What Dr. Maria Uloko Teaches Us About Vulvar Health, Shame, and Why Sexual Health Education Matters
When people think about sexual health, they often think about performance, desire, or relationships. Rarely do they think about the vulva as a living, hormone-responsive tissue that can be protected, repaired, and optimized across the lifespan.
In this powerful interview, Dr. Maria Uloko—internationally recognized sexual medicine specialist, surgeon, researcher, and educator—shares an insight that truly moves the needle:
You can have the same vulva at 20 at 100 years old.
It’s a statement that surprises almost everyone. But it’s grounded in science, regenerative medicine, and years of clinical expertise.
For professionals pursuing advanced education—such as a Sexuality Counselor Certification—this conversation highlights exactly why comprehensive sexual health training matters. Without proper education, advocacy, and examination skills, vulvar health remains misunderstood, under-treated, and clouded in shame.
Learn more in this Sexual Health Alliance interview with Dr. Maria Uloko about what this doctor wants the world—and especially healthcare providers—to understand.
The Vulva Is Regenerative (And Hormone-Dependent)
One of Dr. Uloko’s favorite facts to share is that the vulva has remarkable regenerative capacity. Contrary to common belief, vulvar aging and decline are not inevitable.
The vulva is:
Highly hormone-dependent
Dynamic and responsive to life stages
Influenced by menstrual cycles
Affected by pregnancy, menopause, stress, and illness
With every hormonal shift, the vulva changes. But change does not automatically mean deterioration.
According to Dr. Uloko, optimal vulvar health is possible at any age—if we know how to assess and treat it properly.
Poor Vulvar Health Has Serious Consequences
The consequences of poor vulvar health are often misdiagnosed or misunderstood.
Dr. Uloko explains that unhealthy vulvar tissue can lead to:
Chronic pain
Recurrent infections
Sexual dysfunction
Difficulties with arousal and sensation
Recurrent urinary tract infections (UTIs)
Many patients suffering from recurring UTIs assume the issue originates in:
The bladder
The kidneys
The ureters
But emerging research—including new findings from Dr. Uloko’s team—demonstrates a direct link between vulvar health and bladder health.
In many cases, the root cause is not the urinary system at all. It’s compromised vulvar tissue.
This is a critical clinical insight—one that sexuality professionals trained through a Sexuality Counselor Certification program must understand. When providers fail to examine the vulva properly, patients suffer unnecessarily.
The Vulva and Recurrent UTIs: What the Research Shows
Dr. Uloko describes how many of her patients arrive with debilitating recurrent UTIs, often after sex. They’ve been treated repeatedly with antibiotics. They’ve undergone imaging. They’ve seen multiple specialists.
And yet, no one thoroughly examined their vulva.
Once the vulva is assessed, a pattern often emerges:
Hormonal insufficiency
Tissue thinning
Early disease changes
Inflammation
The solution? In many cases:
Affordable medications
Targeted hormone therapies
Evidence-based treatment algorithms
These interventions can restore tissue health—and stop the infections entirely.
Dr. Uloko emphasizes that we already have the medications. We already have the science. What we lack is widespread education and advocacy.
Research Equals Advocacy
Dr. Uloko is known for her pioneering research on clitoral nerves, regenerative ED treatments, and vulvar health. Her work has reshaped how we understand female sexual anatomy and sexual medicine more broadly.
But she is also a fierce advocate.
For her, research is not abstract—it’s protective.
When clinicians are educated:
They recognize disease earlier
They reduce unnecessary suffering
They prevent chronic complications
They empower patients
This is why advanced professional pathways—like earning a Sexuality Counselor Certification—are essential. Counselors trained in sexual health must understand that vulvar concerns are not cosmetic, trivial, or secondary. They are foundational to well-being.
The Culture of Vulvar Shame
Beyond the clinical science, Dr. Uloko addresses something even deeper: shame.
She shares a personal story about being told as a child that female genitalia were a “shameful secret.” That message, she explains, is generational trauma.
And she sees it every day in her practice.
When examining patients with vulvas, she observes a nearly universal pattern:
They apologize for their bodies
They express embarrassment
They feel exposed and ashamed
By contrast, patients with penises rarely apologize during exams.
This is not a biological difference. It is cultural conditioning.
Shame affects health outcomes. When people feel embarrassed about their anatomy:
They delay care
They avoid examinations
They minimize symptoms
They normalize pain
Breaking this cycle requires both medical expertise and therapeutic skill.
Professionals trained through a Sexuality Counselor Certification program are uniquely positioned to challenge shame, normalize anatomy, and provide affirming education.
Teaching the Next Generation Differently
When asked what parents should teach their daughters, Dr. Uloko’s answer is simple but profound:
Teach them not to be ashamed of their bodies.
That means:
Using correct anatomical language
Normalizing menstruation
Explaining hormonal changes
Encouraging body literacy
Rejecting secrecy
Body shame is not protective. Education is.
When young people learn early that their anatomy is normal, dynamic, and deserving of care, they are far more likely to seek treatment when needed and advocate for themselves later in life.
Why This Matters for Sexuality Professionals
For sex therapists, counselors, and educators, this interview underscores the importance of medical literacy within sexual health work.
A strong Sexuality Counselor Certification program should prepare professionals to:
Understand the hormonal basis of vulvar changes
Recognize signs of tissue dysfunction
Refer appropriately to sexual medicine specialists
Address generational shame
Provide trauma-informed care
Integrate somatic awareness into sexual health conversations
Sexual health is not just about desire and relationships—it’s about anatomy, tissue integrity, hormone balance, and prevention.
Without this knowledge, we risk overlooking the very conditions that cause suffering.
Vulva Health Summary
Dr. Maria Uloko explains that the vulva has regenerative capacity and can remain healthy from age 20 to 100 with proper hormonal support and care. Poor vulvar health is directly linked to recurrent UTIs and bladder issues, yet it is often misdiagnosed. Effective and affordable treatments exist, but stigma and lack of education prevent proper care. Dr. Uloko emphasizes that generational shame surrounding female genitalia contributes to delayed treatment and poor health outcomes. Sexual health professionals, particularly those pursuing Sexuality Counselor Certification, must understand vulvar anatomy, hormonal influence, and the impact of cultural shame to provide comprehensive care.
Final Takeaway
You can have the same vulva at 20 at 100.
Not because aging doesn’t happen—but because tissue health is modifiable. Because hormones matter. Because science works.
And because when we replace shame with education, we give people their lives back.
For professionals seeking deeper competence in this field, a Sexuality Counselor Certification isn’t just a credential—it’s a commitment to advocacy, literacy, and breaking cycles of silence.
Sexual health is anatomy.
Sexual health is science.
And sexual health is freedom from shame.
Want to become an in-demand sexual health professional? Learn more about becoming certified with SHA!
