Let That Coochie Breathe — A Nurse Midwife on Vaginal Health Across Your Whole Life

Dr. Jennifer Ashby talks with nurse midwife Erinn Lance, CNM — a close friend and the midwife who was in the room when Jen birthed her last baby — about vaginal health across a woman's whole life: why the vagina is a self-cleaning organ, the microbiome and common infections, how discharge changes from first period through menopause, GSM (genitourinary syndrome of menopause) and vaginal estrogen, pelvic floor PT, lubricants, sex after menopause, hydration, and learning to trust your own body.FEATURED OFFERThe Energy Prescription, Dr. Jennifer Ashby's new Wiley book, turns her whole-body, East-meets-West approach into a daily toolbox for thriving through perimenopause and menopause. Out October 20th. 👉 Pre-order here: https://www.amazon.com/dp/13943896635 KEY TAKEAWAYSThe vagina is self-cleaning — leave it alone. Douches and scented washes disrupt the microbiome that keeps pH acidic and hostile to infection. See a provider only when something changes (itching, burning, foul odor).Know your "normal," including discharge — often it's just the body cleaning itself or a sign of ovulation.Sex shifts the environment, and spit is a culprit. If infections recur, skip saliva as lube and use a clean, water-soluble, glycerin-free lubricant.GSM is real, common, and under-treated. As estrogen drops, tissue thins — including the bladder — causing dryness, recurrent UTIs, and incontinence. Vaginal estrogen (cream or ring) is largely local, not systemic.Trust your body and advocate for yourself. If you're dismissed, find another provider — a pelvic exam should never simply be endured.TIMESTAMPS00:00 Welcome + today's topic: vaginas & vaginal health00:30 Meet Erinn Lance, CNM — nurse midwife & homeopath05:30 All the names + the origin of "vagina" (a sheath for a sword)07:30 Birthing a baby together in this room; matrilineal wisdom18:00 Reproductive years: BV, yeast & the self-cleaning vagina23:00 pH, lactobacilli, ovulation mucus & "ferning"32:00 Sex & vaginal health: spit, new partners & clean lubricants38:00 Talking to kids: "Switzerland" & the "Ace of Sparkles"44:00 Pregnancy & postpartum; the first 40 days54:00 Hormonal contraception & the microbiome56:30 Perimenopause, menopause & GSM1:01:00 Vaginal tissue changes & vaginal estrogen (cream vs. ring)1:05:00 GSM & the bladder: UTIs & incontinence1:08:00 Sex after menopause; "you never have to endure a pelvic exam" 1:12:30 How to pee + hydration deep-dive (weight ÷ 2 in ounces)1:19:40 One piece of advice: trust your body1:26:30 Wrap-up + the send-off songGUESTErinn Lance, CNM — certified nurse midwife caring for women since 1998 in clinics, homes, birth centers, and hospitals. Master's in Nurse-Midwifery, UCSF (1998); founded Centering Pregnancy at Marin Maternity Services; retired from birth work in 2025 and now focused on menopause. 🔗 CONNECT WITH DR. JEN ASHBYNewsletter: https://www.drjenniferashby.com/newsletter-sign-up Website: https://www.drjenniferashby.com/Instagram: https://www.instagram.com/drjenashby/YouTube: https://www.youtube.com/@drjenashby