By: Sigourney Cross
I love taking bubble baths. I use my scented body wash and a loofah down there. Sometimes I wipe so hard I bleed a little bit. I always use scented wet wipes to stay fresh. I wear thongs under my yoga pants. I use a daily scented panty liner just in case I have discharge or urine leakage.
The above statements are common responses I get when I ask my patients about the care of their vulva or the entrance to the vagina. All of the above statements have one thing in common. These are examples of poor hygienic habits. These poor habits don’t surprise me because women have been taught that the vagina is dirty and smelly. To learn more about how your vagina is supposed to smell, you can read one of our previous blogs here. Many women experience vulvar and vaginal discomfort from irritation and infection that can occur due to an overgrowth of bacteria, funguses or other organisms. These infectious organisms can be introduced into the vagina by improper hygiene. Below are some tips to follow to prevent vulvar discomfort, vaginal infections and to ensure a happy and healthy vulva and vagina.
Just use water!
Did you know the vagina is self-cleansing? This is because the vagina is naturally acidic with a normal pH range of 3.8-45. This acidity is due to good bacteria keeping bad bacteria away. When a women’s pH level is greater than 5 this is considered less acidic and more basic meaning bad bacteria have been given a chance to grow. An overgrowth of bad bacteria can result in vaginal yeast infections, bacterial vaginosis, trichomoniasis and atrophic vaginitis. Things that can change your pH level include antibiotics, intercourse, breastfeeding, menstruation, menopause and last but not least, SOAP! Yep, you heard me right. Those lovely scented body washes and soaps can raise your pH, causing an overgrowth of bacteria, ultimately causing you more harm than good. Gently wiping or rinsing the area with warm water is all you need. During that time of the month or when you’ve maybe had an extra sweaty workout session and you feel water isn’t enough, use an unscented and fragrance free soap without any other harsh chemicals. After washing gently pat dry or allow your vulva to air dry. Also stay away from scented wipes, douches, vaginal deodorants, perfumes, bubble baths and drugstore products labeled “feminine hygiene.”
Ditch the thongs and go commando
Thongs and tight clothing make a great breeding ground for yeast and other types of vaginal bacteria. It is important to always wear breathable cotton underwear for good ventilation. Avoid wearing nylon, acetate or other manmade fibers. Please ditch your thongs, especially during your workouts. When you are exercising, your thong will carry the bacteria from your anus up towards your vagina. The last thing we want is bacteria from where you evacuate your feces making it to your lady parts. Be sure to also remove damp clothing from sweating, swimming, or other strenuous activities to allow the area to dry. Sleep without underwear and loose fitted pajamas to further improve ventilation. Using fragrance free laundry detergent can also decrease risk of irritation.
Tampons not pads, toilet paper not wipes
Use tampons instead of sanitary pads to control menstrual bleeding. These are generally less irritating. Do not use deodorant tampons and be sure to change them every 4 hours to avoid toxic shock syndrome. If you are unable to use tampons be sure to use pads without chemical additives. When toileting, it is best to use plain white unscented toilet paper. Always wipe from the front to the back. Avoid using wet wipes that contain alcohol or other chemicals. At PHRC we use water wipes that are 99.9% water with a drop of fruit extract. When experiencing urinary incontinence be sure to use pads that promote dryness such as Poise and Depends. Do not use menstrual pads for incontinence. Daily use of panty liners can increase irritation around the vulva.
Estrogen can be your friend
Whether you’re going through menopause, breast feeding, or have a history of taking oral contraceptives, vulvar pain and dyspareunia can be potential side effects due to tissue changes. Applying a topical estrogen and/or estrogen and testosterone compound cream at the vulva can help with tissue sensitivity and pain as well as restore moisture and elasticity to the vulva. Topical hormone therapy in conjunction with pelvic floor physical therapy is the best course of treatment for most pain syndromes surrounding the vulva. Be sure to check with your doctor to see if your appropriate for hormone therapy as this is contraindicated with certain types of cancer. If topical hormones aren’t indicated, there are many over the counter vaginal moisturizers that mimic the effects of topical hormones that are good alternatives. Ask your pelvic floor physical therapist for some recommendations!
Considerations with sex
The pure mechanics of having sexual intercourse (bacteria moving in, out and around your genitals) can increase your risk of getting a urinary tract infection. Peeing before and after sex can help reduce your risk. Use of vaginal lubricants during coitus can decrease friction, allowing for increased ease and comfort. Vaginal lubricants unlike moisturizers are made to be used short term. For advice on the latest and greatest lubricants click here.
When it comes to taking care of your vulvar and vaginal tissue, less is more. Give these techniques a try and feel free to ask questions or comment below.
References
- Burrows, L. and Goldstein, A. (2013). The Treatment of Vestibulodynia with Topical Estradiol and Testosterone. Sexual Medicine, 1(1), pp.30-33.
- The International Society for the Study of Vulvovaginal Disease
https://www.issvd.org/handouts/Gen#eralVulvarCare.pdf
- The Cleveland Clinic. Department of Obstetrics and Gynecology. Vulvar Care.
https://my.clevelandclinic.org/health/articles/4976-vulvar-care