Symptoms Associated with Chronic Urinary Urgency & Frequency in the Absence of an Infection:

Feeling like you need to pee when really your bladder is not at all full.

Testing negative for a UTI, but your doctor prescribes you antibiotics to treat you clinically. You feel partial improvement in your symptoms, but you never get fully better.

Testing negative for a UTI, but your doctor prescribes you antibiotics to treat you clinically. You feel fully better with treatment, but a few days later, the symptoms come right back.

Burning at the urethral opening with or without urination.

Non-infectious Causes of Urinary Frequency/ Urgency:

The urethra is the urine tube that connects from the bladder and leads to the urethral opening, located in the anterior vulvar vestibule. If there is something causing irritation to the vestibule, it can stimulate the urethral opening resulting in the sensation of "feeling like I need to pee." These symptoms can mimic those of a bladder infection. Many patients with this condition are mistakenly given antibiotics because it “sounds like” a bladder infection to the healthcare provider and “feels like” a bladder infection to the patient. However, if a catherized urine culture is preformed, it will not show an infection. Instead of infection, the etiology of the symptoms is an irritant which has triggered contact dermatitis in the vestibule. This diagnosis is elusive because the external genitalia and vestibular tissues often look perfectly normal when this is occurring. To complicate matters, contact dermatitis results from irritation caused by a number of sources. If you have been evaluated by your local physicians and intrinsic causes coming from your bladder have been excluded, a potential cause which is commonly overlooked or not recognized by most gynecologists or urologists is abnormal bacterial milieu in the vagina, known as altered vaginal micro-flora patterns. It is believed that the secretions from the altered micro-flora can trigger contact dermatitis in the vestibule. After the condition sets up, external exposure to a number of different products can perpetuate the symptoms even though the exposure to the inciting factor may long since be gone. Therefore, treatment requires attention to everything that comes in contact with these tissues. That means all products must be hypocontactant or neutral, non-reactive and non-allergenic. This applies to shampoo/ conditioners, detergents, body soaps, body rinses, clothing, toilet paper, female hygiene products, lotions, sexual lubricants, the constituents of the vaginal secretions, and even the micro-organisms allowed to be colonized on the external genitalia and the urine itself!

The “External Factors”

It’s difficult to avoid all potential contact irritants from multiple sources. It took Dr. Fowler over 25 years and thousands of women-year observations to figure out just the right combination of skin products to help prevent “external factors” sensitization. This prized combination of products is now referred to by FGI as the “FeminaRx Pure SkinCare Collection.” Now, you too can benefit! FGI makes this secret combination available all American women. This collection of products may be purchased without registering as a client. All women with sensitive external genital tissues including those with unexplained external irritation, itching, dryness, and feeling chaffed can greatly benefit from use of these products.

In 1997, Dr. Fowler presented research findings on Hypoallerginic products for vulvar skin to the International Society for the Study of Vulvar and Vaginal Disease (ISSVD) World Congress XIV in Baveno, Italy. This lead to the concept of a Hypocontactant Vulvar Skin Regimen. Over the past 15 years, Dr. Fowler has continued to refine the combination of skin care products for sensitive external genitalia; now referred to as the FeminaRx Regimen. This is an integral part of the approach used by Dr. Fowler with success for the treatment of thousands of women with vulvovaginal conditions that have features of contact dermatitis. Reference: Fowler, R.S. Vulvar Vestibulitis: response to hypocontactant vulvar therapy. Journal of Lower Genital Tract Disease. 2000;4(4):200-203. The FeminaRx Pure SkinCare Collection has the core products of the FeminaRx Regimen.

The “Internal Factors”

Avoiding the external exposures may be only part of the problem. The “internal factors” are the relative concentrations and types of vaginal constituents; in other words, the make-up of the vaginal secretions. If abnormal bacterial concentrations are present in the vagina, known as altered vaginal micro-flora patterns, this can give rise to secretions that bathe the vaginal opening and external genitalia tissues which may result in itching, irritation, and dryness.

The Vaginal Micro-flora

The vagina has a normal micro-flora ecosystem consisting of 30+ co-existing strains of bacteria at any one time. Normally, the good bacteria known as “lactobacillus” predominate and are numerous enough where they coat the entire vaginal mucosal surfaces forming a protective barrier. Problems arise when a shift in bacteria milieu occurs and the “bad” strain proliferate and dominate the “good” strains.

Altered Vaginal Micro-flora Patterns

When the lactobacilli do not thrive, the 30 plus other “bad” bacteria strains proliferate and dominate the micro-flora.  This results in one of several “altered vaginal micro-flora patterns.” In 2007, Dr. Fowler published a landmark study which expanded the known spectrum of altered vaginal flora patterns. Up until then, the medical literature commonly referred to ‘Vaginitis” as consisting of four etiologic types. Dr. Fowler proposed a new Vaginitis Classification System that expands the types of vaginitis to ten types. Reference: Fowler, R.S. Expansion of altered vaginal flora states in vaginitis. J Reprod Med. 2007 Feb;52(2):93-99.  

Symptoms Associated with Altered Vaginal Micro-flora Patterns

The “bad” bacteria that predominate in these patterns consist of a host of aerobic and anaerobic microbes. The resulting vaginal secretions from this shift of bacterial milieu bathe the tissues surrounding the vaginal opening and external genitalia causing variable symptoms including itching, irritation, and sensitivity as well as discharge, odor, burning, urinary urgency/frequency depending on the innate sensitivity of a particular woman’s external genitalia tissues. It follows that the higher the concentration of these bad bacteria, the higher propensity of getting symptoms.

Determining if an Altered Vaginal Micro-Flora Pattern is Present:

If an altered vaginal micro-flora pattern is found, an FGI treatment protocol could prove to be of great benefit for you! The only way to determine whether you have an altered vaginal micro-flora pattern is to perform the Vaginal Fluid Analysis Test (VFT Test). You can have the VFA Test done by the FGI Lab regardless of where you reside in the US. 

In October of 2012, Dr. Fowler published a breakthrough in the understanding of the vaginal micro-flora analysis preformed under phase-contrast microscopy titled, “Quantification of normal vaginal constituents using a new wet prep technique.” He had been using this technique for years for women with vaginal symptoms but for the first time, the relative concentrations and constituents of what constitutes “normal” on wet preparations from women without symptoms became known. This knowledge is essential because these patterns become the therapeutic goal of vaginal therapy. Prior to the findings of this study, it was only inferred by clinical deduction as to what constituted healthy vaginal constituents.  Reference: R.S. Fowler. Quantification of normal vaginal constituents using a new wet prep technique.  J Low Genit Tract Dis. 2012 Oct; 16(4):437-441.

The Bottom Line

The FGI treatment approach uses vaginal rejuvenate therapy to change the abnormal vaginal micro- flora patterns into one of the normal patterns. The therapy can be monitored to see how effectively the particular therapy is moving the vaginal constituents towards a normal flora pattern while maintaining strict hypocontactant conditions on the external genitalia. This approach has used with success for the treatment of thousands of patients. Are you ready for expert help?