When we think about health maintenance, we often think about diet and exercise. But, there are multiple facets to staying healthy, including being aware of the health of your vulva and vagina and knowing how to keep it clean and healthy.
Not only is it important for fertility and pregnancy, but also for enjoying sex and being confident and safe in relationships. Knowing when to seek professional help can be life-saving and may prevent dangerous complications in the future.
What is the vulva?
Before we get started, let's clarify exactly where the vulva ends and the vagina begins. The vulva is the outer part of a group of sex organs, which includes the labia. Labia means "lips" in Latin, and there are two types. The outer folds are called the labia majora, which is covered by hair, and the inner folds are the labia minora [4].
The vulva also includes the pubic bone in the front, the openings of the vagina and urinary canal (also known as the urethra), and the outer part of the clitoris [4].
While the clitoris may look small and unassuming, it's actually part of a complex network of erectile tissue and nerves that go deeper into the pelvic cavity [5].
What is the vagina?
The vagina is a muscular canal that begins at the opening of the inner labia and ends at the opening of the uterus, which is called the cervix [4].
Hygiene: how to wash down there and what to avoid
Gently wash the vulvar area using just warm water or very mild soap. Make sure to dry thoroughly with a clean towel. Luckily for us, the vagina has a natural self-cleansing mechanism, vaginal discharge. The discharge consists of dead cells and bacteria [6].
Discharge changes depending on the menstrual cycle, pregnancy, menopause, and other factors. The colour, smell, consistency, and other symptoms need to be taken into consideration when trying to figure out if it's normal discharge or abnormal discharge due to an infection or other causes [6].
Unless recommended by a physician, douching should be avoided since it increases the risk of bacterial imbalances and infections. Sprays and deodorants should be avoided as well, as they can cause irritation to the vulva [4].
Laundry and clothing
When it comes to laundry and the health of your vulva and vagina, clean, loose cotton clothing and mild detergents are the way to go. Synthetic fibres in underwear as well as thongs should be avoided for those prone to irritation or infections [4].
Rinsing underwear with water after washing and using less detergent can also be a good idea. You can also try using a milder detergent and forgo fabric softeners. Also, try to avoid detergents with the enzymes amylase, lipase, protease, and cellulose [4].
Nylon pantyhose should also be avoided whenever possible since they trap moisture. If you do wear them, then it's better to wear cotton underwear underneath. It's also good to remember to change out of wet swimsuits or sweaty clothes as soon as you get a chance [2, 4].
Hygiene products
It's generally a good idea to avoid deodorized products such as deodorized tampons or pads, scented oils, powder, talc, or bath oils. Tampons are less irritating to the vulva than pads, but remember to change them regularly to avoid toxic shock syndrome and not to leave them in at night [4].
Sex
The most important takeaway here is to simply stay clean and safe. While barrier contraceptives with spermicide, such as condoms and diaphragms can irritate the vagina [4], they're important to protect against sexually transmitted infections.
Try to have honest discussions with your partner about your infection histories, and reach out to them if you find out that you're infected. Also, make sure to clean sex toys after every time they're used [4].
It's important to note that vaginal trauma can occur after an injury or forceful sex. Using water- or silicone-based lubricants before sex can make penetration more comfortable and enjoyable, especially if it's your first time [2].
When using condoms during sex, be sure to use a new condom if you're switching from one area of penetration to another. For example, if you're switching between oral, anal, or vaginal.
Lastly, if it isn't a habit already, make sure to pee after having sex to avoid urinary tract infections. It's a simple habit that could prevent future discomfort and complications.
Food and alcohol
The main things to consider here are diabetes, alcohol, and nicotine. Diabetes can predispose to vaginal infections, so seek treatment to get it under control if you already have it, and try to avoid it by eating a well-balanced diet if you don't [1].
We all know about the liver and lung issues that alcohol and smoking cause, but another reason to quit is that they can also impair sexual function and sexual arousal [3].
Exercise
If you haven't heard about Kegel exercises yet, now's the time to start. Kegel exercises are a workout for your pelvic floor muscles [3]. They can easily be done anywhere, anytime, and are vital for preventing prolapse and incontinence.
They are especially important for people who gave birth or are planning to at some point since vaginal delivery stretches the vagina and weakens the pelvic floor muscles [7].
Going to a gynaecologist
As they say, prevention is the best medicine. And one of the best ways to prevent disease is by getting regular checkups from your gynaecologist. When you go, the gynaecologist will use a speculum, or device, to open your vaginal canal and look inside to check for any abnormalities.
The gynaecologist might also do a pap smear to check for cervical cancer. It's a quick, easy, and lifesaving test that should be done at the recommended intervals. Most healthcare organizations recommend starting at 21 years of age and checking every three years [8].
Another thing to take into consideration when visiting your healthcare provider is to get vaccinated. The HPV vaccine, or Human papillomavirus vaccine, protects against certain strains of genital warts, which I think we can all agree are not great for vaginal health. The Hepatitis B vaccine protects against the hepatitis B virus, which spreads through sexual contact and can cause a serious liver infection [3].
Also, talk to your doctor about which birth control methods are right for you and any medications you might be taking. Some medications increase the likelihood of vaginal infections, so talk to your doctor about how to prevent or treat infections [3].
If you think that your vaginal discharge might be abnormal, talk to your healthcare provider about it. Many people experience infections and smelly or weird-looking discharge, so there's no need to let embarrassment prevent you from seeking the care you need.
Mental health
While mental health isn't often discussed alongside vulvar and vaginal health, it's vital for a healthy sex life. Anxiety, depression, and other illnesses can impair arousal and enjoyment during sex. If you're experiencing pain during sex caused by trauma, talk to your doctor about possible treatment options [3].
Pregnancy, childbirth, and menopause
Pregnancy and childbirth can be intense experiences, both personally and for your vagina. It starts with a possible increase in vaginal discharge and might end with a vaginal tear or cut, otherwise called an episiotomy [3]. Afterwards, vaginal delivery can decrease muscle tone in the vagina and pelvic floor muscles, causing prolapse.
So if you think you might be pregnant or are planning a pregnancy, visit the gynaecologist to make sure you're healthy and to discuss everything that goes into growing and delivering a baby. Be sure to discuss any medications you're on with your doctor as well.
If you're over and done with that stage and have entered menopause, a change in hormones can also have implications for your vaginal health. A decline in estrogen can cause the vaginal lining to thin (vaginal atrophy), which might make sex more painful [3]. Using lubricant can prevent chafing, irritation, and breakage of the skin [4].
Tracking your cycle
As we mentioned before, vaginal discharge varies depending on the menstrual cycle. It's usually white and stringy, but can be a slight yellow colour upon drying. During ovulation, it can become clear with an egg-white consistency [2].
Whether you're trying to become pregnant or just want to keep track of your cycle, you can use an app or a hormone detection kit, like the inne minilab, to accurately track ovulation using your saliva.
What to do about signs of illness or infection
Whether you have pain, itchiness, suspicious discharge, or signs of prolapse, the best idea is to seek help from a healthcare provider. It's generally advisable to avoid trying home remedies found on the internet, as some can simply be useless and delay proper diagnosis and treatment, while others can be downright dangerous.
In conclusion
While you may be busy trying to juggle and maintain the health of the rest of your body, try not to forget your vulva and vagina. A few simple habits can save you from bad sex, annoying yeast infections, or even malignant cancers.
References:
- Bishop GB. Vaginal Discharge. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 172. Available from: https://www.ncbi.nlm.nih.gov/books/NBK281/
- Maintaining Vaginal Health. (2019) Cornell University. https://health.cornell.edu/sites/health/files/pdf-library/Maintaining-Vaginal-Health.pdf (Accessed 1/23/23)
- Vagina: What’s typical, what’s not. (2022, December 6). Mayo Clinic https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/vagina/art-20046562 (Accessed 1/23/23)
- Vulvar Care.(2018, March 23). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/4976-vulvar-care (Accessed 1/23/23)
- Clitoris. (2022, April 25). Cleveland Clinic. https://my.clevelandclinic.org/health/body/22823-clitoris (Accessed 2/2/23)
- Vaginal Discharge. (2022, July 22). Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/4719-vaginal-discharge (Accessed 1/23/23)
- Kegel Exercises. (2023, February 1). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/14611-kegel-exercises (Accessed 2/2/23)
- Cervical Cancer Screening. (2022, October 13). National Cancer Institute. https://www.cancer.gov/types/cervical/screening (Accessed 2/2/23)
