As a woman of color, the extent of my knowledge of reproductive and vaginal health was: Don't have sex. Check down there often. Go to the Doctor. No sex = no problems. I knew very little about my sexual organs, and I knew even less about how sensitive and complex the body can be. Most preventative information I'd learned seemed like old wives' tales from my Bible-toting grandma: Dark underwear and tight pants cause yeast infections; wiping front to back was important; no scented soaps, tissues, or douches -- but she didn't dare cover the complexities of sex education and health. So when I started getting urinary tract infections (UTIs) in college, not only did I not know what to do, I was traumatized. I was in a constant state of fear and panic waiting for the next one to occur.
I also knew very little about what may have been causing them. My WebMD search, mixed with limited sexual education or activity, taught me that some women can be allergic to synthetic materials in underwear and that intercourse can cause infection. I learned that cleaning and urinating before intercourse is super important, and drinking lots of water was key. As a teen, birth control wasn't allowed. Tampons were barely accepted, and much of my sexual health conversations centered around menstruation. Like many girls who went to private Christian school and grew up in a religious black home, much of my sex education was about abstinence, not prevention or awareness. As Philadelphia Inquirer writer Aneri Pattani recently put it, most women of color don't know that much about their own bodies, "especially black teenage girls, who often face stigma against asking questions at home and are poorly served by sex-education school curriculums tailored for a white majority."
I didn't start becoming curious about sexual health and intimacy until my senior year in high school. When I arrived to college, my lack of knowledge made me feel like I was always 10 steps behind my peers. There were so many missing pieces for me to put together somehow, and the campus med center nurse wasn't the best person to ask 12 years of burning questions. Neither were my classmates at a predominantly white college. As a natural hypochondriac mixed with a sexually curious Nancy Drew, I had lots of questions. Not just that, I quickly learned that my body was extremely sensitive -- human papillomavirus (HPV) scares, ovarian cysts that ran in my family, and chronic pelvic pain -- and I didn't know the first thing about how to troubleshoot. I never received any of the myriad preventative measures that a medical provider might give their patients about vaginal health, either in the doctor's office or at home. Throughout my college and post-college journey toward a healthier life, I was in and out of the doctor's office with health concerns related to inflammation and stress -- from undiagnosed autoimmune issues, digestive issues, an ulcer, headaches, to frequent UTIs. The problem persisted and progressed the older I got -- after using public toilet seats, not wearing breathable underwear, and with the introduction of a new partner.
When I turned 30, things started to get serious with my life partner, now husband -- but so did my health concerns. The Austin Urology Institute's Koushik Shaw, M.D., says that women over 30 often find themselves dealing with an uptick of UTI symptoms. "As women age, vaginal flora and pH changes, along with decreases in local estrogen levels," says Shaw. He goes on to say that with the increase in age comes a higher risk of diabetes, which can also increase your risk of UTIs.
I was determined to get pre-existing health concerns answered. Like so many single women of color, good health insurance doesn't come until we meet a partner and have a two-person household income, or we land a salaried position with benefits. So I scoured the internet trying to find a good OB/GYN, and at least a good doctor. Most doctors I saw gave me the traditional answers and prescriptions. I was told to drink plenty of fluids, use non-spermicidal contraception, empty my bladder before intercourse, consider vaginal estrogen therapy, wipe front to back, and avoid tight underpants and jeans. They even mentioned cranberry juice.
I took everything from AZO to antibiotics, and the problem continued -- even after I finished my course of antibiotics. I quickly learned that the suggestion to drink cranberry juice was doing more damage than good. My doctor stated that cranberry juice, although it flushes the urinary tract, it does not clear up a urinary tract infection, and it increases the acidity in your body and bladder, which can increase symptoms and pain. A 2019 Bustle article, "Why Cranberry Juice Doesn't Work for UTIs," states, "According to the U.S. Department of Health and Human Services, 50 out of every 100 women will have at least one UTI in their lifetime, and some will even experience recurring UTIs, which is three or more infections in a year."
If UTIs were so prevalent, why was I not getting the answers and the treatment I needed?
By the time my husband proposed, like clockwork, after intimacy the problem would reoccur. I assumed after WebMD searches that my body was rejecting sexual intimacy and was somehow allergic to my partner. The guilt rushed in, and I assumed this was the universe's way of paying me back for ignoring the abstinence classes. That somehow right before I got married, my body refusing to allow me to enjoy intimacy with my partner must be all the Christian school principals coming back to haunt me. Not only did doctors advise me to avoid physical intimacy, but the pain and discomfort made me want to avoid sexually intimacy all together. I noticed UTIs lowered my sex drive and libido. Like many women with UTIs, I didn't feel like a sexual being, let alone want to engage in physical intimacy.
I lucked up and found an amazing practitioner, and I formed an intense relationship with my OB/GYN office. I had a standing appointment every month and was determined to break the cycle of sexual health ignorance in my culture and family. After six different doctors in six months, I finally got an answer that made sense. My doctor informed me that my body was highly sensitive to bacteria due to inflammation, but also that much of what I was experiencing was actually called interstitial cystitis -- which is an inflammation in the bladder often worsened by the Ph level and acidity in your body.
Gaining that knowledge was so healing and informative. So many women who experience chronic UTIs think they are suffering from a sexually transmitted infection or worse. WedMD's Gina Shaw, M.A., discusses the sexism and mistrust that exist between doctors and women that lead to misdiagnosis. However, both Vice and Oprah magazines and even John Oliver have collected horror stories of black women who have not only been misdiagnosed, but experienced fatal repercussions of the doctor ignoring their sexual health concerns. Moreover, the health care disparities for women of color are still stifling. I am still on a journey to find the a place of normalcy and health, but just having the power of that knowledge makes a world of difference.