The Facts About Vaginal Health and Feminine Hygiene

The microorganisms that inhabit the vagina are known as the vaginal flora or microbiome. Maintaining a healthy vaginal microbiome is important because it can help prevent infection, support fertility, and improve a woman’s quality of life. Unfortunately, not all products and behaviors promoted as “feminine hygiene” have a beneficial effect on the vaginal flora. The following are facts on vaginal health and feminine hygiene to help you sort through some of the most common misconceptions.

Fact 1: The vagina is self-cleaning.

Many women believe it is necessary to clean their vaginas with soaps, sprays, wipes, deodorants, and/or douches, but this is not true. The vagina is a self-cleaning organ, and using such products can interfere with its natural process and cause irritation. Some of these practices have even been linked to negative vaginal health outcomes. In particular, frequent and long-term douching has been associated with pelvic inflammatory disease, bacterial vaginosis (BV), reduced fertility, ectopic pregnancy, and pre-term birth. Instead of douching or using other products on the vagina, most health experts recommend just using warm water to wash the area.

Fact 2: Not all vaginal discharge is cause for alarm.

Vaginal discharge that is white or clear with a faint or nonexistent odor is normal. This discharge keeps the vagina lubricated and protects against infection and irritation. However, when there are changes in the odor or look of vaginal discharge, or when it accompanies itching or other symptoms, it may be a sign of infection, inflammation, or another vaginal health issue.

Fact 3: Overall health impacts vaginal health.

Some behaviors and medical conditions have been linked to an increased risk of vaginal health problems. For example, smoking cigarettes has been associated with an increased prevalence of BV and is considered to be a risk factor for the development of cervical cancer. Obesity has also been linked to BV, and poorly controlled diabetes may increase a woman’s risk of yeast infections and urinary tract infections (UTIs). Women are encouraged to eat a varied and nutritious diet, maintain a healthy body weight, and refrain from smoking to support their overall health as well as their vaginal health.

Fact 4: Not all sexually transmitted infections (STIs) have symptoms.

While many STIs have symptoms such as pain during sex or urination, abnormal vaginal discharge or odor, and/or genital sores or warts, not all do. In fact, high-risk strains of human papillomavirus (HPV) often have no symptoms, and many people with HPV may never even know that they have it. Although HPV often clears up on its own, long-lasting cases of HPV can lead to cervical cancer. As such, practicing safe sex, completing STI testing if/when necessary, and following recommended cancer screening guidelines are imperative for good vaginal health.      

Summary

You do not need special products to care for your vagina. Its natural microbial composition is its best defense against infections and other vaginal health issues. However, if you are experiencing unusual discharge, odor, itchiness, abnormal vaginal bleeding, or pain during sex or urination, speak with a trusted health care provider to address these symptoms.

Resources:

Baird, D. D., Weinberg, C. R., Voigt, L. F., & Daling, J. R. (1996). Vaginal douching and reduced fertility. American Journal of Public Health, 86(6), 844-850. DOI: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.86.6.844

Crann, S.E., Cunningham, S., Albert, A., Money, D.M., & O’Doherty, K.C. (2018). Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey. BMC Women's Health, 18(52). DOI: https://doi.org/10.1186/s12905-018-0543-y

Fiscella, K., Franks, P., Kendrick, J. S., Meldrum, S., & Kieke Jr, B. A. (2002). Risk of preterm birth that is associated with vaginal douching. American journal of obstetrics and gynecology, 186(6), 1345-1350. DOI: https://doi.org/10.1067/mob.2002.122406

Holzman, C., Leventhal, J. M., Qiu, H., Jones, N. M., Wang, J., & BV Study Group. (2001). Factors linked to bacterial vaginosis in nonpregnant women. American journal of public health, 91(10), 1664-1670. DOI: https://ajph.aphapublications.org/doi/full/10.2105/AJPH.91.10.1664

Lewis, F., Bernstein, K.T., & Aral, S.O. (2017). Vaginal Microbiome and Its Relationship to Behavior, Sexual Health, and Sexually Transmitted Diseases. Obstetrics and gynecology, 129(4), 643–654. DOI: https://doi.org/10.1097/AOG.0000000000001932

Mayo Clinic. (2021, June 22). Vaginal discharge. https://www.mayoclinic.org/symptoms/vaginal-discharge/basics/definition/sym-20050825

Mayo Clinic. (2020, February 11). Vagina: What’s normal, what’s not. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/vagina/art-20046562

Ridgeway, B. (2018, May 7). 9 Tips to Keep Your Vagina Happy + Healthy. Cleveland Clinic. https://health.clevelandclinic.org/how-to-keep-your-vagina-happy-healthy/

Zhang, J., Thomas, A. G., & Leybovich, E. (1997). Vaginal douching and adverse health effects: a meta-analysis. American Journal of Public Health, 87(7), 1207-1211. DOI: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.87.7.1207