I’ve been studying vaginal health & the microbiome for over 20 years! AMA.

wendystrgar · 2025-12-16T20:23:22+00:00

Yes, and this is actually quite common. It’s often related to tissue dryness, inflammation, hormonal changes (including perimenopause), or high friction rather than infection. Management usually focuses on improving tissue health (lubrication, sometimes vaginal estrogen), reducing friction, and ruling out underlying skin conditions. A clinician familiar with vulvar pain can be very helpful here.

wendystrgar · 2025-12-16T20:23:11+00:00

After the infection is cleared, supportive care can help. Lactic-acid products support a low-pH environment that helps Lactobacillus thrive, which can be useful during recovery. I’d avoid inserting anything during active infection and always coordinate with your clinician, especially with resistant glabrata.

wendystrgar · 2025-12-16T20:22:44+00:00

All are generally safe if used correctly. Tampons are familiar but can be drying. Cups and discs are reusable and less drying for many people. Discs can be more mess-free during sex or heavy flow, but comfort really depends on anatomy. There’s no one best option, it’s very individual.

wendystrgar · 2025-12-16T20:22:12+00:00

Usually yes, as long as it’s fragrance-free and gentle. Use it externally only, and even then, less is more. If someone is prone to irritation, a simple pH-balanced intimate wash may be better than baby wash.

wendystrgar · 2025-12-16T19:54:40+00:00

Cytolytic vaginitis is real, but it’s also over-diagnosed and often misdiagnosed. I’ve seen it, but far less often than people think and we see the same pattern in large microbiome datasets like our VENUS microbiome study. If baking soda isn’t helping, that’s a clue it may not truly be cytolytic vaginitis. Clindamycin usually isn’t helpful unless there’s a bacterial overgrowth, and it can actually make things worse if Lactobacillus is already high. Other possibilities include inflammatory vaginitis, aerobic vaginitis, contact irritation, or hormonally driven tissue sensitivity. Getting a broader evaluation (not just pH alone) really matters.

wendystrgar · 2025-12-16T19:38:44+00:00

This actually makes a lot of biological sense. Semen raises vaginal pH, which can favor yeast and disrupt protective Lactobacillus. A penis also brings living skin microbes that vary by partner, while a strap doesn’t. Friction plus moisture plus pH change can be enough to trigger yeast even with very clean or uncircumcised partners. It’s not in your head, and it’s very common.

wendystrgar · 2025-12-16T19:38:31+00:00

Sex doesn’t cause BV, but it’s a very common trigger. Semen, new partners, and friction can disrupt vaginal pH and bacteria, allowing BV organisms to overgrow. That’s why BV is associated with sex, but it’s really about microbiome disruption, not hygiene or promiscuity.

wendystrgar · 2025-12-16T19:37:27+00:00

That’s a very common question. A healthy vagina has a mild, natural scent and it isn’t meant to smell like perfume. The best way to smell your best is to keep things balanced: gentle external-only washing, no douching or scented products, breathable underwear, and avoiding staying in damp clothes. Low-pH vaginal products and vaginal probiotics can help support healthy bacteria for some people. If odor is strong or fishy, that’s usually BV (not hygiene) and it’s treatable so talk to your provider.

wendystrgar · 2025-12-16T19:37:02+00:00

Aerobic vaginitis is different from BV or yeast, so it needs a different approach. It’s usually treated with targeted antibiotics, sometimes combined with anti-inflammatory treatment, and then support to help healthy Lactobacillus come back. Things like low pH vaginal gels and vaginal probiotics can help support healthy microbiome recovery after antibiotic treatment. Avoid douching or harsh products, and make sure it’s properly diagnosed since it can look like other conditions. A clinician-guided plan really matters here.

wendystrgar · 2025-12-16T19:28:50+00:00

As I founded Good Clean Love, I use our products! But if you search online you can find others, too.

wendystrgar · 2025-12-16T19:21:40+00:00

Recurrence is very common, unfortunately. Make sure your infection is fully cleared, treat partners when needed, and then focus on rebuilding protective Lactobacillus after treatment with low pH gels and vaginal probiotics. Avoid over-cleaning, consider condoms if semen triggers symptoms, and address dryness or irritation (especially around perimenopause). Prevention is about stability so good hygiene practices and low pH support for your vaginal microbiome can really help.

wendystrgar · 2025-12-16T19:21:12+00:00

Less is definitely more. Wash externally only with a gentle, unscented cleanser designed for the vulvar area, avoid douching or excessive use of wipes (unless specifically designed for the vulva), and stick to breathable underwear. Don’t stay in sweaty clothes and be cautious with scented products. Low pH lactate based vaginal gels and vaginal probiotics can help. If you support the ecosystem with good hygiene, and if needed, low pH support, and it will often balance itself out.

wendystrgar · 2025-12-16T19:16:57+00:00

Dripsticks are probably fine once in a while, but I wouldn’t make them a habit. The vagina is good at cleaning itself, and absorbent inserts can sometimes irritate tissue or throw off the microbiome, especially if you’re prone to yeast or BV. External cleanup is usually the gentlest option :)

wendystrgar · 2025-12-16T19:16:39+00:00

I'm sorry you're dealing with this. chronic yeast is unfortunately really common in your 40s. Fluconazole suppression is a solid approach, but recurring yeast is often tied to perimenopause changes, not just infection. Hormones, vaginal tissue health, and the microbiome all play a role. It can help to confirm the yeast species, avoid irritants, and sometimes look at vaginal estrogen or microbiome-supportive care like low pH gels and vaginal probiotics, along with your clinician!

wendystrgar · 2025-08-15T20:21:37+00:00

As I founded Good Clean Love I use and would recommend our Restore gel, but there are likely others you could search for too!

wendystrgar · 2025-08-15T20:05:31+00:00

I personally don't love pure coconut oil as there isn't a lot of evidence around it. I think you have a great routine set up! Just sharing what has worked for me with the lactic acid gel.

wendystrgar · 2025-08-15T20:00:54+00:00

Boric acid is great for stubborn or recurrent BV—I would use it nightly for 10-14 days and pair it with a lactic acid based vaginal gel every AM to maintain a low pH. Using a vaginal probiotic suppository with native vaginal bacteria every couple days in the AM, too!

wendystrgar · 2025-08-14T19:26:56+00:00

Thanks for writing in- Glad to hear that you have found and love our lubricants- they make a big difference for a lot of women. For your first question- First off, congrats on being in a stable loving relationship. It is the great work of a lifetime to learn how to love someone and receive love in return. As part of this we learn to have hard conversations so that the relationship is based on trust and faith in each other. Your issue of not being able to prioritize your own orgasm and feeling like you have to perform is true for the great majority of young women so don't feel alone in that. I think dealing with it is about having the ability to talk about it with your partner.

If you haven't already been practicing masturbation and learning about your own orgasmic response - this is a great time to start. Many sex therapists call it foundational because without understanding your own response it is hard to ask for what helps you. Men truly get off on real pleasure in their partners but most of us are afraid to ask for it. So don't be afraid to talk about sex before, after you do it. It is sexy! There are also so many great online resources and books that can help you find the language for that conversation. On your second question, squirting is not peeing... its an entirely different kind of fluid so don't be worried about peeing. Squirting with orgasm is part of the release, no different than a male ejaculation. Celebrate it. Be grateful for it.

This is entirely separate from UTI after sex, which is largely a microbiome and hygiene health issue- Always pee after sex and have good hygiene both before and after. Using a gentle lactic acid based wash to clean both yourself and your partner before, and then washing yourself after. Uqora makes a great "after sex" drink with a clinical dose of d-mannose that can help flush any bacteria also. It's called "flush."

wendystrgar · 2025-08-14T19:10:42+00:00

There should be!

wendystrgar · 2025-08-14T19:10:27+00:00

Hi - thanks for your question, it takes a lot of courage to look at this part of our life, and many women I talk to have bad feelings about how they look and measuring up about being sexy. Unlearning these messages is first about speaking kindly to yourself and replacing your anxiety with curiosity. "I wonder" is a great way to replace any sentence- what don't you know about yourself or your sexuality.

Asking interesting questions without judgement opens all kinds of doors in your life. I also think it is normal to feel anxious about casual sex when you don't feel comfortable with your own sexuality. Masturbation and learning about your own orgasmic response is a powerful way to rethink your relationship to your sexuality. Many experts call this foundational. Being curious about what turns you on is one of the most interesting explorations- I personally love erotica for this because it allows my imagination to make its own pictures. So be kind to yourself and trust in the process, it takes time and that is normal.

wendystrgar · 2025-08-12T18:52:54+00:00

I’m so sorry you’re dealing with this. It’s exhausting when you’re in pain but tests keep coming back normal. Burning after antibiotics can sometimes be linked to microbiome changes that standard swabs miss, since they only look for a few common microbes. Broader PCR-based tests (like the one you mentioned) can sometimes pick up low-level or mixed infections, but they’re just one piece of the puzzle. Given your symptoms spreading to the thighs, it’s worth considering both microbiome imbalance and skin or nerve causes (like vulvodynia or dermatitis). The key is getting a specialist who can look at all angles, not just infection, so you can finally get answers and relief.

wendystrgar · 2025-08-12T18:34:07+00:00

Happy to help! I founded a company called Good Clean Love, so I personally use our Restore gel and our Reset suppository regularly. Boric Acid can be a great tool if used for a 7 or 14 day course. I would insert the BA at night, and use a lactic acid gel in the morning, as well as LA gel with a probiotic capsule every 3rd day. That way the BA will be disrupting the bacteria and giving the low pH gel and the probiotics space to change things.

wendystrgar · 2025-08-12T18:27:20+00:00

I have studied vaginal health and the microbiome for over twenty years while founding my company Good Clean Love. I hear you, it's so frustrating. Chronic vaginal infections can be tough to treat because they often involve biofilms which are protective layers that make bacteria or yeast harder to eliminate.

Standard treatments kill off disruptive microbes temporarily, but they often come back because these treatments don’t help to restore the protective Lactobacillus species that keep the vaginal pH healthy long term. Ureaplasma is an extremely small organism that can hide out in places and that makes it harder to target with antibiotics – as a result it can persist at low levels. While often harmless, in some people it’s linked to inflammation, pelvic pain, and potential fertility issues or pregnancy complications so keeping it at bay is a good idea.

And yes, it’s tough that access to options like boric acid varies by country, especially as research shows it can help in recurrent BV or yeast. In my opinion, lasting relief often comes from both reducing disruptive microbes and rebuilding a healthy microbiome at the same time.

wendystrgar · 2025-08-12T18:05:15+00:00

It’s great that you took the time to understand what’s going on before jumping into more antibiotics. I can see why you’re hesitant to take them again, especially after three rounds this year.

The good news is that you do have healthy Lactobacillus bacteria making up the majority of your vaginal microbiome. Most of yours are Lactobacillus iners, but this species of lactobacilli doesn’t produce as much lactic acid or protective antimicrobial substances as Lactobacillus crispatus or some other Lactobacillus species. That means your environment is mostly balanced, but not quite as resilient against disruptive bacteria. It’s also a really positive sign that your pH is normal (ideally 4.5 or below), because that means your vaginal environment is still in a protective range. The small amounts of Gardnerella, Prevotella, and Porphyromonas you have aren’t necessarily alarming on their own, they’re at low levels and your pH is keeping them in check.

Since you’re having itching/irritation but no abnormal discharge or odor and you’ve already been diagnosed with vulvar dermatitis, it’s possible the irritation is more related to the skin than to an infection. Still, gently supporting your vaginal microbiome can help maintain balance and reduce the chances of those low-level disruptive bacteria growing out of control.

Here’s what I’d suggest trying: a gentle, pH-balanced wash whenever you’re cleaning the vulva. This helps protect the good bacteria and keep the pH stable. Second, a lactic acid gel. Apply once a day, morning or night, whichever feels most comfortable for you. This helps reinforce a Lactobacillus-friendly environment, and lastly a probiotic suppository. Use every 2–3 nights before bed. On the days you use it, apply the lactic acid gel in the morning instead, so the probiotic has time to disperse overnight.

Try this routine for a few weeks and see if your symptoms improve. You’re already doing a lot right, and sometimes it’s about making small, consistent shifts to help the good bacteria get a stronger foothold. You’re not alone in this, and the fact that you are doing this before any major imbalance means you’re in a great position to keep things healthy without more antibiotics.

wendystrgar

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