Women?s intimate health

Interview with gynecologist-oncologist dr Barbara Kozakiewicz

Natalia Miuska: Are women today healthy? Are we ill more or less often than 10, 20, 30 years ago?

Dr Barbara Kozakiewicz: Unfortunately, as far as intimate health is concerned, we suffer more often. Dominant among gynecological problems are: recurring infections, dryness of vulva and alergic reactions of mucous membranes which in this area are predominant and whose improper care results in such problems.


Why does this happen?
I think that a certain lifestyle, a certain widespread approach to intimate hygine is to blame. There are a few factors which weaken the mucous membranes of the vulva and partially the vagina. The first one which leads to health problems - our hygienic habits. We use soap ? in bars or as gels - for washing our bodies and our intimate parts as well. We are encouraged to buy gels, they are widely advertised as wonderful products for women?s hygiene, and who doesn?t want to smell nicely and be perceived as well groomed?

Can simple soap have such negative influence on our health?
Yes, by using soap, regardless of its type: white, imported, baby soap etc; we change the acidity, or pH, of the mucous membranes of our crotch from the physiological acidic pH to a higher, alkaline one. Such alkaline pH is a ?paradise? for all kinds of microorganisms.
Additionally, soap, whether liquid or in bars, has added fragrance and colour. They are chemicals which further affect our mucous membranes.
This is another problem. Why not use an intimate gel which ?gives the fragrance of spring and lightness of a butterfly?s wings? or promises similar wonders? And this is the style of advertising of different hygienic products which maybe make our life easier but may have nothing to do with health. Producers of such ?wonders? care about sales? increase. We, gynecologists, will have to treat their users. Women increasingly suffer from recurring problems caused by using hygienic products which ?burst? with unidentified chemical substances.
Another important issue is the way we dress. We often wear very tight trousers, our underwear is made from artificial fibers etc. Skirts ensure better ventilation. Tight trousers create ideal conditions for microorganisms which need warm, damp places without access of fresh air.
Finally, and in my opinion most importantly, there is the habit of wearing sanitary pads continually, not just during periods. Nowadays women of all ages wear disposable pads and liners - ultra thin, fragrant, matching the panties colour, plain and patterened: flowers, butterflies, stars, what have you. Is it to protect their underwear? To be like the beautiful girl advertising such products in a glossy magazine? Or because other women do it?
Often, especially in hot weather, when I examine women I can see the shape of the pad as a painful, sometimes bleeding print on the crotch. Especially harmful are those with added rubber and perforated surface.
I often advise such patients to take an old linen bedsheet or a cotton towel, cut it to pieces and put such cloths on the pad to separate and protect the body from the chemicals in the pad.

What is inside disposable pads that requires women to use such isolation?
I don?t know their content because producers don?t inform about it, but based on my 30 years of clinical experience I can state that disposable pads irritate and dry the vulva and anus area.
I suspect that the harmful ingredients are absorbents, fragrances and colours of prints. Also, bleaching with chlorine to achieve the white colour must intensify the negative reactions of the skin and mucous membranes.

What happens to the crotch area exposed to continual contact with such pads?
Substances from the pad react with the mucous membrane. It tries to defend itself, becomes bloodshot. It is hard to explain all the biochemical processes but I know how the crotch of a healthy woman looks like and that of a woman exposed to chemical substances.
Basically, everything starts with hyperemia and swelling of mucous membranes. It is the beginning of an infection because every bacteria or fungus can attack such a changed and defenceless membrane. An infection starts from mycosis, when white, cheese-like discharge occurs, then bacteria join in and the dicharge becomes greenish, sometimes with blood, stinging.
Women with such problems use liners, which causes further irritation and the symptoms intensify. It is a vicious circle. Such chronic infections cannot be cured without changing hygienic habits. If infections appear again and again, they may permanently change the membranes of the vulva and the anus area. They are most exposed to harmful chemical influence as well as most sensitive to it ? just like the uvea in our eyes. As a result, they lose their natural properties.

What dangerous changes can you observe?
Dryness of mucous membranes of the vulva, the vagina and the anus area affects even young women, whose hormone levels are still balanced. The crotch of a woman strongly reacting to contact with chemical substances is dry, pale, with tiny cracks, painful during examination but also during sexual intercourse.
The mucous membrane should normally be damp and pink, covered with a film of mucus. If not, it is prone to drying and infections, and this in turn might lead to cancer.

Is cancer of this area a common phenomenon?
Personally, I fear that vulvar cancer will become a huge oncological problem. It used to concern septo- and octogenerians. Today we treat ever younger women. Epidemiological reporting still doesn?t reflect the real scope of the problem, but I can see this trend in my medical practice, and it is frightening.

What causes vulvar cancer?
As in many cancers, it is difficult to indicate a specific reason, but our hygienic habits provoke a number of changes which may eventually lead to this terrible illness.
Everyday use of soap, gels, sanitary pads, very early beginning of sexual activity and the use of latex condoms, tight trousers ? these are some of the factors affecting women?s health.
In the case of vulvar cancer hygienic habits are a well proven factor. Already in Victorian Britain it was noticed that weavers working in factories producing fabrics with asbestos who used scraps of the fabric during menstruation suffered from vulvar cancer on a mass scale.

How can this cancer be treated?
It requires a very radical action ? surgical removal of the vulva together with lymph nodes. But if additionally so called negative forecasting factors are present, which means that the probability of the disease spreading is high, radio- and chemotheraphy also need to be used.

So it is a very serious operation with far-reaching consequences.
The consequences are tragic since the extent of intervention is enormous, and it is accompanied by pain, suffering, shame, even insanity.
This cancer has a high rate of recurrence. In radical treatment, apart from surgery, radiotherapy is also used. However, it cannot be repeated so if the illness returns, additional surgery is the only option, and it is obviously also limited.
Treating such patients is difficult for the oncologist and for the women themselves.

How can we prevent it?
1. Change hygienic habits today.
2. Resign from washing with soap, bar or gel.
3. Use only acidic water solution for everyday hygiene.
Acidic solutions are: 3% solution of water with acetic acid, or vinegar, which we all have in our kitchen, or with lactic acid, available from the chemist?s. Even adding juice from half a lemon to app. 2 l. water changes its pH favourably. And it won?t take women much time even in today?s busy world.
4. Resign from or at least limit everyday use of pads and liners, especially those bleached with chlorine or covered with foil and containing superabsorbents of unknown content but with a harmful effect on the human body.

If not pads then maybe tampons?
I?m sorry but I?m their declared opponent. Od course, since the publishing of information about Toxic Shock Syndrome, when first fatal cases in the USA were described, we know that obstructing the flow of blood and the body?s interaction with chemical substances can lead to vein inflammation in the lesser pelvis and, consequently, even to death.
It was proven that deaths resulted from using tampons during menstruation. As a consequence of court trials at that time, it is now obligatory to place the information about the product?s possible harmful effect on the packaging.
Every box of tampons must contain such information, but it is printed in the smallest possible letters. Thus, very few women notice it. Also, it says that you should consult a doctor if fever and abdominal pain occur.
It must be said that women who are affected by TSS may not make it to the doctor since the illness progresses very fast and results in death.

N: I accessed research which describes negative effects of using tampons ? dryness, tampon fibre incorporation into the wall of the vagina, ulcers. The research suggests that it is the result of using artificial fibres, artificial cotton in tampon production. They aren?t usually sterilised either, because it would reduce absorption, they are additionally soaked with substances increasing it. It is often said that a tampon absorbs so it won?t emit any harmful substances affecting the vagina.
It is complete rubbish. If there is a reaction ? and it is inevitable, the toxic substances from a tampon are emitted into the vagina, which is covered with mucous membrane ? more delicate than skin. The contact with chemical substances is immediate and possible to observe with the naked eye. The membrane becomes dry, with abrasions and cracks. It bleeds when touched. It is not difficult to guess who uses tampons, especially since this group of women often seek doctors? help in connection with painful, unsatisfactory intercourse, problems with recurring pain, stinging and discharge.
One extremely important fact, and you must also realise it very well, is that it is impossible to know the content of tampons, absorbents in pads or methods of disinfection of those products commonly referred to as ?hygienic?. There are no legal regulations concerning chemical substances used in producing pads and tampons. As we can see in commercials, such substances increase absorption so much that you can pour a glass of ink into a thin pad.

Then how to care about ourselves wisely?
As I said before ? change habits regarding intimate hygiene. I am all for progress and making women?s lives easier, but the progress which ignores our health is nothing but harmful. And, sadly, today?s situation when a company?s profit dominates over women?s health seems tragic. My job is to help women who require gynecological advice. It is frightening that today they are predominantly victims of hygienic products ? full of unidentified chemical substances which are the company?s secret.
We have no information how these products are disinfected, what substances are added to condoms or toilet paper etc., etc.

I wholeheartedly support the idea of producing pads which don?t harm the body. We have learned to dispose of products used but once, but suddenly we need to go back to old methods, using pads which require washing and keeping clean. However, it seems a small price for being healthy, not suffering from stinging or discharge.
Since I learned about this possibility to buy in Poland pads made 100% naturally, I have been recommending them to my every patient. I believe that spreading information about this product will encourage first of all women with health problems, but also these who want to avoid them in future, to use safe, not irritating pads.
I sincerely wish for it to happen, for your sake and for the sake of women, their health and comfort.

Thank you very much for our conversation.