For women, vaginal health is an important part of overall health. However, vaginal health is often shrouded in mystery and a little confusion. How do you keep your vaginal area clean? What can make it prone to infection? What types of vaginal odors are normal, and which ones are not? Here’s a guide to help address questions you might have about vaginal health.
Basics About a Women’s Genital Organs
Many people use the word vagina to describe what are actually several different body parts:
— The outside genital organs are the vulva. The parts of the vulva include the mons pubis, labia majora/minora and the clitoris. The clitoris is an area with sensitive tissue that’s associated with sexual arousal.
— The opening from where you urinate is called the urethra. It’s directly above the vaginal opening and below the clitoris.
— The vagina itself is actually inside your body. It’s a tube that connects the external genital organs with the internal genital organs, which include the cervix and uterus.
— The vagina is lubricated by what are called the Bartholin glands.
— The cervix is the entrance to the uterus that opens when you give birth.
— The uterus is what carries a baby. When you have your period, your body sheds a lining from the uterus called the endometrium.
A healthy vagina has a balance of good bacteria and low pH. A pH level indicates how acidic or alkaline something is. The vagina is usually acidic. If the pH is too high, it can make you more vulnerable to vaginal infections.
Importance of Vaginal Health
Vaginal health plays a key role in overall health for a few reasons:
— Sexual problems and vaginal health problems that recur can have an impact on your self-esteem and affect relationships, says Dr. Gil Weiss, a partner at Association for Women’s Healthcare and an assistant professor of clinical medicine in the Department of Obstetrics and Gynecology at Northwestern Memorial Hospital, both in Chicago.
— Recurring problems, such as a yeast infection or bacterial vaginosis, can lead to chronic pain in the vaginal area, says Heather Jeffcoat, a pelvic floor physical therapist, owner of Femina Physical Therapy in Los Angeles and author of “Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve.”
— Certain vaginal problems can be signs of other whole-body health problems. For instance, if the labia or the clitoris are becoming smaller, these can be signs of hormone deficiencies, Jeffcoat says.
— Maintaining good vaginal health is also important for keeping sperm alive if you’re trying to get pregnant.
8 Tips for Better Vaginal Health
1. Keep cleaning simple. You’ve probably heard of different ways to keep your vaginal area clean. The best ways to stay clean down there are simple. Keep your vaginal area clean by washing it daily with unscented soap and water. Avoid douching. That’s because douching may actually disrupt the balance of good bacteria present in your vagina, says Dr. Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive services at Yale University in New Haven, Connecticut.
Scented soaps also can disrupt your vaginal environment. When cleaning, don’t put soap directly in your vagina, and don’t scrub your vaginal area hard with a loofah, which can be full of bacteria, cautions says Dr. Brittany Noel Robles, an OB/GYN and certified personal trainer in Brooklyn, New York.
A few other tips to keep your vaginal area clean and healthy:
— If you’re on your period, make sure to change your tampon or pad regularly — avoid using the same one all day, Weiss advises.
— Make sure to pee after sex to get rid of bacteria before it reaches the bladder, making you more prone to infection.
— You can maintain pubic hair per your personal preference. However, if you decide to shave it, use a clean razor and unscented, natural shaving cream to lessen the chance of an injury.
2. Stick to cotton underwear. Good old cotton allows your vaginal area to breathe. By contrast, synthetic materials tend to promote moisture and increase the chances of a yeast infection, Weiss says. Plain white cotton underwear that is not too tight is preferable because dyes in clothing can irritate the sensitive tissue in the vaginal area, Minkin says.
If your underwear or other clothes near the vaginal area get wet, change out of them. The wetness can promote yeast infections. At night, avoid wearing underwear. This helps the vulva and vagina be free of moisture produced during the day, Robles says.
3. Don’t stress over normal vaginal odor. Vaginal odor is usually a mix of the normal smell your vagina gives off and the smell from your normal discharge, Weiss says. Diet changes, recent sex and your period all can change that odor, but that doesn’t mean anything is wrong.
Certain foods that can affect vaginal odor include:
— Red meat.
— Onions and garlic.
— Staying hydrated also can go a long way in controlling odor.
A more fishy smell is often linked to an overgrowth of bad bacteria, Minkin says. For those patients, she recommends RepHresh, an over-the-counter gel that lowers the pH in the vagina and makes it less conducive to bad bacteria. If an over-the-counter product doesn’t help after a few applications, you should see an OB/GYN. Several health issues could cause an odor, Robles says, including:
— Bacterial vaginosis, caused by overgrowth of the bacteria Gardnerella vaginalis.
— Trichomoniasis, which is a sexually transmitted infection.
— A foreign body. This happens more with girls, who may insert something in their vaginal area like a small toy but not remove it entirely. There also may be times when a tampon or part of a tampon may get stuck.
— A yeast infection, a common infection caused by a fungus called Candida albicans, can be caused by pregnancy, uncontrolled diabetes or antibiotic use. Some treatments for yeast infections are available over-the-counter, while other requires a prescription.
All of these issues usually have other symptoms, including discharge or burning and itching with trichomoniasis.
4. Proceed with caution when using any new products. Sexual lubricants and condoms may have ingredients that irritate the vaginal area. When you buy new products that will be used in the vaginal area, read the ingredients to make sure you aren’t allergic to something, such as latex in condoms.
Some people, for example, are sensitive to the spermicide called nonoxynol-9 found in some condoms, Weiss says. For this reason, he recommends using condoms without spermicide. If using condoms, stick with water-based lubricants as oil-based ones can make condoms less effective.
Other ingredients to avoid in products used in the vaginal area include:
— Glycerin, as it can foster bacterial growth and increase your chance of a yeast infection or urinary tract infection.
— Preservatives like paraben and citric acid, which may cause burning and itching.
— Flavorings or fragrances, which could be full of chemicals and cause irritation or affect the bacteria in the vaginal area, making you more prone to infections.
— Petroleum-based ingredients, which can alter your vaginal area’s pH.
5. Expect hormonal-related changes. When you enter menopause or perimenopause (the period of time before menopause), your estrogen levels decrease. That can make it harder for the vaginal area to maintain its normal environment and can lead to dryness, Weiss says. Vaginal dryness can cause pain during sex or exercises like biking, as well as burning, itching and increased risk of an infection.
Water-based moisturizers or estrogen treatment can help manage vaginal dryness. Estrogen treatments are available in various forms, including creams, lubricants, pills and suppositories. Avoid petroleum-based products such as petroleum jelly to address dryness, as these can change the pH of your vagina and make you more prone to infections.
6. Exercise regularly, including exercises that help your pelvic floor. There are certain exercises that can keep your pelvic floor toned. Your pelvic floor includes muscles, tissue and ligaments that support the organs in your pelvis, including your bladder, cervix, uterus and vagina.
Your pelvic floor can become weaker during pregnancy and after delivery. A weakened pelvic floor can make you more susceptible to a lowering of the organs in the pelvic area or urinary or gastrointestinal dysfunction, Weiss says. Exercises like squats, glute bridges and posterior pelvic tilts can help your pelvic floor, Robles says.
Kegel exercises — which involves contracting the muscles that you use to control urination — can be helpful to strengthen your pelvic floor. However, Jeffcoat has seen females who focus too heavily on strengthening the pelvic floor, causing it to shorten over time and leading to urinary urgency and pelvic pain. She finds that most of her patients need to stop doing Kegels and focus on pelvic floor muscle relaxation and stretching exercises before doing Kegels.
If you have concerns about your pelvic floor muscles, ask your OB/GYN to test your pelvic tone during your next pelvic exam, Minkin advises. There also are physical therapists, such as Jeffcoat, who specialize in addressing the pelvic floor muscles.
7. Eat right and stay hydrated. What you eat can affect your vaginal health. “New eating plans and overindulging can make it difficult for your vagina to self-regulate, making you more susceptible to infection,” Weiss says. Foods that are rich in antioxidants and probiotics (good bacteria) can help balance vaginal pH, inhibit infections and ease PMS, Robles says. Fruits and vegetables are full of antioxidants. You can find probiotics in fermented foods like yogurt, sauerkraut and tempeh.
There also are probiotic supplements geared toward vaginal health, some of which are taken orally and others that are used as a suppository that dissolves in the vaginal area. A vaginal-geared probiotic may be useful if you’re prone to infections or if you’re using antibiotics, which can also affect the balance of bacteria in your vagina.
In addition to eating healthy, make sure to also drink water regularly. If your mouth feels dry, increase your water intake, Jeffcoat advises.
8. Know when to see a doctor. Although some vaginal problems can be managed with over-the-counter products, there are times when you need to see a primary care doctor or OB/GYN. This includes if you have:
— Abnormal bleeding.
— A change in odor and unexplained itching.
— A fever or abdominal pain along with vaginal symptoms.
— A mass or bulge in the vaginal area.
— Bladder leakage.
— Burning when you pee.
— Chronic itching that isn’t associated with an infection.
— Discharge, odor or itchiness when you have a new sexual partner.
— Dryness that leads to discomfort.
— Heavy periods along with severe pain and vomiting that result in missed days from school or work. This could be a sign of a period-related problem called endometriosis.
— If you think you are pregnant.
“There’s nothing to be ashamed of in dealing with issues of vaginal health. We can help with just about everything,” Minkin says.
More from U.S. News