How to best care for your vulva and vagina is something that most women are left to figure out primarily on their own, with a LOT of trial and error.
New research into the bacteria that live in our vaginas (the "vaginal microbiome") shows that imbalances are potentially putting millions of women at risk of serious health problem. This is driving a quest to better understand what it means and what it takes to have an "optimal” vagina, and why that is so central to your wider health.
Meticulously pruning the bushes in your lady garden might be second nature, but... that's not what we're discussing here.
Say it out loud...
What we're talking about is the distinctly less sexy side of sexual health. Including how to avoid two things that make even the most liberated, modern woman still cringe when they're mentioned in public: thrush and bacterial vaginosis (BV).
Admit it, did you just wince a little?
Well done if you managed not to. It's a fact: we've all still got to get over the conditioning that's taught us these things are dirty, shameful and meant to be hidden.
Which is kind of strange, given how common these conditions are. Scientists say that at any given time, nearly one third of American women of reproductive age have BV.
Really, if you've reached this ripe age and haven't been caught out or confused by something suspicious, sore or seemingly unsanitary at some point in the gauntlet that is the gynecological gamut, can we even call you human?
Getting ready for fertility treatment
Vaginal health takes on a whole new significance in the build up to your egg freezing cycle when you're presumably wanting to make sure your reproductive organs are as healthy as possible to encourage the best outcome. That's because BV hinders the vagina's ability to defend itself from other unwanted infections, including some that could lead to inflammation and even infertility. (Read more about how taking some of these steps could help protect your longer term fertility.)
Let's just be clear what we're talking about here:
Thrush - as most women know all too well - is a vaginal yeast infection that stems from an imbalance in the vagina when a fungus called Candida starts to outnumber other microorganisms.
Bacterial vaginosis basically means an imbalance of bacteria. Specifically, BV is caused by a lack of the most common GOOD bacteria in the vagina -- a strain called Lactobacillus - plus an overgrowth of some other microbes.
These can lead to symptoms like an unpleasant or fishy odor, discharge, discomfort, itching, swelling. This imbalance can occur for a number of reasons, but here are the things you can do that make it more or less likely to strike...
Our Guide to a Finer Vagina...
Part One: How You Wash
1. Don't: Think you need to clean
2. Don't: Try this at home...
3. Don't: Take frequent hot baths or showers
4. Don't: Douche
5. Don't: Steam
6. Don't: Aim for odourless
7. Don’t: Think there’s a solution to discharge...because it’s not a problem!
8. Do: Notice natural changes
Part Two: What You Wear
1. Do: Aim for natural fiber panties
2. Do: Use hypoallergenic washing powder
3. Do: Throw out your old favorites
4. Do: Keep wearing thongs
5. Do: Get TF out your yoga pants
Part Three: How You Move
1. Do: Practice "clean" sex
2. Do: Pick the right protection
3. Don't:Take lube lightly
4. Do: Have sex
5. Don't: Wipe back to front
BONUS: What You Consume
1. Do: Make yogurt part of your diet
2. Do: Consider taking a probiotic, too
3. Do: Also eat plenty of prebiotic foods
4. Do: Be careful with antiobiotic use
PART ONE: HOW YOU WASH
Don't: Think you need to clean it
Your vagina does not need these to be “cleaned”. Cleaning inside can actually cause small tears in the vaginal lining.
Doctors like to describe the vagina as like "a self-cleaning oven". It cleans itself with natural secretions.
Your vulva on the other hand, should be washed. Every day.
Don't: Wash with scented products
Warm water is all you need.
There’s a motherload (pun intended) of products for vaginas and vulvas out there. We’ve all taken a trip down that aisle marked “Feminine Treatments” and stood, confused, in front of all those deodorants for “downstairs”, freshening wipes and “intimate” washes on the shelves, wondering if we need them.
The companies making these products know that on the whole, we’re pretty keen for problem-free vaginas and vulvas (that’s all the bits on the outside, while the vagina is just literally the old “birth tunnel”), and add to the angst with subliminal messaging like “discreet” and "odor controlling."
The trouble is, most gynecologists think products marketed for cleaning the vagina are useless at best, damaging at worst. Too many unnatural ingredients and scents can alter the pH of the vagina, which is what can lead to dryness, irritation or infection. The natural pH balance of the vagina is 3.5 to 4.5, which is slightly acidic to prevent “bad” bacteria from thriving.
If you do use soap, wipes, or other products, opt for as mild as possible. Your checklist should be that the products is:
Dermatologist (and/or gynecologist) tested
Hypoallergenic
Fragrance-free
Shame-free!
Do: Always test the product first
Give it a test run on another less sensitive part of your body. Or just go for a small patch rather than lathering up the whole vulva with something that could be irritating.
Don’t: Douche
Vaginal douching involves squirting a solution into the vagina, also with the intention of cleaning the vagina.
The American College of Obstetricians and Gynecologists recommends against using douches, because of a number of complications it can lead to.
Basically, douching can push STIs upwards toward your fallopian tubes and even cause something called pelvic inflammatory disease (PID), which can cause infertility.
Women who douche frequently before pregnancy are more likely to give birth to a premature baby and more likely to contract human papilloma virus (HPV).
In short, douching is unnecessary and could even be harmful.
Don't: Steam Clean
The same goes for vaginal steaming, which has garnered headlines over the past decade mostly thanks to Gwyneth Paltrow.
Basically, steaming involves steeping herbs in hot water and sitting over the water so that the steam enters your vagina. Although practitioners claim it can ease cramps, there's no scientific evidence it works. In fact, steam can BURN the sensitive skin of the vulva.
Do: Wipe front to back
Some dybiosis in the vagina is thought to be down to some of our gut ecosystem bacterias (namely, Faecalibacterium and Roseburia) getting all in up in when they shouldn't.
Basically, they're introduced to your vagina by poop.
So...at risk of sounding like your Mom...remember: front to back, ladies.
Don't: Use scented period products
Scented panty liners can contain irritants. Yet another reason why making the switch to milder, natural products is a good shout.
Don’t: Listen to the Internet
Doctors tell us they’ve had women asking about all kinds of...let’s put this kindly…”alternative” treatments you can find on the Internet.
These include putting yogurt-soaked tampons, tea tree oil (!) and even garlic cloves into their vaginas to try to introduce beneficial bacteria.
Just...no.
Don’t: Take hot baths or hot showers too frequently
This can upset your natural pH.
A warm bath with a cup or two of apple cider vinegar mixed in might be beneficial, though: its thought vinegar may naturally reduce an over-abundance of bacteria.
Don’t: Aim for an odourless vagina
No vagina is naturally odorless!
It can smell:
coppery or earthy
sweet
tangy / fermented
foul (OK, that's when you want to go see your doctor)
The way your vagina smells has everything to do with its pH, so your odor might change depending on your diet and menstrual cycle, if you've had sex, or even foods you've eaten.
Masking the way your vagina smells naturally could actually cause bacterial vaginosis instead, because scents affect the natural balance of vaginal flora.
If you know what's normal for you, and notice fluctuations that naturally occur due to your cycle, or activities you do, then you're better placed to spot anything awry if it does happen.
Do: Notice natural changes
Change is normal - from scent, to discharge amount and consistency, even the colour of your vulva.
The bacteria balance in your vagina changes on a daily basis, and your vagina and vulva will change as you age.
Menopause has an effect on vaginal pH, because vaginal secretions decrease as estrogen falls. without these cells you can end up with a much higher pH. It's also normal for the skin on your vulva to darken a bit as you age, thanks to hormone changes.
Don’t: Think there’s a solution to discharge...
Because it’s not a problem! Discharge is healthy, and keeps your vagina safe.
You might need to chat with a doctor if your discharge is gray, green, or yellow in color, or if it’s accompanied by itching, pain, or any other uncomfortable symptoms.
But otherwise, discharge is usually just your vagina. Doing its thing.
_
PART TWO: WHAT YOU WEAR
Do: Aim for natural fabric panties.
Specifically cotton. If you like lace (hello…) make sure the bit on your actual..well, bits...is cotton. you want your underwear to gently absorb any extra moisture, like every woman has with natural, healthy discharge.
Do: use hypoallergenic washing powder
Use gentle, hypoallergenic soap to wash them because some detergents can lead to irritation, itching, allergic reactions.
Also, if you or someone you live with is sick, consider washing in separate loads and then tumble drying your smalls - this is bacteria, after all, and you want to stop it spreading!
Do: Keep wearing thongs if you like them!
Scientist have legit studied this (!) and found that despite the rumours, there's no evidence that wearing thongs causes thrush, BV, or urinary tract infections (UTIs).
Don’t: Hold onto that really old pair of panties
They might be your lucky pair, but bear this in mind: even clean underwear can contain up to 10,000 living bacteria!
Think about it - it’s even there in washing machine water and...there’s about a tenth of a gram of poop in the average pair of undies!
So if they’ve been used more...there might BE more!
Do: Get The heck out of your yoga pants or any sweaty or wet clothes ASAP
Damp, warm conditions are ideal for breeding bad bacteria!
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PART THREE: HOW YOU MOVE
Do: Have sex!
As women age and estrogen levels decrease, the vagina can become less elastic, shorter, and more narrow, which in turn makes intercourse uncomfortable. This is why continuing sexual activity can help prevent changes in the size and shape of [the] vagina.
But also...
Do: Practice “clean” sex
Toys, fingers, tongues, penises, Anything should be washed before it goes into your vagina...including penises, fingers, tongues and toys...
Do: Think carefully about lube
Some ingredients just aren’t great for your vagina.
Take Glycerin, for instance...it’s kind of like sugar so it can contribute to bacteria growth in the vagina. Petroleum products can also spoil the vagina’s natural pH level. Not to mention scents, parabens and dyes.
Remember coconut oil shouldn’t be used for latex condoms. Try specially formulated natural brands instead!
Do: Use protection where appropriate
New or multiple sexual partners is linked to an increased risk of thrush and BV as well as serious STDs, of course.
Don’t: Use bog-standard condoms
Just like lube...check the ingredients label! Spermicides aren’t great for the vagina as they can kill good bacteria in there. Try natural, smartly crafted brands.
And then...
Do: Pee after sex
To push any germs outside of your urinary tract.
PART FOUR: WHAT YOU CONSUME
Do: Make yogurt part of your diet
Data shows that women who ate probiotic yogurt containing Lactobacillus had a larger amount of good Lactobacillus bacteria in their vaginas than those who did not AND they were less likely to experience BV.
Do: Consider taking a probiotic
There’s not conclusive evidence showing that probiotics are effective at preventing and treating BV or other imbalances BUT some evidence does show that probiotics may help prevent and treat imbalance in the vagina.
Just bear in mind that probiotics, as with any supplement, are not FDA regulated, so shop wisely.
Do: Be careful with antiobiotic use
This has been linked to thrush, as by killing off ‘good’ bacteria along with 'bad' ones they're being taken for, antibiotics allow thrush to multiply without competition.
(Thrush symptoms in women are white vaginal discharge (like cottage cheese), which does not usually smell, itching and irritation around the vagina, soreness and stinging during sex or when you pee.)
Do: Eat plenty of prebiotic foods
These help promote growth of healthy bacteria.
So that's: like fresh fruits, vegetables, and whole grains. Also reduce your sugar intake (if you’re not already!) Women with high blood sugar are more susceptible to contracting yeast infections.
Do: Consider taking a probiotic.
There’s not conclusive evidence showing that probiotics are effective at preventing and treating BV or other imbalances BUT some evidence does show that probiotics may help prevent and treat imbalance in the vagina. Especially if you’re using antiobiotics, which can lead to thrush.
Do: Also eat plenty of prebiotic foods
These help promote growth of healthy bacteria. So that's: like fresh fruits, vegetables, and whole grains. Also reduce your sugar intake (if you’re not already!) Women with high blood sugar are more susceptible to contracting yeast infections.
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So there with have it. Your guide to a finer vagina!!! Let us know if anything surprised you...OR you have any tips too!
And remember: if you have vaginal or vulvar symptoms, talk to your doctor or healthcare provider. The only accurate way to diagnose a vaginal or vulvar condition is to do tests on a swab of your vaginal fluid.