March 2025
Dr. Rebecca Levy-Gantt, a Board-Certified ObGyn and certified menopause specialist, has been an established private practice in Napa, California for the last 15 years. Her special interests include menopause management, with a focus on hormones and alternative strategies, as well as vaginal and vulvar pain syndromes.
What inspired you to transition from physical therapy to becoming an Ob/Gyn, and how has your background influenced your approach to specialized areas such as menopause management, hormonal treatments, and fertility care?
I earned my master’s degree in physical therapy (PT) because of my passion for health care, sports, and helping people heal. During PT school, we shared some classes with medical students, and the coursework was challenging. It was then that I began to consider pursuing a career as a doctor—I realized not only that I could do it, but that I wanted to.
During my rotations in medical school, where third-year students explore every medical specialty, I had the incredible opportunity to deliver babies and witness remarkable surgeries. One specialty, in particular, caught my attention and felt like a true calling. I never looked back.
My background in PT influenced my decision to attend an osteopathic medical school. I am a firm believer in the value of hands-on care, and I’ve always approached patient care by focusing on the whole person, integrating the skills I developed as both a physical therapist and an osteopath. This holistic perspective continues to guide my evaluations and treatments.
Can you explain the role of lactobacilli in maintaining vaginal health and how you assess and support its balance in your patients?
Lactobacilli play a vital role in maintaining the health of the vaginal environment by helping to acidify it. These beneficial bacteria are natural inhabitants of a healthy vagina and an essential part of a normal vaginal ecosystem. Patients experiencing recurrent vaginal infections, dry vaginal mucosa, or vaginal discomfort often lack sufficient lactobacilli, which can exacerbate their symptoms. Lactobacilli possess antimicrobial and anti-inflammatory properties, so when they are present in abundance, the vaginal environment is typically balanced and comfortable. Simple things like vaginal probiotics may help replenish these beneficial bacteria. Empowering patients with this knowledge is a step toward helping them establish a healthier vaginal ecosystem.
How do you educate your patients about the importance of maintaining healthy vaginal pH, and what changes or interventions do you typically recommend?
I talk to my patients about the healthy and normal vaginal pH (which should be low, between a range of 3 – 4.5) and I sometimes check the vaginal pH with a test strip. We talk about what kind of things may raise the vaginal pH, possibly making the environment unhealthy and uncomfortable (blood, semen, vaginal products, lack of estrogen). I always recommend doing a vaginal culture first, if they are uncomfortable, checking for the common and less-common bacteria and yeast and treating the infection. Then correcting the pH so it does not recur. Sometimes we use hyaluronic acid or boric acid products, suppositories, creams and washes in various regimens to bring the pH down.
How have PCR tests transformed your approach to preventing recurrent vaginal infections in your patients? What factors do you consider when determining the best diagnostic approach for a patient experiencing recurrent vaginal infections?
PCR tests are useful because I can check for different species of Bacterial Vaginitis, Candida, as well as Ureaplasma, Mycoplasma as well as various types of aerobic bacteria. The same test that I use also checks the vaginal environment for the presence or absence of four different strains of lactobacilli, and I am looking to see if the patients have at least 2 types present.
PCR tests detect small amounts of DNA or RNA (genetic material) from bacteria, viruses and fungi. These tests can recognize infection even when there may not be much, or any, discharge present. I usually do multiple PCR tests to test for various pathogens, and sometimes find multiple causes for vaginal discomfort or discharge. We also get our results back, sometimes as soon as forty-eight hours, and for an uncomfortable patient, that means starting treatment sooner, and starting the right treatment.
What advice do you have for other Ob/Gyns looking to incorporate more advanced diagnostic tools, such as PCR tests, into their practices?
Many patients come to me after seeing other doctors who only tested for STIs and yeast, leaving them without a clear diagnosis or effective treatment plan. This highlights a critical gap in women’s healthcare—one that advanced diagnostics like PCR testing can help bridge. By identifying the exact bacteria or infections present, we as Providers can move beyond generalized treatments and provide targeted, evidence-based care. This approach not only ensures that patients receive the right treatment from the start but also allows us to take proactive steps in restoring and maintaining a balanced vaginal environment.
Educating patients about vaginal health, including the role of pH balance, lactobacilli, and proper hygiene, is just as important as treatment. Rather than waiting for symptoms to return and repeatedly addressing the same issues, a more comprehensive diagnostic approach enables true prevention, leading to long-term health and well-being.