For Bladder Health Month we talk with Brooke Faught, Director of the Women's Institute for Sexual Health (WISH), on the importance of urogential and pelvic health, her advocacy for sexual health education for the IDD (individuals with intellectual and developmental disabilities) community, and the need for normalizing sexual topics among women and healthcare providers.
Dr. Brooke Faught is a board certified women’s health nurse practitioner and certified menopause practitioner specializing in female sexual and pelvic floor medicine, urology, and vulvoscopy. Dr. Faught developed and implemented the Women’s Institute for Sexual Health (WISH) in 2005 as a division of Urology Associate in Nashville, Tennessee for which she continues to serve as Director.
SHWI: What led you to your career to become a women’s health nurse practitioner, and to specialize in pelvic floor medicine and urology?
While in undergrad at Ohio State, I really focused on each clinical rotation to determine which area of healthcare interested me the most. I really enjoyed my women’s health clinical experiences and I realized that, ironically, I was really effective at patient education. After graduation, I moved to Philadelphia, PA and worked for a couple of years as a floor nurse on a maternity floor. I cared for patients in labor and delivery, long term antepartum and postpartum units, and the newborn nursery. While most of my colleagues preferred the high-paced experience of labor and delivery, I thrived on the postpartum unit, where I spent time teaching my patients about the changes to their bodies, proper care of their newborns and effective breastfeeding.
I began the Women’s Health NP program at the University of Pennsylvania. One of my clinical rotations included a urogyn site where I cared for patients with pelvic floor dysfunction, sexual pain and general urologic conditions. I absolutely love it. After graduating with my masters degree and successfully passing my NP licensure exam in 2003, I moved to Nashville, TN where I currently live. I worked for two years in reproductive endocrinology (fertility). Many of my fertility patients went through expensive and invasive therapies to achieve pregnancy simply because they had severe pain with intercourse or low libido that prevented successful conception. At that point I knew that I needed to change my career path and somehow focus on helping these patients that believed they had no options.
In 2005, I was hired by my current practice to develop and implement a women’s health division of a large urology practice. It was truly my dream job - A position that offered the autonomy to care for women facing the unique challenges associated with sexual and pelvic health with the support of nearly 30 established physicians. Over the years, my practice morphed into the management of a variety of unmet women’s health issues including sexual dysfunction, hormone/menopause management, pelvic floor dysfunction, pelvic pain, and vulvar skin disorders, to name a few.
I have been the Director of the Women’s Institute for Sexual Health (WISH) for nearly 18 years and I am now the mother to three beautiful daughters, ages 10, 14 and 16. My middle daughter, Lily, has Down syndrome. Her birth sparked a personal mission to fight for the sexual and reproductive rights of individuals with intellectual and developmental disabilities (IDDs). In 2018, I graduated from Vanderbilt University with my Doctor of Nursing Practice (DNP) during which I studied sexuality in the IDD population. I now lecture internationally on this very important and underrepresented topic. Unfortunately, individuals with IDD are often assumed to not require sexual health education. The presence of an IDD does not preclude the need for sexual and reproductive health (SRH). Individuals in this population generally develop at the same rate as their typical peers, and they crave intimate relationships like the rest of the population. The avoidance of proper sexual health education results in a massive disservice to individuals with IDD. Additionally, the risk of unwanted pregnancy and sexual/intimate violence is significantly higher in this population, partly due to the lack of proper education.
SHWI: Many providers are learning about the relationship between the vaginal microbiome and urinary tract health. Can you share more about the connection between these two areas? How does vaginal biome health affect bladder health?
The female urethra opens into the vaginal introitus. While the urethra and bladder are sterile structures (organisms such as yeast and bacteria should not grow in this environment), the vagina is not sterile. In fact, the vagina maintains a complicated and diverse microbiome that serves a very important purpose. Disruption in this vaginal ecosystem can lead to vaginal infections as well as urinary tract infections, due to the close proximity of the bladder and vagina.
SHWI: What is your approach to treating women with recurrent urinary tract infections (UTIs)? For example, along with standard medical care, do you integrate supplements, lifestyle modifications, and other approaches?
I see many patients with rUTIs. First, I ask about lifestyle including hygiene regimen, feminine product usage, diet, exercise, employment, and sexual activity. In many cases, I identify factors that may be fostering the rUTIs. In this care, patient education is absolutely critical. I also ask take a full medical and sexual health history. I generally recommend a cranberry supplement and reputable probiotic.
SHWI: November is Bladder Health Month. What should women know more about when it comes to understanding and taking care of their urinary tract health, and even pelvic health?
We may have two kidneys but we only have one bladder and one vagina. Urogenital health is so very important to overall women’s health. Sadly, women are often unfamiliar with their urogenital anatomy as well as safe and appropriate hygiene. Feminine hygiene aisles at stores and pharmacies are ridden with products that can actually cause more harm than good. However these products are heavily marketed to women not only as safe, but also necessary, including perfumed vaginal cleansers and chlorinated/bleached menstrual products, just to name a few. Women MUST be properly educated on the ingredients within and processing of their feminine hygiene products as well as products that are appropriate/inappropriate for sensitive urogenital tissues.
SHWI: As a practitioner who is passionate about enriching women’s health, what are you most inspired to see change in medical approaches to women’s healthcare? What are some of the achievements you’ve been part of or some of the research you’d like to see in the areas of urology and pelvic medicine?
I am on a mission to normalize the discussion around everything women’s health and empower as many women as possible with the basic knowledge of their bodies. Unfortunately, women are often socialized to avoid discussion of sexuality, urogenital/pelvic health, menstruation, pregnancy, and menopause which are frequently deemed taboo topics that should only be discussed behind closed doors. This is completely ludicrous and incredibly damaging to women across the globe. Women deserve the right to understand their bodies, know what is in the products that they are using, enjoy comfortable and pleasurable sexuality, and openly discuss their sexual, physical, emotional and urogenital concerns with confidence.
I would like to see more health care provider education within medical programs. I would also like to see a significant uptick in patient education on female sexual and reproductive health. I would like to see more open use of proper terminology (ie: the difference between the vulva and vagina) and a reduction in stigma associated with terms such as orgasm, vulva, clitoris, sex, penetration, etc. And finally, it is my ultimate goal for EVERYONE to enjoy safe and healthy sexuality, regardless of our unique characteristics/backgrounds including culture, gender, race, religion, sexual orientation and intellectual, developmental and physical abilities.