YOUR PRIVATE PARTS SHOULDN'T BE PRIVATE TO YOU Being comfortable with your body is not a matter of modesty—it's a matter of good health. For the first time, women have all the information they need in The V Book, ensuring the best possible vulvovaginal health, now and in the future. Dr. Elizabeth G. Stewart answers these common questions and many more in The V Book: How does a woman's V health change throughout her lifetime? How do you know when you have a simple infection—or a more serious condition? Which over-the-counter treatments work or should you always call your doctor? What really happens during a Pap smear? Why aren't speculums heated? If sex hurts, what do I do? Does cranberry juice really help prevent urinary tract infections? Can yogurt cure a yeast infection? Are there simple solutions to embarrassing problems such as odor and itching? Why is it important to see a gynecologist even after menopause? What questions should you always ask your gynecologist? And much, much more. Disclaimer The information in this book is designed to supplement, not substitute for, the advice of a trained medical professional. This book should not be used as a manual for self- diagnosis or self-treatment. Matters regarding vulvovaginal care often require medical supervision. Readers are strongly recommended to consult with a clinician before starting any medical treatment, diet, exercise, or other health program. The authors and publisher disclaim liability arising directly or indirectly from the use or application of this book. For Donald, with heartfelt thanks. Your unconditional support for all my projects has helped other women as I became first gynecologist, then V specialist, and now V Book author. —E.G.S. Table of Contents Acknowledgments Foreword Introduction PART 1 AN OWNER'S MANUAL Chapter 1 THE MIND: Why V health starts here A short history of the Vs The power of positive thinking Chapter 2 THE VULVA: A road map to the external genitalia Learning what's what Vulvar self-exam PLUS: Labial Enhancement Chapter 3 THE VAGINA: Demystifying the amazing "secret" organ V is for versatile What's where A design marvel Vaginal secretions The all-important V bacteria So what's "normal" discharge? PLUS: Kegels, the Essential Inner Exercise;The G-Spot: Fact or Fiction?; Normal Bacteria in a Healthy Vagina Chapter 4 AT DIFFERENT AGES: V changes throughout the life cycle Prenatal and newborn Childhood Puberty and reproductive years Pregnancy and postpartum Perimenopause Menopause A controversial rite of passage PLUS: Common Questions: Newborn, Childhood, Puberty, Pregnancy, Perimenopausal Symptoms; Common Questions: Menopause Chapter 5 V SMARTS: Everyday habits that make a difference Tampons Pads Panty liners Alternative protection Underwear Douching Hair removal Other V styles PLUS: The Heart of V Health: Ten Rules to Remember; Tampon Absorbency; More Tampon Dangers to Discount; Guilty or Not Guilty? The Truth About Common Tampon Concerns; Does Your Tampon Feel Right?; Instead of Douching Chapter 6 SEX MATTERS: V health facts for sexually active women First, desire Stage 1: excitement (arousal) Stage 2: plateau Stage 3: orgasm Stage 4: resolution Masturbation and V health Passion's pests Safer sex Birth control and V health PLUS: Lubricant Lowdown; Do Women Ejaculate?; Vibrating with Care; At-a-Glance Guide to STDs; Contraception and V Considerations PART II WHEN YOU NEED HELP Chapter 7 THE MOST BOTHERSOME SYMPTOMS: Possible causes and cures Odor Itching Unusual discharge Dryness PLUS: Odors That Talk; Itch Relief Dos and Don'ts; Common Vulvar Irritants and Allergens Chapter 8 NOW WHAT? How to proceed when there's trouble Why you can't tell by looking Evaluating your symptoms Why telephone diagnosis doesn't work Which doctor to see PLUS: Warning Signs Not to Ignore; Don't Believe These Medical Myths Chapter 9 THE IDEAL V EXAM: What to say, what to expect, and a guide to tests Why timing is everything The vulvovaginal history The pelvic exam Three important in-office tests Other testing methods Vulvar biopsy The Pap test PLUS: How to Talk to Your Gyn; Nagging Little Questions About Pelvic Exams; The Silent STDs Worth a Routine Test; Common Questions: Pap tests; All About AGUS; The First V Exam PART III PROBLEM AND ANSWER GUIDE Chapter 10 YEAST INFECTIONS: Separating the truths from the popular beliefs What is yeast? Symptoms of a yeast infection What causes yeast? Diagnosing a yeast infection Self-diagnosing a yeast infection A yeast infection action plan Steps to controlling recurrent yeast Complicated yeast PLUS: For Immediate Relief; Are You at Risk?; Common Questions: Sex and yeast; Can Yogurt Prevent Yeast Infections?; Common Questions: OTC yeast treatments; Natural Remedies; Simple Yeast or Complex Yeast?; Is There a Yeast Hideout? Chapter 11 BV:The leading cause of vaginal complaints What is Bacterial Vaginosis (BV)? What causes BV? Why treatment is important Diagnosing BV Treating BV When BV recurs PLUS: Is It Yeast or BV?; Treatments for Bacterial Vaginosis Chapter 12 TRICH: The STD that causes vaginitis What is trich? Diagnosing trich Treating trich Treating resistant cases PLUS: When a Pap Smear Finds Trich Chapter 13 VAG ITCH, CONTINUED:Lesser-known sources of vaginitis The estrogen-loss vaginitis: atrophic vaginitis Strep vaginitis Mobiluncus vaginitis The mystery vaginitis: desquamative inflammatory vaginitis (DIV) The discounted problem: lactobacillus overgrowth PLUS: A Mobiluncus Success Story; A DIV Success Story Chapter 14 COULD YOU BE ALLERGIC? Surprising irritants that trigger the body to attack What is allergy? Allergy to semen Other V allergies Allergy to latex PLUS: A Semen Allergy Success Story;The Mystery Allergy: Hives Chapter 15 WHEN SKIN GETS SICK: The vulva sees these skin conditions too What to know about cortisone Eczema/dermatitis/lichen simplex chronicus (LSC) Lichen sclerosus (LS) Psoriasis Lichen planus (LP) Hidradenitis suppurativa (HS) PLUS: Steroid Safety;The Leading Vulvar Irritants; Handle with Care: Hygiene Help for Women with Vulvar Skin Disease; LS Success Stories; An LP Success Story; Detecting HS Early Chapter 16 V BUMPS AND COLOR CHANGES:Should you be alarmed? Usually not Common small bumps Less common small bumps Really rare small bumps Common large bumps Uncommon large bumps Conditions with a red color Conditions with a white color Common dark discolorations Rare dark discolorations Ulcers Chapter 17 "IT HURTS": New insights into the V pain syndrome vulvodynia Pain theory Vestibulodynia (VBD) Vulvodynia (VVD) PLUS: Ask Yourself: Clues to Vestibulodynia; What to Rule Out First; The Q-tip Test; High-Oxalate Foods to Avoid; Tricyclic Antidepressants and Their Side Effects; Don't Let Side Effects Stop You!; Common Questions:Vestibulectomy; A VBD Success Story; A Vulvodynia Success Story Chapter 18 SEXUAL HEALING: Help for coping with painful intercourse Causes of painful sex The downward spiral The partner's pain A coping plan Pregnancy and
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