Given all the feminine hygiene products in the marketplace and the endless information on the Internet, it's easy to get confused about something as seemingly straightforward as proper vaginal hygiene and vulva hygiene.
Let's ask the expert! Dr. Alicia Jeffrey-Thomas, one of our wonderful pelvic floor physical therapists, sat down with us for a Q&A on vaginal hygiene tips.
As with all content on Greater Boston Urology's blog, the following information is educational in nature, not medical advice. Always talk to your physician about your specific health care questions and conditions.
[Editor's note: This article was reviewed and updated with additional links on January 17, 2022.]
First, let's talk anatomy. What's the difference between the vulva and the vagina?
DR. ALICIA JEFFREY-THOMAS: Simply put, the vulva is what you see externally when you're looking 'down there.' The vagina is the internal component—it's the internal tube. Once you go inside, then you're in the vagina.
What do a healthy vulva and vagina smell like?
DR. ALICIA JEFFREY-THOMAS: Your vulva and vagina will have a scent, due to things like sweat and the fact the area is in a darker, moister environment compared to other parts of your body. But your vulva and vagina shouldn't have a strong scent one way or the other.
If you start noticing fishy odors, odd discharge, different color discharge, different smelling discharge, talk to your doctor. Because those could be signs of an infection.
That said, you don't want your vulva or vagina smelling like fresh-cut spring flowers, either. Your body is supposed to smell like a body. Putting extra fragrances in that sensitive area can cause problems, like irritation, itchiness, and infections.
People sometimes compare the vagina to a "self-cleaning oven." Is that true? What about the vulva? Do you need to wash one or both?
DR. ALICIA JEFFREY-THOMAS: You don't need to wash the vagina. That's the part that's very self-cleaning. That's what discharge is for. Discharge moves things towards the exit. Discharge helps maintain that specific pH and flora balance. If you wash your vagina with soaps or scented washes, you can throw off this delicate balance, which can lead to irritation and infections.
As for the vulva—which, again, is the external area of the genitals—debate surrounds this topic because there's a very prominent feminine hygiene industry that likes to try to sell you specific feminine washes. But like I said earlier, we don't need to be sticking any fragrances or soaps of any kind inside the vagina, because that can throw off pH balance and put you at risk for infections.
So should people be using soap down there at all?
DR. ALICIA JEFFREY-THOMAS: You can use a gentle, fragrance-free soap on the labia with hair. That's perfectly OK. But on the labia without hair, you want to just use water. If you have one of those shower handles that comes off and you can directly apply the water in that area, that's the best way of doing it. Just don't use any soap on that particular area and tissue because, again, that can throw things off. The tissue is different. It's thinner, and it's more susceptible to things. And so you want to be very gentle.
Is it okay if I wash more often if I'm having my period?
DR. ALICIA JEFFREY-THOMAS: I wouldn't go overboard if you're simply using a gentle, fragrance-free soap on the labia with hair. But you're welcome to rinse with water more frequently if that makes you feel fresher. And I would definitely recommend showering every day to make sure that you're feeling fresh and clean.
What if I skip a shower? Do I still have to wash my vulva if I skip a shower one day?
DR. ALICIA JEFFREY-THOMAS: Ideally, yes. But at the same time, as I mentioned earlier, it's a self-regulating environment. So as long as you're changing your underwear, then skipping the occasional shower should be okay every once in a while.
Let's talk about shaving do's and don'ts. Is it okay to shave the entire pubic area?
DR. ALICIA JEFFREY-THOMAS: So I think we need to examine the cultural reasons for why we feel like we need to shave everything. Because there is a physiological function for pubic hair. It's there to prevent things from entering the vaginal area.
Bottom line: It's up to you. I think it's absolutely a personal choice whether to remove the pubic hair. And it's important to remember that you don't have to do anything that you don't want to do.
What about hair removal products? Yay or nay?
DR. ALICIA JEFFREY-THOMAS: I don't recommend using any kind of chemical remover, like the over-the-counter products you find in your drug store. That just sounds like a chemical burn waiting to happen. If you want to remove hair, your best bet is to talk to an aesthetician who's trained and appropriately licensed to wax that area of the body. They will use appropriate techniques and tools—and can guide you as well.
If I just want to trim back the hair, should I use scissors or a razor, or does it matter?
DR. ALICIA JEFFREY-THOMAS: It doesn't really matter. Just make sure that you're using a fresh razor or clean scissors when you're doing anything approaching the pubic area.
Let's talk about sex and proper vaginal hygiene. Are lubricants okay? And if yes, what kind should I use?
DR. ALICIA JEFFREY-THOMAS: Lubricants are awesome. There should be no stigma in using lubricants for sexual activity. There are some lubes that are better than others. Ideally, we want to be using a water-based lubricant. And unfortunately, the things that I see in the store don't always have the best ingredients.
So you want to look for a water-based lubricant that doesn't have any glycerin or parabens or spermicides or petroleum-type products in them. You also want to avoid things that have warming or cooling agents or fragrances or flavors. All of those things can really irritate vulva and vaginal tissues.
People often ask me about coconut oil. Coconut oil is a great lubricant, but there's one caveat. If you're using condoms, don't use coconut oil. Oil-based lubricants can break down condoms.
Speaking of condoms, are there certain condoms that people should use or avoid?
DR. ALICIA JEFFREY-THOMAS: Again, it's going to depend a lot on what your body responds best to. But if you have the ability to just get simple condoms and then add your own lubricant, that would be great. Some people will have latex reactions and things like that, so there are alternative condoms available, but usually a latex condom is fine so long as you're not using an oil-based lubricant. Avoid condoms that have flavors or scents or things like that. Because again, that's not going to help anybody.
Should people pee after having sex?
DR. ALICIA JEFFREY-THOMAS: Urinating after sex has long been the recommendation to prevent bacteria from traveling up the urinary tract and causing a UTI. However, actual research to back this up is sparse. This one probably falls into the category of "it can’t hurt." If you feel more comfortable urinating after sex, then do it. But if you can't make yourself pee right after, don't panic.
Some people claim putting yogurt in their vagina can ward off or cure infections, like yeast infections. Is that true?
DR. ALICIA JEFFREY-THOMAS: Ah, please don't put yogurt in your vagina! If you think that you might have a vaginal infection, or if you think that you're prone to infections, you need to see your gynecologist or urogynecologist because they're going to be instrumental in giving you appropriate, evidence-based preventative care.
Thanks, Dr. Jeffrey-Thomas!
If you're experiencing any vulva or vaginal issues, speak to a pelvic health expert like a urogynecologist. Learn more about our urogynecology department in our Women's Health Center at GBU.