The vagina gives us pleasure and allows us to bear children, yet so many of us know very little about it, and discussing this particular body part can make us squirm. We need to reflect on why so many of us are embarrassed to openly talk about the vagina, considering its powerful role in our lives.
Regardless, owners of vaginas need to take an active role in maintaining our sexual health. This means getting informed. A good place to start is by asking your gynecologist questions as part of your yearly routine exam (which I hope you go to!). Ask about your PAP smear, and what that’s for, ask whether there are other tests you should be considering, etc. Another suggestion I have is to ask your gynecologist to place a mirror down there so you can see what they see. It’s important to really get to know what your own vulva looks like — get to know what’s normal for you (color-wise, shape, etc.). Check it regularly so that you can keep track of any changes you observe that might be noteworthy.
First, we need to know what a healthy vagina looks like. A healthy vagina has tough, resistant skin characterized by accordion-style folds of skin in its walls which have the capacity to expand to accommodate any size penis, and a full-size baby during childbirth! True, some women can’t push out a baby through their vagina, but that is usually due to narrow pelvic bones rather than a too-small vagina.
Vaginal secretions are something else we need to be aware of as variations in these can indicate an issue. Secretions are produced from the cervix and can vary with the menstrual cycle. Fluid also passes through the vaginal walls in response to physical activity and sexual arousal. There are also secretions from the glands at the entrance of the vagina, which are called Bartholin’s glands. It is all of these secretions that make up the vaginal discharge and fluid that a woman notices. Normally, it is a whitish fluid that dries yellowish on underwear, varying in amount throughout the month, with a characteristic (but not bad) smell.
Many women are very self-conscious of their smell “down there.” That smell, however, is not noticeable to you or others, if you maintain normal hygiene. You should also be aware that a variety of bacteria, yeasts and other microorganisms occur naturally in the vagina’s mildly acidic environment. Certain bacteria are actually necessary to maintain the natural acidity in the vagina, and that keeps other bacteria under control. Many women don’t realize this and do things to try and “clean their vagina” like douching, for example. Douching, unless specifically recommended by your doctor for a specific problem, is not necessary as it can actually wash away that good bacteria. Furthermore, douching can force bacteria back into the vagina and up into the uterus and tubes, putting you at risk for very serious infections.
Having old-fashioned showers should be absolutely enough to keep everything as clean as it needs to be. Remember, your vagina is a self-cleaning organ.
Hygiene is important, but there are other steps that are important as well. Your vagina needs a nice, airy, dry environment. It is recommended that women wear only cotton underwear and change it daily, don’t keep a damp bathing suit on or workout clothes on for too long, change pads and tampons regularly (at least every 8 hours), avoid tight-fitting clothes and synthetic materials next to the skin, and avoid long exposure to hot, sweaty or chafing conditions.
You can also avoid causing unnecessary irritation to your vagina by not using soaps or antiseptics, not using perfumed deodorants or powders near the vagina and not using perfumed pads and tampons. Avoiding infection is also important, so a few things you can think about is wiping from front to back when using toilet paper, being particularly careful with hygiene if you have a bowel upset (e.g. washing rather than wiping), and eating a healthy, well-balanced diet.
As I alluded to, the vaginal balance is very delicate and it can be upset by external factors as well as by some naturally occurring bacteria, which, although necessary, can increase and cause symptoms. Some women are more susceptible than others, however, to disturbances in the vaginal environment. Factors such as stress, illness, and hormone changes can also alter the vaginal environment.
If you experience any of the following symptoms, it may indicate a vaginal infection, and a visit to the doctor is warranted:
- itching
- irritation or soreness
- a burning sensation when passing urine
- increased or unusual discharge
- swelling of the labia
- bleeding
- uncomfortable or painful intercourse
- unpleasant odor
- abdominal pain
- fever
These symptoms can also be caused by a sexually transmitted disease, so it’s really important to check it out.
The vaginal environment can also change with age, especially through menopause. Menopausal women typically experience some form of vaginal dryness or irritation, and this is because the vaginal mucous typically thins as hormone levels decline. However, the severity of the symptoms may vary from woman to woman.
Fortunately, there are many treatment options available for those experiencing symptoms of vaginal tissue thinning like itching, irritation, and burning, as well as for those who have pain that’s either constant or occurring only during intercourse. The goal is to increase circulation to the pelvic area, re-hydrate tissues, soothe and support damaged tissue, strengthen cell walls and thicken cellular layers. Besides getting a prescription for a hormonal or non-hormonal vaginal cream, you need to keep yourself well hydrated. This will increase vaginal moisture. So drink lots of water! Increasing circulation to the pelvic area is helpful, so practice your Kegel exercises or take some Pilates classes which focus on strengthening this area.
For women who need extra moistening and lubrication during lovemaking, a personal lubricant can reduce friction and irritation.
Finally, another often-neglected method to maintain vaginal tissue health is frequent sexual stimulation (self or partnered), which promotes the thickening of the vaginal tissue as well as stimulating blood flow and the secretion of moisture and disease-fighting enzymes.
Recommended reading: The V Book, by Dr. Elizabeth Stewart