I see many women worried about perceived vaginal odor who have no problem, but have been conditioned (by the feminine hygiene industry and, sometimes, a well-meaning mother or clueless partner) to believe that all vaginas are naturally offensive and smelly, even when all is well.
Vaginal shaming is not a new phenomenon. In the 1950s, women were advised to douche with Lysol to prevent odor and avoid losing their husbands.
However, if there is a foul, fishy odor despite a daily shower and basic hygiene, the most likely culprit is an alteration of the pH, which refers to the vagina’s acidity level.
What is a healthy vaginal microbiome?A healthy vaginal microbiome is predominantly populated with beneficial bacteria, the lactobacilli, which produces lactic acid and keeps vaginal pH in a low and healthy range. A low pH keeps good bacteria (lactobacilli) in balance and decreases the opportunities for bad bacteria (Gardnerella) to grow. Women of reproductive age (after puberty and before menopause) normally maintain a healthy vaginal pH between 3.5 and 5 on a scale of 0 to 14. Post-menopause, the pH rises and there is an alternation in the microbiome, which in turn increases the risk of infection.
If Gardnerella predominates, the result is a funky odor. At its extreme, the result of too much bad bacteria is bacterial vaginosis (BV). BV, not yeast, is the most common form of abnormal vaginal discharge, accounting for forty to fifty percent of cases. But it’s not just about irritating discharge. Women with BV are at risk for many more serious medical conditions, including an increased tendency to acquire sexually transmitted infections such as gonorrhea and chlamydia.
When things seem to go awry, it’s understandably tempting to dash to the store and get a basketful of products that promise to keep your vagina smelling like a flower shop. But before you make that expensive run, you need to know which products might actually help, and which ones may make matters worse.
What about products that claim to prevent vaginal odor?External washes and wipes are promoted as essential to keep your vulva clean and odor-free. That’s fine in concept, but most of these products are not only unnecessary, but also potentially irritating to sensitive vulvar skin. Many of these washes and wipes are loaded with preservatives, perfumes, and additives that cause inflammation. Most promise to keep your vulva “pH balanced” as a strategy to prevent vaginal odor from starting. But if you think about it, that approach is biologically impossible.
Using a pH balanced vulvar wash to balance vaginal pH (and odor control) is akin to washing your face to prevent bad breath.
What about products that claim to eliminate or cover up vaginal odor?
Vulvar and vaginal deodorant sprays, powders, panty liners, and washes are essentially perfume to camouflage vaginal odor. Even if you want your vagina to smell like a Tahitian sunset, tropical rain, or Mandarin blossom, keep in mind that, like vulvar washes, these products are loaded with preservatives and chemicals that can cause irritation, burning, and redness.
Tips to avoid irritation to the vulvar tissue
- Do not use any douches, perfumes, antiperspirants, deodorants, or creams on your vulva.
- Some over-the-counter vaginal itch medications contain benzocaine, a topical anasthetic/numbing medication, that can cause severe skin problems.
- Avoid bubble baths.
- No scented toilet paper!
- For women who wear a protective pad because of urine leakage, be sure to use fragrance-free, unscented ones. Change these pads often to minimize moisture and irritation (urine is really irritating to vulvar tissue).
- Wash underwear and clothing in fragrance-free, dye-free, laundry detergent with an extra rinse cycle.
- Forget fabric softener when washing your underwear.
- And speaking of underwear: Leave it off when you go to bed.
What should I use to clean my vagina instead?
So now that I’ve given you a mile-long list of things not to do, what you should do to stay clean and fresh is simple.
There is never a need to clean your genitals internally. Your vagina is self-cleaning.
There is no need to clean your genitals externally with anything other than simple soap and water. Stick to fragrance-free, neutral cleansers — examples include Basis bar soap, Vanicrean bar soap, Cetaphil bar soap or liquid cleanser, and Aquanil cleanser. If you use a vulvar wipe, choose one that's unscented, hypoallergenic, chemical and preservative-free. Water Wipes (available at most drugstores) contain 99.9% water and a drop of grapefruit seed extract, and are a safe option.
If you’re having vulvar issues, your best bet is to stop using soap. Just clean your vulva with water. I promise you, there will be no odor. Avoid toilet paper altogether and instead spray lukewarm water on the vulva using a sports bottle or perineum care bottle.
If you have discomfort or burning during urination, pour or spray lukewarm water over the vulva while urinating. Pat dry.
If there’s a persistent foul odor despite normal hygiene or if you’re getting recurrent bladder infections or vulvar burning and irritation, skip the trip down the feminine hygiene aisle and take a trip to your doctor instead.
By Lauren Streicher, MD
Excerpted from Slip Sliding Away: Turning the Clock Back on Your Vagina
Image by Anna Shvets/ Pexels