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? 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-cleaning.  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.)

2.  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.

3.  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).

4.  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).

5.  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 underwear 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. 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. Thank you, Sara! We hope you write more articles for us in the future…and looking forward to other professional collaborations as well!   If you are interested in more pelvic health education, please see our online platform, Pelvic Guru Academy for some amazing courses.