Vulvovaginal Cleansing

by Adelaide G. Nardone, MD,
Fellow of the American Congress of Obstetricians and Gynecologists

The vulvovaginal area actually consists of two organs: the vagina and the vulva. They have two very different coverings; the vaginal walls are covered by vaginal epithelium and the vulva is covered by skin with specialized structures.

Therefore, the approach to "cleansing" this area should be specified per organ; vagina and vulva.

Vagina

The vagina is "self-cleansing" through the elimination of vaginal discharge daily. It is normal for women of reproductive age to have vaginal discharge.

Vaginal Discharge is a mixture of:

• Cells shed from the vaginal walls
• Mucus and fluids from the reproductive organs and cervix
• Bacterial by- products
• Salt and water

Since the vagina cleanses itself there is no need to insert products or douches into the vagina for cleansing. Additionally douching does not help in the treatment or prevention of vaginitis.

Linda O. Eckert MD, Associate Professor at Harborview Medical Center in Seattle, Washington and a member of the American College of Obstetricians and Gynecologists (ACOG) task force on Infectious Diseases in Obstetrics and Gynecology states that douching has no role in the treatment of any cause of vaginitis.1 Furthermore, to decrease your risk of getting vaginitis, not douching2 is recommended - it is better to let the vagina cleanse itself.

Both ACOG and the American Society ofColposcopy and Cervical Pathology (ASCCP) in a Joint Opinion on Vulvodynia in 9/2006 stated that women with vulvodynia (which is a vulvovaginal pain disorder) are advised to avoid douching.

The vagina keeps itself healthy by maintaining the vaginal pH in a mildly acidic range of 3.5 - 4.5. This normal pH is maintained through a balance between hormones and intra vaginal microorganisms.

If there is concern that your discharge has changed in color, odor or texture this may be an indication that something is not right. You can actually measure your vaginal pH with the Over-the-Counter (OTC) Vagisil® Screening Kit at home to help determine your vaginal health. You also may need to consult with your gynecology provider.

Vulva

The vulva is in contact with the outside world and covered by a "skin" that is somewhat more delicate than skin on other parts of your body. The vulva has many sweat glands. It also has specialized secretory glands called the Bartholin's gland and the Skene's gland. These produce an oily substance that helps to lubricate and protect the vulva. The pubic hair that covers the vulva also serves to protect it from trauma and infection. Many bacteria live on or close to the vulva so that long hours of confinement and moisture can result in malodor. Like skin elsewhere on your body, the vulvar area can be very sensitive to harsh detergents, dyes, perfumes, chemicals, hot water, constriction, bacteria, fabrics, latex, medications etc.

Vulvovaginal hygiene simply involves daily washing or showering with warm water (not hot) and a mild, non irritating cleanser, such as Vagisi® Wash. Don't over dry the labia of the vulva as they are meant to be slightly moist. Also avoid constrictive non- breathable clothing. If you have a problem with too much wetness, discharge, sweating or odor you can apply Vagisil® Deodorant Powder each day to help wick away wetness and help keep you odor free.

Do's:

• Do allow your vulvovaginal area to "breath" with cotton lined undergarments, light weight, and non-restrictive clothing during the day and, if possible, nothing at night
• Do practice good hygiene by washing daily with a mild "vulvar friendly" cleanser such as Vagisil® Wash
• Do contact your gynecology provider if your discharge and/or odor seem unusual for you

Don'ts:

• Don't douche unless it's doctor's orders
• Don't "hang out" in sweaty work-out clothes, constrictive pants, or undergarments longer than needed
• Don't over wash, over bubble bath, or over dry the delicate genital area