HOW TO MAINTAIN VAGINAL HEALTH
Experts’ advice on vaginal health
Vaginal health affects more than just your sex life. Find out about common vaginal problems and ways to promote a healthy vagina.
The vagina is a closed muscular canal that extends from the outside of the female genital area (vulva) to the neck of the uterus (cervix).
Vaginal health is an important part of women's overall health. Vaginal problems can affect fertility, desire for sex and ability to reach orgasm. Ongoing vaginal health issues can also cause stress or relationship problems and affect self-confidence. Know the signs and symptoms of vaginal problems and what you can do to protect your vaginal health.
What affects vaginal health?
Various factors can affect the health of the vagina, including:
• Sex. Unprotected sex can result in sexually transmitted infections. Forceful sex or an injury to the pelvic area can result in vaginal trauma.
• Certain health conditions and treatments. Some conditions, such as endometriosis and pelvic inflammatory disease, might cause painful sex. Scarring from pelvic surgery and certain cancer treatments also can cause painful sex. Use of some antibiotics increases the risk of a vaginal yeast infection.
• Birth control and feminine-hygiene products. Barrier contraceptives, such as condoms, diaphragms and associated spermicide, can irritate the vagina. The use of sprays, deodorants or douches can cause or worsen irritation.
• Pregnancy and childbirth. During pregnancy, vaginal discharge often increases. Vaginal tears are relatively common during childbirth. In some cases, an incision made in the tissue of the vaginal opening during childbirth (episiotomy) is needed. A vaginal delivery also can decrease muscle tone in the vagina.
• Psychological issues. Anxiety and depression can contribute to a low level of arousal and resulting discomfort or pain during sex. Trauma — such as sexual abuse or a painful sexual experience — also can lead to pain associated with sex.
• Hormone levels. Changes in hormone levels can affect the vagina. For example, estrogen production declines after menopause and during breastfeeding. Loss of estrogen can cause the vaginal lining to thin (vaginal atrophy), making sex painful.
What are the most common vaginal problems?
Conditions that might affect the vagina include:
• Sexual problems. These might include persistent or recurrent pain just before, during or after sex (dyspareunia). Pain during penetration might be caused by involuntary spasms of the muscles of the vaginal wall (vaginismus). The muscles in the pelvic floor can become tense, causing chronic pain and pain during intercourse. Vaginal dryness, often occurring after menopause, also can cause pain during intercourse.
• Sexually transmitted infections. Various sexually transmitted infections can affect the vagina, including chlamydia, gonorrhea, genital warts, syphilis and genital herpes. Signs might include abnormal vaginal discharge or genital sores.
• Vaginitis. An infection or change in the normal balance of vaginal yeast and bacteria can cause inflammation of the vagina (vaginitis). Symptoms include vaginal discharge, odor, itching and pain. Common types of vaginitis include bacterial vaginosis, yeast infections and trichomoniasis.
• Pelvic floor relaxation. If the supporting ligaments and connective tissues that hold the uterus and the vaginal walls in place become weak, the uterus, bladder, rectum or the vaginal walls might slip down (prolapse). This might cause a bulge in the vagina or urine leakage during coughing and sneezing.
• Other rare conditions. Vaginal cysts can cause pain during sex or make it difficult to insert a tampon. Vaginal cancer — which might first appear as vaginal bleeding after menopause or sex — also is a rare possibility.
What are signs or symptoms of vaginal problems?
Consult your health care provider if you notice:
• A change in the color, odor or amount of vaginal discharge
• Vaginal redness or itching
• Vaginal bleeding between periods, after sex or after menopause
• A mass or bulge in the vagina
• Pain during intercourse
You might not need to see your health care provider every time you have vaginal irritation and discharge, particularly if you've been diagnosed with a vaginal yeast infection in the past and you're having similar signs and symptoms. However, if your symptoms don't go away after you use a medication that you get at your drugstore, consult your provider.
What can I do to keep my vagina healthy?
You can take steps to protect your vaginal health and overall health. For example:
1. Be sexually responsible. Use condoms or maintain a mutually monogamous relationship with a partner who's free of sexually transmitted infections. If you use sex toys, clean them after every use.
2. Have good, clean sex – Because your vulva is an important center of pleasure, protecting it from harmful chemicals and bacteria is important.
Check the ingredients of any lubricants you plan to use. Some may contain unhealthy ingredients that can throw off your pH balance. Avoid lubricants that contain:
o Petroleum products
o Non-natural oils
Check condom ingredients, too. Many brands are made with spermicides that can kill your vagina’s good bacteria, upset your pH balance, and lead to irritation and infection.
If you’re switching between anal and vaginal sex or vice versa, use a new condom each time. Your anus can carry strains of bacteria that can irritate or infect your vagina; similarly, your vagina has bacteria that can irritate your anus.
Bacteria can sometimes get into the urethra during sex, so afterward, urinate to flush out bacteria and avoid contracting a urinary tract infection.
Shower or clean the vulva with warm water, then thoroughly dry the area.
3. Keeping it generally clean – Cleaning your vulvo-vaginal area is simple:
- Wash daily with warm water — soap is optional, but use a gentle soap like Dove-Hypoallergenic, Neutrogena, Basis, or Pears. Use your fingers instead of a washcloth.
- Do not wash inside your vagina. Doing so could upset its delicate pH balance and cause irritation and infection. The vagina usually cleans itself with discharge.
- Avoid using special scrubs, scented soaps, and douching — even products that say they’re designed for vaginal care. These can also throw off your natural pH balance and bring on infection. If you’re concerned about vaginal odors, first, remember the vagina is not a flower — nor was it ever intended to be. However, if you smell something other than your usual "Eau de You" and are also experiencing burning, itching, or other discomforts, you should contact your OB-GYN doctor.
- After using the toilet, wipe in the front and then in the back. Doing the reverse could transfer bacteria to the urethra and cause a urinary tract infection.
4. Dress for Success – Choose clothing that will ensure your vulvo-vaginal area can breathe easily and stay dry. Moisture can promote the growth of bacteria, which can lead to a yeast infection.
- Wear cotton underwear rather than silk or polyester. Cotton is less likely to hold moisture and makes it more difficult for smell-producing bacteria to build up. Consider women’s boyshorts for a more open fit around your legs.
- Avoid tight-fitting clothing — including thongs, which can collect fecal matter that can reach the vagina and cause infections and odors.
- Change your clothes and underwear after working out.
- Avoid wearing a damp swimsuit all day.
- If you experience heavy vaginal discharge, change your underwear twice a day.
- At night, reduce sweat being trapped around the vulva by forgoing your underwear altogether.
5. Mind pubic hair – Pubic hair protects the vulva from bacteria and viruses. It shields and cushions the sensitive skin it covers, protecting it from friction during sex. As long as it’s regularly cleaned, pubic hair poses no health risk.
Some women feel that having pubic hair leads to more moisture and odor and prefer to completely remove it via shaving, waxing, or electrolysis. Others feel that keeping it groomed, using scissors to trim, helps alleviate those problems. And others prefer to leave it all natural. Really the choice is yours.
Shaving can cause razor burn, redness, itching when the hair grows back, and infection from ingrown hairs. Cuts and nicks can also introduce unwanted bacteria. Do not use hair removal cream, which burns off hair and can be especially harsh on the vulva’s sensitive skin.
6. Get vaccinated. Vaccinations can protect you from HPV, the virus associated with cervical cancer, as well as hepatitis B — a serious liver infection that can spread through sexual contact.
7. Do Kegel exercises. Kegel exercises can help tone your pelvic floor muscles if you have prolapse, leaking of urine or weakness of the pelvic floor.
8. Know your medications. Discuss medication use and possible vaginal side effects with your health care provider.
9. Limit the amount of alcohol you drink, and don't smoke. Chronic alcohol misuse can impair sexual function. Nicotine might affect sexual arousal. Substance misuse might also cause poor physical and mental health, which can affect sexual function.
General Vaginal Hygiene tips
Here are a few more tips regarding good vulvo-vaginal health:
• Avoid scented tampons, pads, and liners.
• During your period, change your tampon 4 to 5 times a day. That goes for pads and liners, too.
• Wash or wipe the area regularly during your period.
• Consuming probiotics like yogurt can help prevent yeast infections and reduce vaginal odor by keeping your vagina’s pH levels in order. (Do not put yogurt into your vagina! Its sugars can actually encourage yeast to grow.)
• Staying well-hydrated helps keep bacterial overgrowth and stress-related sweat in check.
• See your OB-GYN doctor annually for your wellness visit and in between if you have any concerns.
While not all vaginal problems can be prevented, regular checkups can help ensure that problems affecting the vagina are diagnosed as soon as possible. Don't let embarrassment prevent you from talking to your health care provider about concerns you have about vaginal health.