Your Vagina is Not Cussing: Good, Simple Vulvovaginal Hygiene Tips

I’m very excited to share this article by guest blogger, Sara Sauder, PT, DPT! She’s a fantastic writer and passionate about her work as a pelvic physical therapist. She has an amazing ability to discuss personal matters in a funny and charming way. Enjoy! ~ Tracy at PG.

Your Vagina is Not Cussing!

One of the most fascinating things I’ve learned as a pelvic floor physical therapist is that women really have a variety of ways that they wash their crotch.  Should that be “crotches”?  Can you make that plural?  If not, why not?  Tell me that….  But, cleaning the crotch – it’s important.  We clean our face, our armpits and our feet.  The crotch has got a lot going on so it should be cleaned too, right?

Women clean themselves differently, but that’s not necessarily okay.  There are some basic facts that are important to know when it comes to keeping your machine well-oiled and running, regardless of whether she’s a 1955 Chevy Bel Air or a 2015 Honda Element; cuz either way she’s a beauty, right?

So what is the right way for a woman to clean her vulvovaginal area in order to ensure cleanliness, odor reduction and avoidance of infection?

Let’s start with what I hear from patients:

  1.  “I usually douche because that’s what my mother did.”
  2.  “I use a lavender scented soap all over my body and I get a wash rag and scrub my vulva.”
  3.  “I spread my labias and get soap on them and then I put soap inside my vagina.  I’m very clean.”
  4.  “I’m careful, so I go front to back with the soap.  I start at the vulva and soap it real good, then I reach over to my anus and get that soapy.”
  5.  “I use a loofa on my vulva and then after I shower I spray a little perfume down there.  You never know what’s going to happen that day.”

Friends, Romans, Countrywomen – lend me your ear! All these people are WRONG!  (and that’s probably one reason why they’re seeing me in the first place)

If you want my advice, I’m going to be succinct, clear and direct.  You can wash your vulvovaginal area any way you’d like as long as you are in the shower, eliminate all soap and let warm water run over the area and only use your hands.  Just call me the Henry Ford of the vagina…or is that weird?

Woman Shower

Here’s what I want you to do:

  1. Wash your hair.
  2.  Wash your body with soap.
  3.  Rinse everything off.
  4.  Let warm water rinse over your labias.  Yes, you can spread your labias.
  5.  Let warm water rinse over your anus.
  6.  Get out of the shower.**
  7.  Gently and lovingly pat the vulva dry and put on white, cotton underwear.

**You can wash your hands before getting out.

So why am I so restricting?

Here’s why:

  1.   The vagina is self-cleansing.  There is no need to douche or soap inside the vagina.  It’s already got a good bacteria called lactobacilli that has several important functions.  Lactobacilli eats up bad bacteria that can cause infection, it keeps the vagina acidic in order to reduce the likelihood of infections and it’s even postulated that lactobacilli can prompt the immune system.  This helps reduce odor, infection and keeps the natural flora healthy.  Oh, and get this – estrogen helps to feed lactobacilli.  So if you’re low on estrogen, it makes sense that you might be prone to more infections.  Please, just don’t use soap on the vulva or in the vagina.  Trust me, your vagina is not cussing.  (Ironically enough, the inside of the mouth is made up of the same durable tissue as the inside of the vagina.)
  1.  The vulva wasn’t meant to be scrubbed – it’s not a potato.  The vulva is sensitive like your fingertips, the skin around your eyes and your lips.  It’s meant to detect fine detail (for pleasure), so being forceful with it is going to make it more sensitive in a negative way – hypersensitive (for pain).  Scrubbing can remove a fine layer of the vulvovaginal tissue which can create an anti-histamine response – much like scrubbing your arm would make your arm red.  This creates an inflammatory cascade of events.  Many people will heal from this quite quickly and may not notice any discomfort, but others may start to notice some irritation after some time.  This is when you might start noticing sensitivity to things that never bothered you before like tight clothes, colorful underwear, lubricants or laundry detergent.
  1.  Scented items (or items with chemicals) like perfume (on the vulva), soap, bubble bath or even flavored or hot/cold/tingly/prickly/naughty sexual lubricant/condoms should be avoided as well because they could irritate the opening of the vagina (the vulvar vestibule) or the vagina itself.  The vulvar vestibule is made of up different tissue than the vagina (but the same tissue as the urethra and bladder), so it’s possible that using chemical products here can cause pain and the symptoms of a urinary tract infection (UTI).
  1.  The vagina needs to breathe.  Wearing tight, conforming clothing all the time or daily pantyliners can be suffocating to your vulvovaginal area and irritating to the skin.  Give it a break sometimes and wear looser clothing and or no underwear at all (like at night).
  1.  If you have a sensitive vulva or are prone to a lot of symptoms of infections, consider wearing white, cotton underwear instead of the fancy stuff.  Over time, it’s possible to develop new allergies and unfortunately, some women develop allergies to synthetic materials and dyes in their underwear.  This also means it’s best to wash your underwear with a detergent that is made for sensitive skin and is free of chemicals. ** Note – we will expand this area in the near future (with Sara’s blessings) to include other options for under wear or safe liners. Stay tuned! 

And get this:  Discharge doesn’t mean you are dirty.  Discharge is natural and comes from a variety of places, most of which are not the vagina itself.  What you see on your underwear is a mix of oil and gland secretions from the vulva and it’s also secretions from the uterus and the fallopian tubes.   Discharge changes during different parts of the menstrual cycle because it serves different purposes.  For example, when you are ovulating, the discharge is a different consistency so that sperm can pass through it more easily.  It’s all normal and healthy.  However, if it starts to change colors or smell really funky – this indicates a possible issue with an area that is potentially apart from the vagina.  Soaping and scrubbing to high Heaven is not going to fix this – you really need to get checked out by a doctor in this situation.

Taking care of the vulvovaginal tissue is easier than we want it to be.  Less is more.  So much more.  Good, simple vulvovaginal hygiene means better flora (not fauna), reduced odor, less itching and less discomfort.  So cheers to you and your polite vagina.  That little number was raised right!

On a Pelvic Guru side note:
Did you know that if a lubricant has GLYCOL in it (KY or Astorglide)…that’s a form of sugar and may make you more prone to yeast infections? (Slippery Stuff, Good Clean Love, and Uber Lube are examples of better ones).
Did you know that many women get treated for yeast infections repeatedly for years and it turns out that they never had that in the first place? It’s a totally different, treatable issue; and the yeast medications make things worse if it’s not what you have.

 

SaraBAPP

Sara K. Sauder PT, DPT is a pelvic floor physical therapist from Sullivan Physical Therapy in Austin, Texas. Her primary interest is pelvic pain. She is consistently learning about new treatment techniques, reading about complex pain treatment approaches and pursues opportunities to learn from pelvic pain specialists across the country. Her goal is to help people living with chronic pain learn how to manage, improve and abolish their symptoms. She feels patient education is vital to recovery and she works to have open communication with each patient’s medical team.  Sara believes that the mind and the body both work together to both create and eliminate pelvic pain.

Sara has an awesome blog all about pelvic pain. You can check it out at Blog About Pelvic Pain.

Thank you, Sara! We hope you write more articles for us in the future…and looking forward to other professional collaborations as well!

No Comments

  1. alli January 10, 2015 at 1:54 pm - Reply

    I agree with all but number 5. News flash: Much of today’s “fancy stuff” breaths better than all cotton underpants and anyway they pretty much all still have cotton lining. I can’t say I’ve tried everything out there but I have had decades of vulvodynia (related to underlying chronic conditions) and I can tell you that Hanky Panky low rise thongs, for example, are way way better for managing my vulvovaginal health than traditional cotton panties. Aside from breathing better, H.P.s (as one example) are a very very light stretchy fabric and so they never pull on my vulvar area as I sit and move the way a regular cotton panty does. Just sayin’. I feel that the #5 advice is common but outdated and actually quite erroneous. I hope my words here help some out there cuz choice of underpants can make a big difference. :))

  2. Pelvic Guru January 10, 2015 at 3:00 pm - Reply

    Alli – thanks for your response! We love getting new ideas or learning about products. I’ll research more and make some add-ons to the site, based on your feedback. TS

  3. Vicki Lukert January 10, 2015 at 4:49 pm - Reply

    One of the things I recommend to someone who has recurrent yeast infections is (orally) oil of oregano, olive leaf extract, and if bad grapefruit seed extract. Worked wonders for me and if I ever get so much as a tiny itch (not the seven year kind) I do a dropper of the oil of oregano. Nasty tasting stuff. I also recommend Candi cleanse and probiotics. All to get our natural fauna and flora healthy.

  4. genahy January 11, 2015 at 1:04 pm - Reply

    Oh my God, what a great post this is. After reading this, I now suspect I have a hormone imbalance, because not only am I prone to infections but I have several other symptoms of low estrogen/high testosterone. My internist also told me not to use soap when washing down there and I was quite surprised, but turns out it’s true! Thanks for all the important info.

  5. Valerie Van S January 12, 2015 at 6:56 am - Reply

    Excellent article! I added your article to my self care tips at http://www.mypelvichealth.ca.

  6. Marie223 January 12, 2015 at 10:06 am - Reply

    Can you talk more about what might be causing frequently recurring “yeast infections.” If they happen not to be yeast infections at all. What are some things to discuss with the doctor?

    • Pelvic Guru January 12, 2015 at 10:43 pm - Reply

      Marie223 – Thanks for asking about this. There are numerous ways that this is not treated well. For example, a patient will test positive one time for yeast and then have similar symptoms in the future… they may ask the doctor’s office to keep getting yeast infection treatment without additional testing. Or, the physician or other healthcare provider assumes it is yeast.
      It could actually be another type of issue that may clear on its own or respond to different treatment – Fro example: bacterial vaginosis (BV). See this link: http://www.rephresh.com/The-Rephreshing-Truth-Blog/Vaginal-Health/14/What-is-the-Difference-between-a-Yeast-Infection-and-Bacterial-Vaginosis.aspx.

      Or, it may be as simple as a PH change and just correct on its own.

      Another big thing that is missed is a local hormonal change. Women say “but I had my hormones checked and everything looks fine.” However, you can have local changes to the vulvar/vaginal tissue that won’t show up on hormonal systemic tests. This can occur at any age. For example, some studies show that women on long-term birth control can have this type of change. Treating over and over for yeast infections, may only exacerbate an issue there rather than treat the actual cause. Some women respond very well to topical estradiol applied right at the vulva/vestibule and/or inside vaginally.

      Finally, there can be dermatological things missed such as lichens sclerosis or lichens planus – which may give itching or some yeast infection types of symptoms. They respond to a totally different type of treatment (for example, corticosteroid creams).

      Other diagnoses – vulvodynia, vulvar cancer…

      Find a healthcare provider who can help you sort this out. It may take a few tries!
      ~ Tracy

  7. Beamishgirl January 15, 2015 at 1:30 am - Reply

    I understand the water only on the vulva, but the anus? Why no soap there? That threw me for a loop.
    Thanks in advance.

    • Pelvic Guru January 15, 2015 at 2:31 am - Reply

      Hello Beamish! Great comment. Actually, this topic is often debated: due to the close proximity of the external anal opening, the perineum and vulva, some say don’t use soap anywhere in that area (if you tend to have vulvar issues/irritation). However, others who are involved in sexual activities that involve the anus or want to be clean specifically there (and don’t have soap sensitivity there), can use a mild soap around that area (something natural… Even an Aveeno). You still should not “scrub like a potato.” I’d love for any other people to provide more info and insight on this and will also reach out to Sara about this. Thanks. Thoughts?

      • Anonymous January 16, 2015 at 9:45 am - Reply

        Hi, I’m also a pelvic floor physical therapist and LOVE this extremely informative article! An option for cleaning your vaginal opening and your anus if uts an absolute MUST, is a gentle Calendula cleanser. Calendula is a gentle flower that is non-irritating and gentle enough to be used on baby’s skin. I buy calendula wash for my 8 year old daughter to wash “down there” when necessary. Calendula products can be purchased online or on Amazon. Otherwise, I agree with Sara, less is more! Also, Luvederm is a good PH balancing product that can be purchased over the counter at your local pharmacy that helps balance your vaginal PH every once in a while. Hope this info helps 🙂

  8. Alicia Vega January 17, 2015 at 4:17 am - Reply

    Great article! Thanks!

  9. Anna January 17, 2015 at 1:39 pm - Reply

    I can’t agree with all of this. It’s true that douching is not necessary because the vagina is self-cleansing, but never wash the vulva? My skin crawls just at the thought of it. Pelvic Guru herself refers to the ‘mix of oil and gland secretions from the vulva and also its secretions from the uterus and the fallopian tubes’, plus the occasional discharge. If you don’t wash this off the vulva with soap, you’re going to smell. Of course don’t use a harsh soap and don’t scrub, use a gentle organic cleanser ( a real one, not something from the supermarket) and rinse with cold water. Best moment of the day when you feel this fresh.

    • Alice January 20, 2015 at 12:42 pm - Reply

      I don’t use soap on my vagina, and it doesn’t smell. I mean it “smells,” but definitely not bad. It smells like my vagina. It smells like really good sex. It smells like me. And if I tried to wash away that smell, I’d get an infection within days, no matter how organic the soap was, I guarantee you. Don’t assume that women who don’t use soap smell bad. Mine would smell bad if I did.

  10. […]  For further information and more useful tips, visit the Pelvic Guru.  […]

  11. Dr. Anne M. Thiel January 21, 2015 at 11:26 am - Reply

    Less is more! Thank you for a great article. As usual, our bodies know what to do but when we interfere with the process, that’s when problems can develop. Glad I found your blog.

  12. Yo January 22, 2015 at 2:35 am - Reply

    I think what you meant was a “histamine response” not “antihistamine response” (in response to scrubbing the vagina). Histamine causes those symptoms of redness, itching, hives, etc. Antihistamines like Benadryl do the opposite. Just thought I’d clarify.

    -A naturopathic student

  13. […] read this — Your Vagina is Not Cussing: Good, Simply Vulvovaginal Hygiene Tips — and learn from it. I would say that all these tips are common sense, but since there are […]

  14. Anonymous March 3, 2015 at 4:35 pm - Reply

    It’s also important to talk with women about using a glycerin free lubricant. Many lubes contain sugar-like substances that yeast love. Lubricants like Earthly Body Water Slide are water and carageenan based and are healthier for the vagina.

    • genahy March 4, 2015 at 12:39 pm - Reply

      I agree with Anonymous’ comment above. I developed a yeast issue as a result of either a drugstore
      lubricant or Rephresh, which is linked here earlier in the comments. Both of these products have glycerin
      and one or both gave me a very bad infection which I am still trying to get rid of several months later. If you go to drugstore dot com or Amazon you will see a lot of people got yeast infections after using Rephresh.

  15. […] attack.  Along these lines, but not exactly along these lines, but kinda close to these lines is this piece I wrote for Pelvic Guru.  If you haven’t checked Pelvic Guru out, you don’t know […]

  16. Vaginal hygiene wash April 17, 2015 at 1:17 am - Reply

    Thanks for sharing the informative article on vagina hygiene tips. It will be helpful to lots of women.

  17. […] bacteria that prevent infections! I could say so much more, but you really should just read this article on Pelvic Guru by Sara Sauder, PT and this one by Dr. Jen […]

  18. Vaginal hygiene wash May 11, 2015 at 2:08 am - Reply

    We are glad to your valuable tips. It’s really helpful to lots of women which are facing vaginal problems, thanks for sharing the post.

  19. […] KW: I love this simple, true (and hilarious!) blog post on proper vulvar hygiene! […]

  20. […] What your Momma Never Told You: Tips for Vulvar Hygiene by Shereen Sairafi at Marathon Physical Therapy and Sports Medicine (Thanks for the PG Vulvar Hygiene article reference) […]

  21. C. December 1, 2015 at 7:45 am - Reply

    Hello, thanks for such an informative post. I do have one question though: I’m a personal trainer, therefore most of my daytime hours are spent on tight lycra. (I can’t wear shorts for many reasons).
    When you wear tight tights, you normally can’t wear big, breathy cotton underwear, and trust me, I’ve tried to find a few thongs or smaller undies made on cotton without success. My problem is summertime. I tend to sweat a lot down there and the odour can get strong, particularly now that Im not taking the pill (After 15 years on the pill!). Do you have any suggestion on what to do or if there’s any natural diy wash in order to control the odour? Thank you so much!

  22. Cece December 30, 2015 at 3:40 pm - Reply

    If one were to have a colpokleisus done how would the vagina self clean?

  23. Shaylee January 1, 2016 at 11:56 am - Reply

    What do you think could be the reason for pain during sex, I’ve only had this after having children.

    • Pelvic Guru January 1, 2016 at 11:58 am - Reply

      There are lots of questions still. Where is the pain located (vaginal opening or deep)? How long has it been since delivering your last child? Vaginal or C-section deliveries? There can be numerous reasons.

  24. Anonymous January 4, 2016 at 9:52 pm - Reply

    I have been searching for this type of information for a very long time now (how best to cleanse the vaginal area) and that’s because I now have prolapsed Uterus & Cervix that are exposed & was worried how to daily treat them in the shower – thank you so much – I feel reassured in what I’m doing with your information & guidance – I had such an unease with it – and in my long search of this specifically – all I ever got was exercise information – I am very grateful for this – Cheerio Mary

  25. Carolyn January 5, 2016 at 12:04 am - Reply

    Can you recommend a good natural lubricant for menopausal women? I’ve tried coconut oil, and maybe I’m not using enough of it, but it doesn’t help that much, there is still pain during intercourse.

    • Pelvic Guru January 5, 2016 at 7:41 am - Reply

      There are natural lubricants such as sliquid organics and good clean love. Another one that people like that seems to be thicker and better is Slippery Stuff (not 100% organic but no BPA or glycol)

  26. Steph January 24, 2016 at 12:33 pm - Reply

    I hate articles like this one. I see so many “experts” telling us that our vaginas don’t smell bad and to stop washing them and “let them breath”. News flash, for women with some meat on their bones that don’t have a thigh gap, the vagina never gets to “breath”. It’s always wet and hot down there and therefore it smells. Not like “oh, that’s just your natural scent” type of smell, but nasty dirty sweaty fishy stank type of smell. All day. Every day. Fresh out of the shower after a good soaping is the only time it doesn’t stink down there. As soon as I get dressed, regardless of underwear and clothing type, and walk around for a few minutes, the smell starts to return. It’s gross.

    Also, anyone that has ever worked in a hospital setting around women that haven’t had a shower in a couple of days, knows good and well that it gets foul downstairs. You only need to have one female patient with a gown on to spread her legs to get onto an exam table (a good 2-3 feet away from you) to know that. A little splash of water isn’t going to get rid of that.

    So please stop telling me I don’t stink and to stop washing myself. If vaginas didn’t smell bad, there wouldn’t be a multi-million (maybe even billion) dollar industry surrounding the desire to make it smell better. If it’s really so terrible to use soap down there, then start giving us better alternatives. Tell me something useful. Or better yet, invent something useful. Just pleas stop telling me I don’t stink. I can smell myself. I know better. If yours doesn’t stink, then good for you, but that doesn’t mean we’re all like you.

    • Pelvic Guru January 24, 2016 at 12:37 pm - Reply

      Thanks for sharing that viewpoint! The honesty is fantastic. In cases where women still have the desire (and need, as you explain) to gently wash: 1. Still don’t “scrub the vulva like a potato” and try to use a very mild soap. For many, Dove is still not mild enough. 2. There are natural soaps and some find Aveeno soaps to be non-irritating (and still smell nice).

    • Anonymous May 27, 2016 at 4:12 am - Reply

      Relax. It’s not that serious.

  27. Anonymous May 7, 2016 at 4:32 pm - Reply

    Wow this was very interesting. I have actually gone through this. The question of how and what to use to have a healthy and clean vagina. I’ve often asked….is soap OK and if so…what kind?? I actually had my obgyn tell me to use Ivory soap to clean my vagina. So I did and it made me dry and itchy. Why would my obgyn tell me to use soap? And I’ve noticed that even if I have a small amount of discharge I’m always treated for a yeast infection. I kinda feel like my obgyn is not advising me correctly. But..this article was very helpful and I will definitely change my routine.

    • Pelvic Guru May 9, 2016 at 4:13 pm - Reply

      Believe it or not, a lot of this information is not taught in medical programs. We are glad you found this article helpful!

    • Pelvic Guru November 20, 2016 at 10:23 pm - Reply

      test

  28. Intimate hygiene wash May 19, 2016 at 8:28 am - Reply

    Nice post,, Though Intimate hygiene is necessary ,still people are not so much open to discuss on this. So these type of post helps to create awareness. Thank You

  29. Angelica Garcia June 20, 2016 at 12:44 am - Reply

    How about how often should we “wash”? I workout 5-6 days a week so I must wash often but for women who don’t need a shower as often and who are generally healthy and normal…how often should they clean themselves? Is a simple change of underwear sufficient? My friend is near obsessively clean and for a while was using wet wipes to clean herself after most toilet room visits until she developed a rash and stopped using them. I also have a 6 year old daughter that I don’t believe needs a bath everyday to remain clean…as her dad would like it. Thanks

  30. Lila McPherson August 10, 2016 at 11:40 pm - Reply

    Hi, I am 51 years old, my husband and I are involved in the swinging lifestyle now and again. I went through menopause at 40. I often deal with vaginal dryness and sometimes cervical pain during intercourse. We use condoms and and get tested regularly, only one time have we contracted a STD.
    I appreciate your article, as I am one of the vagina scrubbers, and old school douche maniac. This has caused me to have an irritated lady part. Just recently I have been cleaning with nothing but warm water and the difference is amazing. Believe it or not but it has helped with irritation fromm waxing/shaving. We will be hanging up our swingers hats this year because as good as WE think we look we remember when we were young and we always said “Man, when we get to be that age please remind me that its time to stay home with eachother ”
    XO L.

    • Pelvic Guru August 11, 2016 at 1:47 pm - Reply

      Lila- thanks for your comment! Funny about hanging up the hats!

  31. […] Source: Your Vagina is Not Cussing: Good, Simple Vulvovaginal Hygiene Tips | Pelvic Guru […]

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