Sep 21, 2026 · 28 min · 14 segments
Dr. Stephanie Lam returns to the podcast to discuss vaginal infections and vaginitis, which are very common and, she estimates, affect 20-25% of patients. Dr. Lam and Dr. Fox review common types of…
Stephanie MelkaGuestNathan FoxHostAnd what you said at the beginning, which is really true about, you know, the bacteria versus yeast, something that's called candida or fungus, it's all the same thing.
Essentially, the way I always learned it is the vagina is lined by this, what we call a mucous membrane, right? So it is a membrane, meaning it's a barrier, but it's not like skin where that sort of is very, the histological term is keratinized, right? Skin is a little like tougher, right? Whereas the mucous membrane is more like the inside of some of the lips, for example.
absolutely can be very sensitive, but also the environment that's there because of sort of it makes this glycogen, which is like a sugar product.
The idea, though, is that there's these bacteria that are supposed to be there, right? The vagina is not supposed to be a sterile environment.
There's certain levels that we're supposed to have where homeostasis, where you kind of your happy sweet spot is.
And that all can be set off and off balance based upon how we live our lives.
And so, you know, I think when we look at our patients here, we really do believe and it sounds a little hokey, but I truly do believe in the mind, the body, the whole way of how you look at a patient.
And so what you eat, how you treat it, are you drinking enough water? Are you taking medications? All of that kind of can set it off a little bit.
So when patients come in or they call the nurses and they say, I was on antibiotics for a sinus infection and they have some itching or irritation, those are certain keywords that will lead us to think of what maybe they're coming in with.
But Yeah, the lining of the vagina, those cells are very different than the cells on our arms or legs.
Since there's this sort of typical environment that's there, right? And there's supposed to be bacteria in there.
And what you said at the beginning, which is really true about, you know, the bacteria versus yeast, something that's called candida or fungus, it's all the same thing.
Essentially, the way I always learned it is the vagina is lined by this, what we call a mucous membrane, right? So it is a membrane, meaning it's a barrier, but it's not like skin where that sort of is very, the histological term is keratinized, right? Skin is a little like tougher, right? Whereas the mucous membrane is more like the inside of some of the lips, for example.
absolutely can be very sensitive, but also the environment that's there because of sort of it makes this glycogen, which is like a sugar product.
The idea, though, is that there's these bacteria that are supposed to be there, right? The vagina is not supposed to be a sterile environment.
There's certain levels that we're supposed to have where homeostasis, where you kind of your happy sweet spot is.
And that all can be set off and off balance based upon how we live our lives.
And so, you know, I think when we look at our patients here, we really do believe and it sounds a little hokey, but I truly do believe in the mind, the body, the whole way of how you look at a patient.
And so what you eat, how you treat it, are you drinking enough water? Are you taking medications? All of that kind of can set it off a little bit.
So when patients come in or they call the nurses and they say, I was on antibiotics for a sinus infection and they have some itching or irritation, those are certain keywords that will lead us to think of what maybe they're coming in with.
But Yeah, the lining of the vagina, those cells are very different than the cells on our arms or legs.
Since there's this sort of typical environment that's there, right? And there's supposed to be bacteria in there.
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