris.

Starting with puberty, the powerful effects of estrogen and progesterone, cause changes of the vagina including pubic hair, enlarging and more prominent labia or lips and more noticeable white vaginal discharge. As you age and lose your subcutaneous fat in your body, the fat in the vagina also decreases making the lips looks thinner.

Childbirth probably has the most dramatic effect on the vagina, especially if you have a vaginal delivery. A recent statistic showed that “30% of women who have a vaginal birth will have some form of trauma to the tissue and muscles in the vagina and pelvic floor. The vagina and all its elastic glory can only stretch so much during childbirth. With each vaginal delivery there is a little more stretching which has an accumulative effect that ultimately changes the outward appearance of the vagina. The pelvic floor muscles that stretch, distend and tear in the vagina to allow the baby’s head to come through this tight space will never be quite the same over time. The more vaginal deliveries you have, the more the vagina stretches, especially in the vaginal opening. Women often chose to have an elective cesaean section to avoid any trauma caused to the vagina from a vaginal birth.

There is a definite correlation between having a lot of vaginal deliveries and big babies that permanently stretch the outward appearance of the vagina.

With menopause and the loss of estrogen nourishing and hydrating the vagina, the tissue becomes dry, pale and dehydrated. The labia of the vagina can become fused and the vagina and clitoris shrink. The labia becomes less full, losing its fatty pads and the skin loses its collagen. The end result is lighter or darker appearing labia that sag. The medical term for this is vulva-vaginal atrophy.

• What are some of the reasons my vagina itches if I don’t have a yeast infection?

The itchy vagina can be challenging to figure out but is a common phenomenon. Once your health care provider has ruled out a yeast or bacterial infection it’s time to look other environmental causes including heavily fragranced body and laundry soaps, sanitary pads, sanitary wipes/pads, warming gels and scented lubricants, nylon underwear, diaphragms, condoms, saliva, semen and stress which are often the offending sources of the vaginal itch.

• What are reasons why my vagina smells funny?

The normal vagina tends to smell like “a vagina” which all of us women know what that means. When there is an unusual odor something is just not right down there. A classically smelling fishy vagina tends to be a bacterial infection such as Gardnerella. Other causes for a strange or offensive odor include a sexually transmitted disease such as Chlamydia, Trichomonas’s, Syphilis and Gonorrhea. Your diet, including garlic, onions, Brussels sprouts and red meat, can also create a different odor in the vagina. Smoking, alcohol and caffeine also affect the vagina’s smell and taste.

• What exactly is the importance of pubic hair?

The best kept secret about a women’s body is why we actually have pubic hair. No one really knows the answer to this question. The suspected theories, some medical and some not, include pubic hair prevents dirt and other floating germs to enter the vagina, it keeps our genitals warm, and it’s the perfect cushion during sex, bicycling and other forms of exercise that put pressure on our vagina.

Pubic hair is also thought to create ‘pheromones’ which are invisible sexual smells that are sexually enticing and erotic to your partner. We know pubic hair can be a decorative accessory under the sheets during Valentine’s Day or for different cultural preferences.

• What impact is the porn industry having on women and men when it comes to vaginas?

The truth is a lot of women don’t like their vaginas. 1 in 7 women have considered getting ”labiaplasty” which basically is trimming and tucking the lips of the vagina and tightening up the entrance. Many women admit that 1 in 5 compare themselves to those vaginas seen in porn. With porn on the rise, vaginas are everywhere. And yet, no one seems to want to admit how this new prevalence, and its resulting misconceptions about sex and the vagina is - or isn't - changing our romantic and sexual relationships and our relationships to our bodies and ourselves.

There’s no denying it. Porn is everywhere. Porn sites get more visitors each month then Netflix, Amazon, and Twitter combined. A recent statistic found that 70% of children ages 8 to 18 report having unintentionally stumbled across pornography online. The average age for a child to be exposed to pornography is now 11 years old. This means that our children are often “learning” about “normal” sexual behavior and physical appearance from the likes of Jenna Jameson and John Holmes. Many women (and men) now expect, even want, all vaginas to look like Jenna’s does. Girls and guys alike visit porn and other sexually graphic web sites, and not just for pleasure, but also to see what the perfect vagina and the ideal penis look like.

We as a society have to fight the porn epidemic and not allow our young women and men to think this is how they should be learning about sex and sexual relationships through porn. Awareness and education is vital!

• What are ways to keep my vagina young?

Your vagina is as young as you think it is. With that said, a young vagina is a healthy and confident vagina. Keeping the vagina clean and enjoying sexual pleasures keeps the vagina young regardless of age.

• Why do you think such little attention has been paid to women's sexual concerns compared with men's?

Unfortunately, there has been a history of “gender injustice” in the bedroom. Women have long been ignored when it comes to finding solutions to sexual dysfunction. If there were a scoreboard it would read 26 and O for men! In short, there are twenty-six approved medications for male erectile dysfunction and zero for women. Clearly, little attention has been paid to the sexual concerns of women, other than those concerns that involve procreation. Why is this the case? Why are women marginalized in every aspect of life? Sadly, this is a truth even in the medical space. Women are not getting the attention and respect they deserve.

Women simply want the same attention in sexual health and responsiveness from the medical community as men have had. With that in mind, the FDA is finally showing support for the challenges faced in female sexual health. Whether you choose a medical alternative, a little self-love in the afternoon, or a romantic weekend without electronics or distractions, the choice should be yours.

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“Just like any other part of your body with skin, glands and hair follicles, the appearance of the vagina is affected by the aging proce3ss and how well you care of it.”

— Dr. Sherry Ross

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• What are the main sexual problems/issues affecting women in their 20s and 30s?

Our sexuality is as part of our lives as is eating and sleeping. Sexuality is an important aspect of our wellbeing, and in a healthy romantic relationship it’s as important as love and affection. Enjoyable sex is learned. Sure, there’s instinct and maybe a dusting of magic involved, but you don’t magically have an orgasm without having an active role in making it happen. You and your partner have to acknowledge each other’s likes and dislikes, and learn how to satisfy each other. Open and honest conversations are necessary to make the sexual experience optimal for both of you, whether you have multiple partners or self-esteem to spare. For women, the sexual experience can be broken down into four parts: desire, arousal, vaginal lubrication, and orgasm. I know you’ve heard it before, but it can’t be overstated; your largest and most important sex organ is your mind. It’s what makes all the parts come together in what can (and should) be a sublimely satisfying experience.

Intimacy, sex and orgasm often all begin with desire. If you don’t have any desire you will not be able to have an orgasm-plain and simple, mission will not be accomplished. Understanding the cause of the sexual dysfunction is the most important step in optimizing a treatment plan. Relationship counseling, stress reduction, sex therapy or a weekend away with your partner without the kids may be all that’s needed to get you back on track.

Hypoactive sexual disorder, the most common female sexual dysfunction, is characterized by a complete absence of sexual desire. For the sixteen million women who suffer from this disorder, the factors involved may vary since sexual desire in women is much more complicated than it is for men. Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. The daily stresses of work, money, children, relationships and diminished energy are common issues contributing to low libido in women. Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms such as a dry vagina, or a history of physical or sexual abuse. It’s not a myth after all that women are more complicated than men.

Learning how to have an orgasm is not a rite of passage. Orgasms are learned and you cannot expect any one to show you how to have one until you know your own sexual body mechanics.

In fact, 10-20% of women (of all ages) have never had an orgasm. Women typically have sexual and emotional issues that get in the way of intimacy which interrupt the four parts of a sexual experience for women.

For some women, finding and enjoying sexual intimacy and sex is difficult. 43% of women report some degree of difficulty and 12% attribute their sexual difficulties to personal distress.

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IG @DrSherryR + @She-Ology

Read more from the July Issue of Athleisure Mag and see Inquiring Minds by Dr. Sherry Ross in mag.

SHE-EDUCATE WITH DR. SHERRY ROSS

When you're out with your girlfriends, you enjoy hanging out and a number of sips - that's when the conversation gets real. You talk about your love life, what you should do in your careers and then its down to talking about what's going on down there. Maybe you have questions or are prepping for when you have your next visit with your OB/GYN. We decided to find out answers to some questions that readers have asked us by talking with Dr. Sherry Ross who is based in Santa Monica. We found that talking with her was like adding her into our tribe of girlfriends!

ATHLEISURE MAG: Tell us about your background and how you knew that you wanted to be an OB/GYN. In addition, if you can, feel free to let us know about celeb clients that you have worked with.

DR. SHERRY ROSS: When I was a young girl, I would go on hospital rounds with my father who was a Urologist—I must admit that initially I went for the endless supply of donuts and apple juice in the doctor’s lounge. However, over time, I learned firsthand how much my father embraced and loved his patients and loved his profession. I took careful note of his compassion and the positive impact he had on his patients, as well as the powerful impact that my father’s patients had on him. I knew I wanted to be a doctor in order to experience that same powerful and healing give and take. I can honestly say that the most gratifying thing about my 25-year career in medicine has been the relationships and bonds I’ve developed with my patients. I gravitated to OBGYN in my 3rd year of medical school since I loved delivering babies and being a part of such a joyous and memorable experience. Helping women was so satisfying and enjoyable and I really felt as though I could make a difference in their wellness journey.

I felt as though when women's legs go up in stirrups, the conversation really begins and I could serve as their best friend or favorite therapist.

I am fortunate to take care of many A-list celebrities who also are committed to women’s health and wellness.  Reese Witherspoon was incredibly kind and generous to write me a wonderful forward to she-ology. Social and celebrity influences can help promote the messaging of empowering women to take better control of their health and wellness.

AM: We had the chance to have lunch with you. Why do you think that women's health in terms of vaginal issues, questions etc seem to be difficult for women to address and what can we do to  make these conversations easier to have?

DR. SR: Women need to be comfortable talking about their vagina’s. 50% of women never talk about their vaginal health with anyone, not even their doctor. If you can’t even say the word vagina how are we supposed to talk about it? Women need to talk about their specific health care issues, issues that are often ignored and not dealt with. There are very few places where women feel comfortable talking about their vaginas without feeling judged, so at the very least, a doctor’s office should be a bastion of comfort. 90% of women wished they had more information about vaginal health.

The inability to say the word “vagina” has been passed on in our culture from outdated attitudes, societal norms and misconceptions about the vagina and sex.  It doesn’t help that our society as a whole is undeniably juvenile about our approach to vagina. As an example, in June 2012, a bill was presented on the House floor seeking to regulate the use of the word "vagina" after Micigan Representative Lisa Brown was banned from speaking because she used the term in a debate over an anti-abortion bill. "Brown's comment

so offensive, I don’t even want to say it in front of women,” complained Representative Mike Callton (R: Michigan). “I would not say that in mixed company.”

A ban on a word that is a medical term used to describe our female genitalia? Politics and mainstream media will not allow the word "vagina: to be said out loud without some sort of backlash. We need to change this reality for the sake of women’s health, especially since there doesn’t seem to be a problem in mainstream advertising for the treatment of erectile dysfunction!  

I am counting on our younger generations of women to help lead the way and change the narrative on how we talk about our health, our bodies, and especially, our vaginas. Women need to take control of their bodies in every way. We cannot be afraid to ask uncomfortable questions. We need to learn and explore the changes our bodies experience throughout our lifetime.

The conversation needs to start at a young age with our girls, daughters, nieces and granddaughters.

It’s not just one “talk” we need to have with our daughters. There are many “talks” about their bodies and overall health that needs to happen depending on the developmental (hormonal!) milestone and what is age-appropriate. Before you start talking about human sexuality and sexual behaviors you have to have created an environment where your daughter feels comfortable discussing other sensitive topics such as puberty, proper nutrition, body image issues, recreational alcohol, tobacco and drug use.

When young girls learn about their body part—“here is my nose, my ears, my belly button”---they need to learn and use the word vagina from an early age so they become comfortable with their own anatomy. When mothers teach their daughters code names for their vagina, such as "Vajaja", this does not move the needle in the right direction of changing this narrative.

If mothers or other role models to young girls don’t initiate these types of sensitive topics, your daughter will find other ways of learning about her health and wellness from other resources. This is where the problem lies. Social media and porn have damaged our children in how they look at themselves.

It’s important for moms to normalize these conversations between a mother and daughter. The more comfortable and candid you can make these conversations, the more relaxed your daughter will be when her breast buds, period, body image concerns and sexual health issues present themselves to her.  

In life there are a handful of sensitive subjects that feel completely awkward between a mother and a daughter and talking about her first period, breast development, pubic hair, the vagina,  where babies come from and sexual health. In

truth, talking about your sexual health may be a completely off limit subject between mom and daughter.

Even though the average age of a young girl getting her period is 12 years old, puberty, in all its glory, starts as early as 8years old. Breast buds are noticeable 2 years before the period actually starts and can be detected between 8 to 13years.  Pubic hair, hair under your arms and legs and acne also joins the hormonal party during the "tween" years. It's important to skowly and comfortably ease your daughter ito talking about her body and changes associated with puberty which empowers young women to embrace their body in a healthy way.

Promote body confidence. Teach your daughter about her body, use the correct descriptive terms when talking about her breasts, vagina and period.  If young girls and women are not able to confidently own the proper words to describe their female body parts, it makes it difficult to comfortably talk about their personal needs and experiences.  

AM: Vaginal care is an essential and we liked your analogy to taking care of this area as we do our faces. Can you break that down for us?

DR. SR: The one thing I wish women knew was where their vulva was located on their "vagina". This is vagina confusion that women will appreciate understanding more about...

You must get to know your vulva and vagina, up close and person. First - let’s be clear what we are talking about regarding the vagina. The “vagina” actually includes the vulva, labia-majora (outer lips) and labia minora (inner lips), the opening to the vagina is called the introitus, the inner vagina, the urethra (small opening leading to the bladder), the clitoris and the protective hood of the clitoris. The inside of the vagina, where tampons go, is a temperamental and ultra-sensitive area. 50% of women wonder if their vagina is normal looking. My first and foremost advice to women is to get to know your lady parts, know what your “normal” is so you will know when a potential problem arises.  If you have not done so already, pull out the mirror and get to know your vagina, your vaginal health depends on it. Every woman needs to take a “vagie” to really know this lady part intimately.

Your vulva and vagina are very sensitive to everyday feminine rituals. Using the wrong types of soap can cause irritation and bad odor. Avoid soaps which are heavily perfumed and are not pH balanced which upset your body. Using a gentle, lightly fragranced wash and natural skin moisturizer daily is ideal, especially ones made specifically for the vulva. Your vulva and vagina does need a special cleaning routine and it usually begins with using a special wash and warm water.  You cannot use the same soap to clean your feet and underarms to wash your vagina! I highly recommend Summer's Eve Cleansing Wash made specifically for our most sensitive area on our body. Vagina friendly washes carefully clean the vulva, remove odor-causing bacteria and are balanced for a woman’s natural pH.

Cleaning the outside of the vagina or the vulva, clitoris, and vaginal opening every day with a vagina friendly wash is so important. You can use a wash cloth or your fingers to clean this area in the shower or bath.

AM: Why have you partnered with Summer's Eve and why is it essential to utilize cleansing products like this as opposed to total body soaps that are not formulated for the vagina.

DR. SR: Partnering with Summer’s Eve was an easy and authentic relationship since I wholeheartedly believe women have to care for their vagina in the same way we care for the skin of our face. Using vagina friendly and specially made products for this sensitive and temperamental area of our body is so important and necessary. Summer Eve’s has been around since the 70’s and they have created products for the vagina that are clinically and gynocologist tested for safety in this delicate area. You can’t use an everyday soap on the vagina like most women used daily. When you use a vagina friendly wash that’s designed to be balanced for a woman’s natural pH and sensitive to the vagina you feel fresh and avoid irritating residue. I am on a mission to change the narrative on how we talk and take care of the vagina.

AM: As many of our readers enjoy cycling, hot yoga, pilates etc how do we take care of our vagina in order to ensure that we are keepig it healthy in the midst of these activities.

DR. SR: Certain sports can be hard on the vagina. Cycling and spinning are at the top of this list!

The way the vagina is positioned on the bicycle seat exerts unfamiliar pressure on certain parts of the delicate soft tissue of the labia majora and minor, better known as the "lips" of the vagina. With prolong bicycle rides or spinning classes the intense pressure on certain parts of the vagina, tailbone, lower back and groin creates restriction of blood flow, skin irritation, and ultimately numbness of the area, especially the clitoris. Some women even report disruptive genital pain and discomfort with reduced genital sensation.

Other problems that are associated with cycling, spinning and horseback riding include vaginal infections such as yeast and bacterial due to the poor vaginal ventilation and moisture buildup that occurs with these sports. With constant pressure on the vagina, skin cysts can develop as well. Your cycling posture and the way you sit on the bicycle seat also affects the pressure that is exerted on the delicate parts of the vagina.  

Recumbent cycling does not create the same problems on the vagina that upright cycling cause.  The pressure and problems of the vagina that are typical of upright cycling are transferred to the buttock for those recumbent cyclers causing minimal discomfort.

You can avoid some of these problems by using the appropriate saddle seat, cycling shorts, professional bike fitting, using proper cycling posture, allying emollients and moisturizing creams to the vagina. Also taking a shower or long bath following these types of activities is helpful.

Hot yoga and any activity that brings excessive heat and sweat to the vagina can increase the risk of a yeast infection or vaginal skin irritation. Changing ito clean and dry clothing after these types of workouts is important to prevent these types of problems. I also love the Summer’s Eve Cleansing Cloths to freshen up after a hot workout. They are balanced for a woman’s pH and also get rid of any odor causing bacteria, so I can feel comfortable all day.

AM: Picking an OB/GYN is such a process - what are the questions that we should have to ask our potential caregiver to see if they are a match for our needs.

DR.SR: Many women are given a list of providers to choose from according to their insurance policy. With social media, Yelp and other physician review sites you can and should learn about the doctor you are going to trust with your health. You can always interview a potential doctor first before you commit to making an official office visit. You want to be comfortable with the doctor you select.  Depending on what is important to you, you may want to ask the following questions:

1. Will I get a call back with my test results?

2. Are you accessible via email?

3. How long does it take to get an appointment with you?

4. Will you be calling me back or will it

be one of your office staff members?

5. How often do you suggest I get a pap smear?

6. Make sure the OBGYN is board certified and there are no malpractice claims against them.

The most important quality to find in a new OBGYN is that you feel comfortable talking openly and honestly with her/him.  

AM: Over the last year, we feel that we have learned about conditions that women are battling such as Endo and thanks to social media we have learned about symptoms and the stories of celebs, influencers etc that have given us information - but what is a resource that you suggest that women can use to find out answers to their questions when they aren't talking to their OB/GYN?

DR. SR: Your medical information is as reliable as the source you are using.  I would stick to WebMD, Mayo or Cleveland Clinic and the Harvard Health Newsletter and avoid chat rooms that can lead to a lot of confusion and misinformation.  I also like GoAskAlice.com for relatable and accurate medical information.

AM: Tell us about what are you up to this summer and fall as we know that you are working on a number of things - feel free to share with our readers.

DR. SR: I am working on my next books, She-sequel and the 7 Cycl Systems that women experience. During the summer I enjoy spending time with my sons who come back home for vacations and family time.  My wife who is a high school principal in Watts, California, also has more free time to hang out together.

AM: We know that you have a book out called She-ology. For those that are not patients of yours, how can they connect with you and find out their pressing questions.

DR. SR: You can connect with me by my website drsherry.com and through my social media channels including on Twitter @DrSherylRoss, Instagram @drsherryr @she-ology and on Facebook DrSherryR.

“Recumbent cycling does not create the same problems on the vagina that upright cycling causes. The pressure and problems of the vagina that are typical of upright cycling are transferred to the buttock for those recumbent cycles causing minimum discomfort.”

— Dr. Sherry Ross

AM: We also know that you have created a line of supplements - can you tell us more about that?

DR. SR: My mission is to change the narrative of how women talk and learn about their health and overall well-being.

Over the course of my 25+ years as a practicing OB/GYN and women's health educator, I came to realize that women can experience up to 7 distinct hormonally-driven cycles. Each of these life chapters introduces both unique wellness challenges and opportunities to maximize well-being. During this same time, my patients were asking for potentially harmful prescription medications to deal with concerns such as PMS, stress, and hot flashes and my advice on what products could help them feel their best during complex, hormonal life stages, such as Fertility, Postpartum and Menopause.

I researched extensively to find a credible source of natural, high-quality supplements designed specifically for women and was shocked to discover the impurities found in many supplements — up to 50% of the ingredients can consist of fillers, chemicals, and preservatives.

That's when my 7 Cycls System was born — an easy-to-follow women's health management framework that addresses specific onerns in each of the 7 cycles with scientifically-formulated nutraceuticals to target each life stage.

Ultimately, the 7 Cycl system delivers practical nutrition and wellness advice that’s science-backed and easy to apply.

I embarked on this journey in 2014 and have been refining my formulations over the years through customer feedback.

I’m excited to introduce you to my Co-Founders. Jennifer Beals is an ardent women's healthcare advocate and serves as Cycl’s spokesperson, and Amber Bezahler, our CEO who has tremendous experience in the direct to consumer and eCommerce space.

AM: We know that you are based in Santa Monica and anytime we're out there we're always looking for great spots. Where would we find you going out to grab a bite to eat, where do you workout and where do you shop?

DR. SR: I work out almost every day on my Elliptical located in my garage.  My goal is always to hit 10,000 steps a day. I am a bit obsessed with my Fitbit to make sure I reach this goal.  I spend most of my free time with my family and close friends. Weekly barbeques, family dinners, scrabble games, making puzzles, playing ping pong and binge watching on Netflix are common daily activities for me. One of my favorite places to have dinner and just chill is at Blue Plate Taco or Lares Mexican Restaurant.  My favorite food…is Mexican food, with the hottest salsa possible!

AM: Please feel free to share anything that we have not covered that you would like for our readers to know!

DR: SR: Your Vagina is talking to you ladies, PAY ATTENTION!

Just like any healthy relationship you have to have good communication with your vagina ladies, your vagina is talking to you and you must pay attention to what your vagina is telling you!

You cannot be distracted or be multi-tasking when your vagina needs your undivided attention…because if you don’t pay attention, your vagina will feel excluded, lonely, depressed and anxious and will act out!

Open communication with your vagina will create the foundation for a healthy, happy and sexually satisfying relationship.

This is the year of the women. The #MeToo movement has brought out so many good things through empower ing women to let their voices be heard and mobilize to fight injustice and inequities.  I want women to use the same voice and power to change the face of how women talk about their bodies, especially their vagina’s.

I am here to empower you to have courageous conversations about your bodies. I want all of you to speak out and stand up for the most vulnerable and voiceless among us. I do have an agenda. It includes encouraging women of all ages to take control of their health and well-being and I am challenging women and others to help me change the narrative and status quo on women’s healthcare.

Read more from the June Issue and see She-Educate with Dr. Sherry Ross in mag.