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Gynecologist Alyssa Dweck’s guide to sex
Gynecologist Alyssa Dweck’s guide to sex

Gynecologist Alyssa Dweck’s guide to sex

It could also be a fountain of delight.

But for a lot of women, sex may also include painful and irritating pitfalls.

The stability of vaginal micro organism is so delicate that, even when women do all the things to keep clear and use safety, it may be troublesome to keep away from infections, dryness, or dangerous smells. 

On the opposite hand, many women need to be spontaneous or adventurous – having sex in a pool, or having sex regardless of getting an sudden interval.  

And some need to know: can a penis be too huge? 

According to main gynecologist Dr Alyssa Dweck, writer of The Complete A to Z in your V, these are a few of the questions she fields day-after-day from sufferers.

The overwhelming majority of women who cross by means of her workplace in upstate New York ask her for recommendation on how to have an lively sex life with out the unwanted effects, she says. 

The questions concern all method of situations, from day-to-day health to one-off conditions.

Here, she outlines the most typical points, and what to do. 

For many women, sex can come with painful pitfalls, and they don't know how to avoid them

For many women, sex can come with painful pitfalls, and they don't know how to avoid them

For many women, sex can include painful pitfalls, and they do not know how to keep away from them


‘This is such a standard query as a result of it is very quite common in women,’ Dr Dweck explains.

Women have a greater than 50 % probability of struggling at the least one urinary tract an infection of their lifetime. Most women endure a number of for years on finish. 

A UTI mostly impacts the urethra, although it may progress to have an effect on the bladder (also called cystitis) or kidneys (pyelonephritis).

It is brought on by micro organism invading the urethra. 

In some instances, it’s a case of fecal micro organism shifting from the anus to the vagina by way of underwear. In this case, micro organism from the massive gut, corresponding to E.coli, depart the rectum and reaches the urethra.

However, it’s extremely widespread for women to get a UTI from sex, since micro organism from the penis can invade the urethra or the thrusting movement can push lingering fecal micro organism in the direction of her urethra.

Symptoms are painful. They embrace:

  • Intense ache within the decrease again
  • Intense ache within the vagina and pelvis
  • A continuing urge to urinate, although not a lot urine comes out
  • Burning and painful feeling whereas urinating
  • Shaky, faint, drained
  • Dark, bloody or cloudy urine
  • Fever or chills

‘The cause women are so susceptible to UTIs is as a result of if you consider the anatomy, the vagina, rectum and urethra are all very shut collectively,’ Dr Dweck explains.

‘Huge areas of micro organism colonize naturally and that is how the urethra can get contaminated.

‘Guys, nevertheless, have actually lengthy urethras and it isn’t as shut to the rectum.’

So how do you keep away from one? 

It is extra widespread amongst women with a number of companions, quite than one companion. 

But Dr Dweck insists that ought to not scare single women. There are some hacks to attempt:


‘The fantasy actually is true: urinate earlier than and after sex. It’s very, very useful. Doing that naturally flushes the micro organism from the urethra,’ she says.

‘That means, once you’re thrusting, there is not micro organism to colonize in your urethra.’


‘Women susceptible to UTIs ought to take cranberry dietary supplements. Take one a day, every single day. 

‘If you don’t need to take dietary supplements, drink cranberry juice or eat cranberry gummies. 

‘It makes the bladder extra slippery to micro organism, particularly E.coli.’

However, she warns, women ought to keep away from any juices or gummies which might be principally sugar.

‘Sugar basically can promote sure infections, you actually need pure juice.’


Vaginal dryness is especially widespread when women hit menopause. 

Reduced estrogen signifies that vaginal tissue can skinny, weaken and shrink, which may make sex uncomfortable and even painful. 

It can have an effect on women of all ages, nevertheless. 

The hormonal fluctuations throughout breastfeeding and being pregnant can set off dryness.

Anxiety also can have an effect on blood move to the vagina, inflicting dryness. 

And some women can endure dips of their sex drive, inflicting dryness. 

According to Dr Dweck, this is among the commonest issues sufferers want treating.  

So how are you going to deal with it?


‘Dryness could be very painful. 

‘Women might get tiny micro-abrasions close to the urethra brought on by dryness, and that may make them extra susceptible to an infection.

‘In this case, I might advocate utilizing a vaginal cream to deal with the abrasions, and decrease your danger of a UTI.’


‘I do know it sounds apparent however utilizing a lubricant helps so much,’ she says. 

‘If you get the proper one, a tiny bit goes a great distance.’ 

Dr Dweck recommends utilizing a silicone-based lubricant which accommodates vitamin E, to moisturize.  


Bacterial vaginosis (BV) is a disturbance of the pure stability of micro organism that reside contained in the vagina. 

Sex with somebody new, having a number of companions, and rinsing out the vagina with a bottle of liquid can all improve a lady’s danger of getting BV.

Semen may also decrease ranges of protecting micro organism, triggering BV.

However, it isn’t a sexually-transmitted illness or an an infection like a UTI.

In reality, the explanations for a lady creating BV stays one thing of a thriller.

According to Dr Alyssa Dweck, the majority of women who pass through her office in New York ask her for advice on how to have an active sex life without the side effects

According to Dr Alyssa Dweck, the majority of women who pass through her office in New York ask her for advice on how to have an active sex life without the side effects

According to Dr Alyssa Dweck, nearly all of women who cross via her workplace in New York ask her for recommendation on how to have an lively sex life with out the unwanted side effects

But the best way it manifests itself is extremely painful. 

It causes an extremely dangerous odor, discomfort, and ache. 

But it additionally has a much more menacing aspect.

Women with BV have a better danger of contracting STIs like gonorrhea, chlamydia, and HIV. 

They even have a better danger of pelvic inflammatory illness (which may lead to infertility) and different infections.

Pregnant women with BV or with a historical past of BV have a better danger of delivered their child prematurely or passing life-changing infections to her child.



‘It’s extra widespread in women with a number of companions, and it may be prevented through the use of condoms,’ Dr Dweck says.


‘Women who sit round in a moist bathing go well with and workout garments have a a lot greater danger. 

‘It is an easy means for micro organism to construct up and to have an effect on the bacterial stability.’ 



The vagina is residence to 5 totally different strains of micro organism.

Studies present that women with BV have a tendency to have decrease ranges of a sure sort of micro organism referred to as Lactobacillus. 

Women with BV ought to attempt to incorporate extra probiotics into their eating regimen, reminiscent of fermented meals or yogurts. 

They also needs to avoid carbohydrates and sugar.

And they need to search a probiotic with a minimal of 10 million micro organism, ideally containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14.


‘I really like this query. Everyone asks it,’ Dr Dweck laughs.

Despite all her sufferers’ considerations, she insists there’s nothing to be nervous about. 

‘If you consider how accommodating the vagina is, contemplating we’ve got infants, it will be extremely unlikely that a penis could be too huge for a vagina. 

‘During arousal, the vagina expands.’

Only if a lady isn’t absolutely aroused might there be issued with measurement and match.  

‘Some women could possibly be small and a few males might be huge. But not to the extent that there is a problem,’ Dr Dweck says. 

‘Even although penises are available all sizes, most erect penises are about the identical measurement.’


Ultimately, Dr Dweck says, the parable is true: a vagina must be seen as a ‘self-cleaning oven’. 

‘The vagina has stuff to hold it clear, naturally,’ Dr Dweck explains. 

‘Our our bodies work to maintain the micro organism balanced.

‘So, even in case you are very involved about odor, you will have to keep in mind that delicate stuff goes a great distance.’

She provides: ‘There are some women who can actually use something of their vaginal space and be positive.

‘But for women who’re delicate, much less is extra.’ 

Instead of shopping for aromatic merchandise and intensely scrubbing, Dr Dweck recommends: 

  • Vitamin D dietary supplements (research present women missing in vitamin D have larger danger of smelly vaginal odor)
  • Hydrate (fluids assist dispel dangerous odor)
  • Boric acid suppositories (positioned weekly to hold vaginal micro organism stability in verify)
  • Probiotics (in your food regimen or dietary supplements to maintain vaginal micro organism stability in verify)
  • Less aromatic merchandise (to keep away from irritants)
  • Less vigorous scrubbing (to keep away from irritating the world) 

She provides that you need to be sure that the world is not smothered. 

‘The space ought to a minimum of get some ‘air-ation’ if you’ll,’ Dr Dweck says. 

‘You don’t need to be sporting a decent pad or panty liners 24/7 365 days a yr.’


Dr Dweck stated sex in several places like the ocean and swimming swimming pools might be enjoyable.

However, some kinds of chlorine might be an irritant, particularly if it is caustic. 

‘In common, some women who’ve sex in very heavy chlorine swimming pools do turn into fairly irritated.

‘The pure lubricant of the vagina will not be as excessive.

‘So there’s a very actual danger of an infection to be careful for.’  


‘There’s nothing incorrect should you’re snug with it. Some women simply discover it messy or gross,’ Dr Dweck says. 

‘The an infection danger can be if there’s an inherent an infection like HIV or hepatitis. If not, you are effective.’

In reality, Dr Dweck reveals, she thinks interval sex could be nice for women. 

‘The good factor about interval sex is that some women discover that their libidos soar in that point. And orgasms might assist with cramps. 

‘Women additionally really feel very snug that – if their durations are common – they can not get pregnant throughout their interval, so which will make them extra carefree, and assist them really feel aroused.

‘It’s actually the mess issue which places most women off. 

‘If that is the case, you possibly can manipulate the lighting, or use a towel.

‘Alternatively, this could possibly be an ideal alternative for bathe sex.’

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