- The "Down There Doctors" are three urogynecologists who wrote a book about the pelvic floor.
- They say no question is too embarrassing to ask your doctor — they've heard it all before.
Dr. Victoria Scott's patients are often shy about asking her questions. But she has a blunt way of reminding them that nothing they ask will faze her.
"We look at and talk about vaginas all day, so it's going to be very hard to come up with something we haven't seen before," Scott, a urogynecologist and coauthor of the book "A Woman's Guide to Her Pelvic Floor: What the F*@# Is Going On Down There," said.
Scott and the other authors, Dr. Jennifer Anger and Dr. Karyn Eilber, were inspired to write the book after they saw too many patients who were embarrassed to discuss treatable conditions such as incontinence or prolapse with their doctors. The authors wrote the book to deliver more in-depth information to patients who otherwise might try to research symptoms themselves rather than seek help from a trusted healthcare provider.
"There is something to the phrase 'a little knowledge is a dangerous thing,'" said Eilber. Google and other online search engines may not understand the intent of your search and bring you to sources that aren't exactly what you're looking for. It may be hard to parse medical research or articles you find online to see if it pertains to what you're actually dealing with. A healthcare provider is better equipped to listen to your concerns and pull from their knowledge base and help you figure out what's going on.
Anger often tries to bring up awkward topics first so that her patients don't have to. But if there's something on a patient's mind that the doctor hasn't asked about, she said it's important that the patient bring it up in conversation.
"Once you just say what is bothering you, the awkwardness will go away and you will feel relief," she said.
Here, Scott, Anger, and Eilber answer some of the most common questions they get from their patients.
Where exactly is my G-spot?
The G-spot is named for Ernst Gräfenberg, the inventor of the IUD, who theorized about an erogenous zone on the front wall of the vagina.
"It's an area that when stimulated, is said to result in strong orgasms and even ejaculation," Anger said. It's typically located two to three inches into the vagina, on the front wall.
However, as doctors learned more about the anatomy of the clitoris (which extends into the vaginal walls) some doctors believe that the G-spot is an extension of the clitoris, Anger said.
"The clitoris has many more nerve endings and is the source of orgasm for most women," she said. "Women who have orgasm from stimulation in the G-spot location may have extensions of the clitoris or other sensory nerves into the vagina."
What does squirting mean, exactly?
Squirting is considered "female ejaculate," sometimes associated with G-spot stimulation. Women don't have glands that make ejaculate fluid, Anger said, so "the fluid expelled during orgasm, often in large volumes, can only be urine."
"This likely occurs when a woman releases her body at the time of orgasm," Anger said.
Can I masturbate too much with my vibrator?
The doctors recently completed a study that looks at vibrator use and found that it relieved incontinence, improved pelvic pain, and boosted people's overall quality of life, Eilber says.
"So if you or your partner is questioning the frequency of vibrator use, remind yourself — or your partner — that you're using it for overall pelvic health," she said.
Why does my pee smell after I eat asparagus?
Lots of things, from various foods to medications, can change the way that your urine smells, Scott said. Asparagus is broken down into sulfur byproducts as it's digested. Those strong-smelling compounds are then released into the urine.
"If you don't experience asparagus pee, you either can't smell it or don't digest asparagus in a way that excretes sulfur byproducts in the urine," Scott said.
Is there Viagra for women?
Contrary to popular belief, Viagra and other erectile-dysfunction drugs aren't magic pills that give erections on demand, Eilber said. They work by increasing the pelvic blood flow needed to get an erection, but people who take Viagra still need stimulation.
"Women don't have the equivalent of erections, so a female Viagra wouldn't necessarily help with sexual function," she said.
Yet, there's hope. Both desire (being turned on) and arousal (body's response to being turned on) are major parts of sexual satisfaction. Both desire and arousal can be affected by low hormone levels caused by menopause and pregnancy, medications, and conditions like depression. So addressing those root causes can help you boost your sex life.
"The best 'female Viagra' may simply be hormone therapy or discontinuation of medications that affect hormones or sex drive," Eilber said.
Does alcohol impact women's ability to have sex or orgasm the same way it impacts men?
This one is complicated, said Scott. Research about the impact of alcohol on men doesn't necessarily apply to women, and there's a wide range of ways alcohol can impact your sex life.
"Although many studies show that women report increased enjoyment of sex with mild to moderate amounts of alcohol, it does likely decrease genital arousal and physical response," Scott said.
Are menstrual cups a good alternative for me?
Menstrual cups are sanitary and convenient, Eilber said. While some women find them more comfortable than pads or tampons, others use them for environmental reasons, since they reduce waste.
As for finding the right cup, it can involve a lot of trial and error, Eilber said. If you haven't given birth, start with a smaller-sized cup, and if you have given birth, start with a larger size, she said.
A condom came off inside my vagina. How do I get it out?
If you have long fingers, try fishing it out yourself, Eilber said. If that doesn't work, get the person who was wearing the condom to lend you a hand while you lay on your back and bear down. Having a condom inside you for a bit isn't a medical emergency, Eilber said.
"If it happens in the middle of the night, I certainly wouldn't recommend waiting hours in the emergency room," she said.
However, if you still haven't retrieved it the next day, head to urgent care or your primary-care doctor.
Regardless of your concern, it's always best to discuss medical worries — no matter how silly or embarrassing — with your doctor.
"It is very important for patients to feel comfortable talking to their doctors and to trust them," Scott said. "If you don't feel comfortable asking your difficult questions, you will continue to live with your worries and concerns without getting them addressed. Our goal is not only to fix your health problems, but also to help you feel more comfortable with your body and anything you might feel embarrassed about."