Taking Care of Your Vagina: Keep it Simple!

Ashlie Buell, MS, CNM, WHNP is a midwife who sees and takes care of A LOT of vulvas and vaginas. After reading our blogpost about NO BABY SHAMPOO AS A BIRTH LUBRICANT she was inspired to write about how we SHOULD be taking care of our wonderful body part, the vagina.

Taking Care of Your Vagina: Keep it Simple!

People with vaginas sometimes worry their discharge or the way they smell is not normal. There is a whole industry of ‘feminine hygiene’ products that increase these worries. Many products marketed toward vaginal cleansing or freshness are often preying on insecurities and unfortunately contribute to a frustrating cycle of vaginal problems in which people worry about odor or discharge, use products that disrupt vaginal wellbeing and cause irritation, more odor and/or discharge, then end up using the same products again to try to relieve these symptoms. This can lead to chronic or recurrent vaginal discomforts that seem not to respond to holistic or medical treatments. In reality, vaginas are very low maintenance and do most of the work to keep themselves clean. They are not supposed to be dry or smell like fruit, flowers, or an ocean breeze. 

Vaginal Discharge

Vaginas naturally have discharge that changes throughout the menstrual cycle. Typically there is less discharge just after menstrual bleeding ends, and it gradually becomes clear and stretchy as ovulation approaches, then thicker and white for a few days, and then clear and watery again just before menstrual bleeding begins. If you are on a hormonal birth control method, your discharge may not change in this cyclic way. What you eat, how much water you drink, exercise, sex, hormones, pregnancy, lactation, stress, and some medications all play a role in the way your discharge looks and feels. Discharge is normal, and it is your vagina’s way of keeping itself clean.

Vaginal pH

Your vagina has its own healthy bacteria that prevents infections. The vagina’s natural pH is low, around 4 - 4.5. This low pH is necessary for your vagina to keep the healthy bacteria happy and prevent infectious bacteria from growing. When a higher pH element, such as soap or douche (9 - 10), semen (5.2 - 8.3) or blood (7.4) is present in the vagina, it can disrupt the vagina’s balanced environment. This pH shift may result in vaginal irritation like pain or itching, an increase or decrease in lubrication or normal discharge, and sometimes a change in the way your vagina or discharge smells. This change may allow problematic organisms to overgrow and cause bacterial or yeast infections, and can also decrease the vagina’s ability to protect itself against sexually transmitted infections.

When Discharge is Not Normal: Common infections

Bacterial Vaginosis, or BV, is an overgrowth of bacteria that results in vaginal burning or itching with a milky or watery white or greyish discharge that has a fishy odor. The odor often is stronger after having intercourse or just after menstruation. This infection is treated with antibiotics that can be taken by mouth as a pill or inserted as a cream into the vagina. 

Yeast infections cause intense itching, thick white or yellowish curd-like discharge, and redness on the skin or vulva. Yeast infections can occur inside or outside of the vagina. Wearing wet, sweaty or tight clothes or having a diet with excessive sugar intake can encourage yeast to grow. This infection is usually treated with an antifungal medication and there are also alternative remedies that may help. 

Sexually transmitted infections can also change vaginal discharge. Chlamydia, gonorrhea and trichomonas usually cause discharge to be thick, heavy and yellow or green in color, sometimes with an unpleasant odor. These infections require antibiotics for treatment.

If you think you may have an infection, contact your midwife, nurse practitioner, or doctor for help.

How to Care for Your Vagina:

• Clean your vulva (the outside part of your genital area) daily with warm water in a bath or shower. Cleansers are not necessary. If you really want to use one, be sure it is gentle and unscented. You do not need to clean inside your vagina, that means no douching.

• Towel or air dry your vulva completely before getting dressed. Cotton underwear is the least likely to cause irritation.

• Always wipe from front to back after using the bathroom.

• If you swim or exercise, change out of your wet clothes as soon as possible. 

• Drink plenty of water and eat a healthy, balanced diet. 

• If you feel dry or prefer more lubrication during sex, use a water-based lubricant. 

• You and/or your partner should wash your hands before touching your vulva and vagina during times of intimacy.

• Consider using a menstrual cup or tampon instead of pads. Pads hold moisture against your skin and can increase irritation to your vulva. 

• Keep scented products away from your vulva and underwear, including soap, lotion, deodorant, body spray, powder, heavily scented laundry detergents, fabric softeners. 

• If you have frequent vaginal symptoms after having unprotected intercourse, it may help to use condoms or withdrawal method to avoid exposure to semen.  

Sources: Clinical Midwifery, Mayo Clinic, Our Bodies Ourselves, UpToDate, Varney’s Midwifery, Women’s Gynecologic Health