Are Female Hygiene Products Really Necessary?
Many people use intimate cleaning products and so-called feminine hygiene products such as wipes, antiseptic products, and even deodorants in the hopes of feeling clean and fresh. Do these products really help maintain genital health?
In high school, I compiled and put together a class called “Health,” an eclectic mix of general biology and sexuality education, by myself.
As fun-loving teenagers, many of my classmates tried to squeeze our teacher by asking challenging questions.
However, one of the friends’ questions caught the attention of all the girls in the class.
One of the girls said that she uses cleanser on a daily basis. Despite that, she revealed that she ended up with a nasty vaginal infection. “How was this possible?”
Our teacher later said that excessive cleansers, even when said to be “safe” for private areas, can upset the delicate balance of the vagina and lead to infections; but was our teacher’s assessment correct or incorrect?
So-called feminine hygiene products – containing different types of special washes, wipes, shaving gels and lubricants, as well as alternative care procedures such as vaginal sprays – are popular in many countries around the world.
Statistics show that the feminine hygiene market brought millions of dollars to the economies of dozens of countries in 2017 alone, with China leading the way and the US.
Sales for vaginal treatments in the US in 2018 totaled over $286 million. Meanwhile, other types of feminine hygiene products — excluding sanitary pads, vaginal cups and tampons — had sales exceeding $309 million.
In recent years, however, a mantra has become commonplace on medical and wellness websites and educational materials discussing vaginal health—that is, “the vagina is a self-cleaning oven.”
This idea refers to the fact that the vagina naturally produces discharge that removes dead cells and bacteria, so there is no need to additionally clean using soap created with different chemicals, washing or touching.
So if the vagina doesn’t require any other cleaning, does that mean the same rule applies to the vulva? How can different intimate area hygiene products affect vulvovaginal health?
Vulva and Vagina
First we should know: What is the vagina, what is the vulva and what is the difference between the two? In medical terms, vagina refers to the internal muscular pathway that extends from the cervix to the vaginal opening.
The vulva is the outer part of the female genital tract and includes:
- Inner and outer labia (labia minora and majora)
- The glans clitoris (outer part of the clitoris) and the clitoral hood (the fold of skin that protects the glans clitoris)
- Entrance (surrounding the vaginal opening)
- urethral opening
To maintain body and vaginal health, one must ensure that two important aspects remain balanced: pH and bacterial balance, which is a measure of something’s acidity or alkalinity.
Studies show that vulvar pH is usually 3.5–4.7, while vaginal pH varies according to a person’s age and the stage of their menstrual cycles.
Therefore, before the person reaches reproductive age and starts menstruating, their vaginal pH is 7 (neutral), while a person of reproductive age may have a vaginal pH of 3.8-4.4. At menopause, a person’s vaginal pH may be 4.5-5 or 6.5-7, depending on whether they are on hormone replacement therapy.
But things are less clear when it comes to understanding what a vagina versus vulva balanced microbiome is.
In the vagina, bacterial populations vary depending on the phase of the menstrual cycle, and people of different ethnicities also have different vaginal microbiota, according to some studies.
As for the vulvar microbiota, experts conducted several studies to determine what a normal vulvar bacterial population should look like. However, existing research suggests that the vulva contains bacteria naturally found in the vagina, as well as some species found in a person’s stool.
However, one study naming these features concludes that “the vulva is more complex than originally thought,” as populations of vulvar bacteria vary widely between people.
Which Products Should Not Be Trusted?
Given that we know so little about what a healthy vulvavaginal environment should look like – in part because it can vary so much from person to person – it can be difficult to set clear guidelines for what products a person should use when it comes to hygiene.
However, research looking at the link between feminine hygiene products and the development of vaginal infections has drawn some strong conclusions about which products and procedures one should avoid when caring for the vagina and vulva.
Washing involves “washing” the vagina with water, or sometimes with the help of specially designed tools, with various cleaners, including homemade water and vinegar solutions. This technique is as common as it is unhealthy.
Various studies have revealed that touching can upset the natural balance of bacteria in the vagina, making it more vulnerable to infections, including sexually transmitted infections, and increasing a person’s risk of cervical cancer and pelvic inflammatory disease.
In 2018, researchers from the University of Guelph in Ontario, Canada, concluded that the use of gel cleansers is linked to an eight-fold increase in a person’s risk of developing a fungal infection and an approximately 20-fold higher risk of contracting a bacterial infection.
The same study found an association between the use of specialty washes and a 3.5 times higher risk of bacterial infections and more than twice the risk of urinary tract infection (UTI). Scientists noticed a similar association between the use of special cleaning wipes and UTIs.
“These products may be inhibiting the growth of healthy bacteria needed to fight infection. Our community has touted the female genitalia as dirty and the marketing of vaginal hygiene products as something women need to achieve their ideal.” says Kieran O’Doherty
An older study in the journal Sexually Transmitted Diseases suggested that people who take bubble baths, apply antiseptic solutions to the vulva or vagina, or use store-bought or homemade solutions and washes to clean the vagina are more likely to have bacterial vaginosis.
It moisturizes and spermicides can also harm. According to a 2013 in vitro study, Vagisil feminine moisturizer and a spermicide (Nonoxynol-9) quickly suppressed the growth of “good” bacteria (Lactobacillus) usually found in the vagina.
The researchers noted that Nonagynol-9 “completely killed the bacteria,” while Vagisil significantly suppressed the growth of Lactobacillus. “
So What Are Good Hygienic Practices?
When it comes to keeping the vagina clean and healthy, the guide from the Office of Women’s Health states that natural ejaculation is “the best way for your vagina to clean itself.”
If a person is concerned about the vaginal discharge changing color or smelling a particular odor, they should speak with a healthcare provider or doctor to check for a possible infection.
Although many people are concerned about vaginal odor and buy products that claim to eliminate it, it is normal for vaginas to have a unique, musky odor.
However, if cleaning the vagina is unnecessary or even harmful, how about cleaning the vulva? Evidence on whether the vulva is clearing is often insufficient.
An expert literature review in 2017 showed that a person should regularly clean the skin of the vulva with mild, fragrance-free, soap-free washes to prevent the buildup of sweat, menstrual blood, dead cells, and other biological materials that can accumulate harmful bacteria.
This recommendation is based on several official guidelines that recommend using “gentle hypoallergenic liquid washes” to clean the vulva. One such principle is as the Royal College of Obstetricians and Gynecologists declared in 2013:
“Washing the vulva with soap and water can cause dry skin and make itching worse. Soap substitutes can be soothing and protective and prevent skin from becoming dry and irritated. An aqueous cream (a special type of moisturizer) can be used instead of soap. “
However, studies also warn that over-washing the vulva (more than once a day) can irritate the vulva and harm its health, and one should avoid using a sponge or soap cloth for cleaning this part of the body. Just dry gently with a soft towel.
In short, the consensus among gynecologists is that the vagina and vulva are mostly good by themselves, and cleansing with soaps, perfumes, creams and gels will do more harm than good.
If you’re worried about the shape, look, smell or feel of your vulva, the best place to go is your doctor, not pharmacies or the internet for advice.
They will give you the right information you need and what is best for you – your doctor will tell you if action is necessary.
Medical News Today, Are feminine hygiene products really necessary?, 2019.