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?

许多人使用所谓的女性卫生产品-如亲密的清洁剂和湿巾,冲洗,甚至除臭剂-希望感觉干净和新鲜。这些产品真的有助于保持生殖器健康吗?

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.

所谓的女性卫生产品——包括不同类型的贴身洗漱液、湿巾、剃须凝胶和润滑剂,也包括用于替代护理程序(如阴道蒸汽)的贴身冲洗和产品——在世界各地的许多国家广受欢迎。

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.”

然而,近年来,有一条口头禅在医学和健康网站以及讨论阴道健康的教育材料上流传开来,即“阴道是一个自洁烤箱”。

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.

这个想法是指阴道自然产生的排泄物可以清除死细胞和细菌,所以不需要用肥皂、水洗或冲洗来清洗。

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.

所以如果阴道不需要任何额外的清洁,这是否意味着同样的规则也适用于外阴?不同的亲密卫生产品如何影响外阴阴道健康?这些是我们要解决的问题。

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

首先,阴道是什么,外阴是什么,两者有什么区别?

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

在医学术语中,阴道是指从宫颈延伸到阴道开口的内部肌肉束。

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

外阴是女性生殖道的外部部分,包括:

the inner and outer labia (labia minora and majora)

内外阴唇(小阴唇和大阴唇)

the glans clitoris (the external part of the clitoris)

阴蒂(阴蒂的外部)

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

和阴蒂包皮(保护阴蒂的皮肤褶皱)

the vestibule (which surrounds the vaginal opening)

前庭(环绕阴道开口)

the urethral opening

尿道口

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.

为了保持外阴和阴道的健康,一个人必须确保两个重要方面保持平衡:他们的酸碱度,这是一个衡量某物酸碱度的指标,以及他们的细菌平衡。

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.

研究表明,外阴的酸碱度通常为3.5-4.7,而阴道的酸碱度则随年龄和月经周期的不同而变化。

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.

在阴道中,细菌数量随月经周期的不同而变化,根据一些研究,不同种族的人也有不同的阴道微生物群。

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.

现有的研究确实表明,外阴自然具有存在于阴道中的细菌以及存在于人粪便中的某些物种。

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.

然而,正如一项命名这些特征的研究得出的结论,“外阴比原先想象的要复杂”,因为外阴细菌种群在不同人群中似乎有很大的差异。

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.

考虑到我们对一个健康的外阴阴道环境应该是什么样子知之甚少,部分原因是它在人与人之间可能有很大的差异,所以很难就个人在亲密的卫生方面应该使用什么产品提出明确的指导意见。

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.

几项研究发现,冲洗会破坏阴道内的自然细菌平衡,使阴道更容易受到感染,包括性传播感染,并增加患宫颈癌和盆腔炎的风险。

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.

同样的研究还发现,使用私密洗液与细菌感染风险高出3.5倍以及尿路感染(UTI)风险高出两倍多之间存在关联。科学家们注意到,在使用私处清洁湿巾和尿路感染之间也有类似的联系。

“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.”

“这些产品可能阻止了抵抗感染所需的健康细菌的生长。我们的社会已经把女性生殖器认知为不干净,而销售阴道卫生产品作为女性实现理想所需的东西,正是造成这一问题的原因。”

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.

关于保持阴道清洁和健康,妇女健康办公室的指导方针指出,“最好让你的阴道自己清洁”,通过它自然产生的分泌物。

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.

一个人应定期用温和、不带抹布、无皂洗液清洁外阴皮肤,以防止汗液、经血、死亡细胞和其他可能积聚有害细菌的生物物质的积聚。

“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.

用水和肥皂清洗外阴可能导致皮肤干燥,使瘙痒加剧。使用肥皂替代品可以舒缓和保护皮肤,防止皮肤变得干燥和发炎。

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.

然而,该指南还警告说,过度清洗外阴(每天清洗一次以上)会刺激外阴并损害其健康,而且在清洗身体的这一部分时,一个人应该“避免使用海绵或法兰绒”,并且只能用软毛巾轻轻拍打以使其干燥。

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.

简言之,妇科医生的共识似乎是阴道和外阴基本上是好的,用肥皂、香水、面霜和凝胶攻击它们可能造成比好更大的伤害。

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.

如果你担心你外阴的形状、外观、气味或感觉,最好的去处不是药店或互联网上的奇闻轶事建议,而是你的医生。