Many people use so-called feminine hygiene products — such as intimate cleansers and wipes, douches, and even deodorants — hoping to feel clean and fresh. Do these products really help maintain genital health?


So-called feminine hygiene products — which include different types of intimate washes, wipes, shaving gels, and lubricants, but also intimate douches and products for alternative care procedures, such as vaginal steaming — are popular in many countries around the world.


Yet in recent years, one mantra has become pervasive across medical and wellness websites and on educational materials discussing vaginal health — namely, that “the vagina is a self-cleaning oven.”


This idea refers to the fact that the vagina naturally produces discharge that eliminates dead cells and bacteria, so there is no need to clean it using soaps, washes, or douches.


So if the vagina does not require any additional cleaning, does this mean that the same rule applies to the vulva? And how can different intimate hygiene products affect vulvovaginal health? These are some of the questions that we will tackle in this Spotlight feature.


First things first: What is the vagina, what is the vulva, and what is the difference between the two?


In medical terms, the vagina refers to the internal muscular tract extending from the cervix to the vaginal opening.


The vulva is the external part of the female genital tract, which includes:


the inner and outer labia (labia minora and majora)


the glans clitoris (the external part of the clitoris)


and clitoral hood (the fold of skin protecting the glans clitoris)


the vestibule (which surrounds the vaginal opening)


the urethral opening


To maintain vulvar and vaginal health, a person must ensure that two important aspects remain balanced: their pH, which is a measurement that denotes something’s acidity or alkalinity, and their bacterial balance.


Studies indicate 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 cycle.


In the vagina, bacterial populations shift depending on the phase of the menstrual cycle and, according to some studies, people of different ethnicities also have different vaginal microbiota.


Existing research does suggest that the vulva naturally features bacteria present in the vagina as well as some species present in a person’s feces.


However, as one study that names these characteristics concludes, “the vulva is more complex than originally thought,” as vulvar bacterial populations appear to vary greatly among people.


Which products are unsafe?

Considering we know so little about what a healthy vulvovaginal environment should look like — in part because it can differ so much from person to person — it can be difficult to outline clear guidelines on what products someone should use when it comes to intimate hygiene.


Several studies have found that douching can upset the natural bacterial balance in the vagina, rendering it more vulnerable to infections — including sexually transmitted infections — and increasing a person’s risk of cervical cancer and pelvic inflammatory disease.


The same study also found an association between the use of intimate washes and a 3.5 times higher risk of bacterial infections, and a more than twofold higher risk of having a urinary tract infection (UTI). The scientists noticed a similar association between using intimate cleansing wipes and UTIs.


“These products may be preventing the growth of the healthy bacteria required to fight off infection. Our society has constructed female genitalia as unclean, and the marketing of vaginal hygiene products as something women need to attain the ideal is contributing to the problem.”


What are some good practices?

When it comes to keeping the vagina clean and healthy, guidelines from the Office on Women’s Health state that “[i]t is best to let your vagina clean itself” through the discharge it naturally produces.


A person should regularly clean the skin of the vulva with mild, unfragranced, soap-free washes to prevent the buildup of sweat, menstrual blood, dead cells, and other biological material that could accumulate harmful bacteria.


“Washing [the vulva] with water and soap may cause dry skin and make itching worse. Using soap substitutes can be soothing and protective, and will stop the skin from becoming as dry and irritated.


However, the guidelines also warn that overwashing the vulva (cleaning it more than once per day) can irritate it and harm its health, and that in cleaning this part of the body, a person should “avoid using sponges or flannels” and only pat it gently with a soft towel to dry.


In short, the consensus among gynecologists seems to be that vaginas and vulvas are mostly fine by themselves, and that assaulting them with soaps, perfumes, creams, and gels is likely to cause more harm than good.


If you are worried about the shape, look, smell, or feel of your vulva, the best place to go is not the drug store or the internet for anecdotal advice, but to your doctor.