Read My Lips (8 page)

Keeping Clean: Easier Than You Think

Because the vagina cleans itself out via vaginal discharge, there’s very little to do when it comes to keeping your genital parts clean. However, many women are convinced that they need to clean their lady parts. Here are a few tips to keep in mind:

• Try to avoid using fragranced and scented bath products.
  This includes scented, colored, or antibacterial soaps, as these can irritate the sensitive vulvar skin.
  
• Go basic.
  Although it surprises some women to hear this, many doctors who specialize in vulvar and vaginal health recommend that women wash their genitals with only water and their hand. That’s right: no soaps necessary.
  
• Stay soft.
  An advantage of using your hand is that it’s soft and unlikely to irritate the sensitive genital skin. Loofahs and other cloths meant for scrubbing can irritate the genitals.
  
• Avoid soaps.
  Harsh soaps and cleansers can cause irritation or itching of the genitals. If you feel you must use some type of cleanser on your vulva, consider using a gentle cleanser such as Cetaphil (sold over the counter in many drug stores) along with water and your hand.
  
• Turn down the heat.
  Opt for warm rather than hot showers, as hot water can dry skin all over one’s body. Of course, most people opt for warm-to-hot bath water. If you’re planning to have sex after a bath, try spending longer than usual in fore-play, as the vagina may be dry (due to the warm water) and may need time to get its lubrication going. You may find it helpful to keep a bottle or packet of personal lubricant nearby in case you need a little assistance with post-bath sex.
  
• Don’t put any bath products up inside the vagina.
  Only the outside parts (the vulva) should be cleaned with water and one’s hand. The inside parts (i.e., the vagina) do not require any special cleaning.
  

Grooming

When grooming your pubic hair, try to choose a kinder, gentler method—something that won’t make your genitals run for cover in the other direction. Take care, for example, to groom carefully and not to nick your sensitive, curvy genital parts with razors or scissors. And while we don’t think you need pubic hair dye or labia dye, we understand that some women may want to use such products, either to cover gray pubic hairs or to have a little fun with their pubes or labia. We get it. If you go this route, please take care to follow package instructions, to patch test dyes on non-genital parts before using them on genital parts, and to avoid doing anything that doesn’t sound right to you. As pubic hair and labia dyes are not approved by any health organization that we know of, the instructions may contain inaccurate information—so please, ask your healthcare provider if you have any questions about whether a product is safe for your cooch or whether you should adjust the instructions in a particular way.

Genital Odor

Most vaginas do not smell like fish—but some do. It is common for women’s genitals to have a slight scent to them, sometimes smelling a bit yeasty or like sour milk. This can be normal, healthy, and nothing to worry about. If you have questions about your genital odor, we encourage you to talk with a healthcare provider who can examine you and see if you may have a vaginal infection, such as trichomoniasis, that can result in a strong and often unpleasant odor. In some cases, women may have strong genital odor as a result of overactive sweat glands (this is sometimes treated with Botox). There are tons of sweat glands in the vulva, which is why you may have noticed a damp crotch during exercise. Having sweat glands down there is a good thing. The vulva is full of blood vessels, which means that as blood flow increases to the genital area, it may feel warmer. Sweat allows the warmth to dissipate, which is useful because it will help you feel comfortable as you cool off. In other words, your sweat glands have an important role to play, so try not to be too hard on them.

Douches, Sprays, and Powders

The vagina is a self-cleaning body part. As such, feminine-hygiene products such as douches, deodorant sprays, and powders are not needed to keep the vagina smelling or looking clean (more on this in chapter 5). As this chapter is about health, we’ll go a step further and tell you a few additional icky facts about douching: not only can douching not prevent pregnancy or STIs, but douching may make a woman’s genital odor and discharge worse instead of better. Why? Because it may promote more bacterial growth. Some research also suggests that women who douche have a greater risk of pelvic inflammatory disease and of ectopic pregnancy, which is when a pregnancy begins to develop outside of the uterus (such as in the fallopian tube). Bottom line: avoid these kinds of feminine hygiene products unless specifically recommended by a healthcare provider.

What to Wear Down There

As the vulva can be quite sensitive, healthcare providers sometimes suggest that the most vagina/vulva-friendly underwear is cotton underwear, as it allows the genitals to “breathe.” It also helps to keep the genital area dry rather than trapping moisture.

Some women also find it helpful or comfortable to sleep or go through their day without wearing underwear. This may be particularly helpful if they are prone to genital discomfort or pain. In addition, thong underwear has been identified as a common irritant of the vulva, so you may find it more comfortable to choose other styles of underwear.

Laundry

Although most women find that they can use any laundry detergent they want and not experience genital irritation, not all women are so lucky. If you’re prone to vaginal or vulvar irritation, itching, or pain, you may want to use a detergent that is free of fragrances and dyes. Some women even run their laundry—or at least their underwear— through an additional rinse cycle to further dilute any detergent that may be lingering in their undies.

EXERCISE

Exercise and Clothing

Not only is regular physical exercise good for the heart, lungs, weight management, and overall wellness, it can also feel invigorating for many women. Plus, exercise helps many women to manage menstrual or premenstrual symptoms such as cramps and irritability.

If you exercise (and we hope you do, whether it’s walking, running, swimming, dancing, or taking your dog out for long walks), try to change out of your exercise clothes or underwear soon after you’re done exercising. This can help to keep your genitals dry rather than having them trapped with all that moisture from sweating, which can irritate the genitals. Putting on clean, dry clothes is a welcome relief for vulvas and vaginas worldwide.

Heave, Ho

When you lift objects, try to adopt a healthy lifting posture (you know, the whole “bend at the knees” thing). It’s not just good for your back, but it might be vagina-friendly, too. Why? Because the pelvic-floor muscles support the bottoms of our bodies including our vaginas, rectums, and reproductive organs. Lifting heavy things, especially improperly, can put strain on the pelvic-floor muscles and weaken them over time. Body weight, including weight gained during pregnancy or even when one is not pregnant, can also put strain on the pelvic-floor muscles. Of course, it’s important to be open to gaining a healthy amount of weight during pregnancy but that amount varies from woman to woman. If you are pregnant or thinking about becoming pregnant, ask your OB/GYN for advice about attaining a healthy pregnancy, including a healthy pregnancy weight. And if you are not pregnant but have questions about your health, weight, or body composition, your healthcare provider can be a good source of information as can a registered dietician. (Note: an RD is different from a “nutritionist,” which anyone can call himself or herself, even with no advanced training.)

Kegels

Kegel (say “kay-gull”) exercises are named for the gynecologist Dr. Arnold Kegel who first described these exercises as a way to help women maintain bladder control. Just as certain exercises can help to strengthen leg muscles or arm muscles, Kegel exercises can help to improve the tone of the pelvic-floor muscles. This can be important in terms of helping to reduce the risk of incontinence that otherwise increases with age and childbearing. Some women feel that pelvic-floor exercises also help them to experience more intense orgasms, though this is not well understood in research.

To identify your pelvic-floor muscles, try stopping the flow of urine as you pee. Those are the muscles that—when you’re not peeing— you will want to squeeze as part of your Kegel exercises. Another way to identify these muscles is by inserting a finger into the vagina and squeezing the muscles, which will likely result in a sense of pressure around the finger. Sex educators and healthcare providers often recommend different variations on Kegel exercises. For example, they may recommend that women:

• Squeeze the pelvic-floor muscles and hold to the count of five, then release for another five counts. Repeat the squeeze-and-release pattern for five minutes. Eventually work up to ten minutes.
  
• Squeeze and release the pelvic-floor muscles in a quick pulsing pattern, squeezing for only one or two seconds and then releasing for the same. Try to do this for up to five minutes.
  
• Use a Kegel exerciser as part of the exercises. A Kegel exerciser often looks like a small, thin, weighted bar (about the length of a typical dildo, or smaller). Some women insert the weighted bar an inch or two into their vagina as they practice their preferred squeeze/release pattern. Over time, some women begin inserting more of the weighted bar into their vagina so that it holds more weight. Using water-based lubricant can help to make it easier to insert the weighted bar into the vagina. Also make sure to clean the bar before and after use.
  
• Use balls meant for Kegel exercises, such as Ben Wa balls or Smart Balls, as part of one’s Kegel exercises. Some women opt to place one ball inside their vagina and use it to squeeze and then relax their muscles. Others opt to place two balls inside the vagina as part of their Kegel exercises. Another variation is to place one or both balls inside the vagina, squeeze one’s pelvic-floor muscles, and then walk several feet or the full length of one’s room using only the strength of one’s pelvic-floor muscles to keep the ball(s) inside the vagina. Again, water-based lubricant can help to make insertion more comfortable, and cleaning the balls before and after use is recommended. These balls can be found in many of the sex shops listed in the Resources section.
  

While practicing Kegel exercises, try to focus only on the pelvic-floor muscles by lifting up rather than bearing down or using other nearby muscles, such as the abdominal muscles. Try to find a time when you are relaxed, comfortable, and have sufficient time to complete your exercises without interruption. Some women do their Kegel exercises daily, and others aim for a few times per week. If you have any questions or concerns about how to perform Kegel exercises or if they are right for you, please check in with your healthcare provider, as everyone’s body and personal-health needs are a little different. Women who experience genital pain, including pain during sex, are particularly encouraged to seek advice from their healthcare provider, such as a physical therapist who has experience treating women for genital-pain issues, prior to starting a program of pelvic-floor exercises like Kegels. This is because some women with a genital-pain disorder may have pelvic-floor muscles that are too tight, and they may benefit from different kinds of exercises.

DITCH THE ITCH

One of the most common complaints that women have about their genitals has to do with itching. On the plus side, this means that you can pretty much always find a shoulder to lean on when it comes to genital itching. If you mention it to a friend or to your mom, chances are she’s been there, too. On the down side, this also means that itching is a non-specific symptom. If your vulva itches, it doesn’t exactly narrow down the list of many things that could be causing the itching. That said, there are a few common causes of genital itching among women. The next time you feel all “ugh!” down there, consider whether any of these may be at the root of your problem:

• Clothing.
  We’ve said it before, and we’ll say it again. Women’s genitals do not like to be bound up and restricted. Multiple layers (think pantyliner, tights, and a skirt) or too-tight clothes, such as spandex pants or tight jeans, can trap moisture. These kinds of clothes can be fine on occasion, but if you opt to spend the day in leggings, try to air out your bits by sleeping in the nude, or at least going without panties, at night. Let your vulva and vagina breathe! Truly, you may be surprised by how many cases of genital itching could be prevented by wearing fewer layers, loose cotton underwear, or more natural, breathable fabrics. Try not to wear constrictive pantyhose or “shape” products (e.g., Spanx) too often.
  
• Chemical irritants.
  You may not think twice about pouring bleach in the laundry, but that bleach may be irritating your lady bits. And if your male partner is using performance-enhancing condoms that help him to last longer, then your itching may be linked to the benzocaine or lidocaine that’s in some of those products. Or if you have ever thought it would be a good idea to sanitize your menstrual cup or sponge with tea tree oil, think again—that, too, can irritate women’s sensitive genitals. There have even been case reports of women experiencing genital irritation from newspaper ink.
  ²
  That’s right—newspaper ink. It turns out that their partners were reading the newspaper in bed before sex. The ink got on their hands, and their hands got on their partner’s genitals, and next thing you know, there’s a case of mysteriously irritated genitals. If your bed partner reads the newspaper before bed, ask him or her to wash up before going any further. (Perhaps this is yet another reason why digital newspapers are a good option!)
  
• Bath products.
  Although these probably belong in the “chemical irritant” section, bath products are so commonly linked to genital itching and irritation that they deserve their own mention. Women’s vaginal itching and irritation are commonly linked to fragranced products, and bath products are among the worst culprits.
  ²
  Although these products may help create a relaxing, fragrant retreat out of your shower or bath, women find themselves less relaxed later when their bits begin to itch. If you choose to use fancy schmancy bath products anyway, try to use only a small amount and dilute them greatly with bath water.
  
• Your lubricant.
  Although lubricant formulations are getting better every day, many lubricants that you’ll find on store shelves contain propylene glycol or chlorhexidine, which have also been linked to genital itching or irritation among women.
  ¹
  If you notice ongoing itching, check the labels of your lubricants and consider switching products.
  
• Feminine hygiene products.
  Please forgive us for saying this over and over again, but feminine hygiene products such as douches, sprays, and deodorants can cause more harm than good. And they can definitely contribute to vulvar itching for some women.
  
• Yogurt.
  Although Debby’s refrigerator is constantly stocked with dozens of cups of yogurt, her vagina is not. You won’t find any yogurt near our lady parts. Why? Because it doesn’t belong there. Forget what you may have read on the Internet about using yogurt down there to fight yeast infections. The next time you have an urge to put food of any kind on or in your genitals, check with your healthcare provider first, as even food—particularly when misplaced—can cause vulvar itching or irritation.
  
• Yeast infections.
  Many women feel itchy down there and race to the drug store to get over-the-counter yeast medications. This can be a huge mistake. Why? Well, if you don’t have a yeast infection, then not only will yeast creams not work, but they may also make your itching and other genital symptoms worse. Or, equally bad is that the cream and any side effects you have from the cream may make it more difficult for your healthcare provider to properly diagnose the cause of your genital symptoms. As such, we recommend always checking in with your healthcare provider before seeking help from over-the-counter yeast infection medications. One of the few exceptions to this is that women who are super prone to yeast infections (meaning, they get four or more per year) are probably pretty good at telling what is and what is not a yeast infection due to experience. Some health-care providers tell these women that they can probably make the yeast-cream decision on their own without much risk. But if you’re not sure, or if you have questions about your personal health, definitely check in with your healthcare provider. If you do have a yeast infection, your healthcare provider can walk you through your treatment options, which may include over-the-counter yeast cream, a prescription pill, or other treatments if the yeast is an uncommon type that doesn’t respond to typical treatments.
  
• Medications.
  Sometimes women’s healthcare providers advise them to use over-the-counter or prescription creams on their genitals, for example, to treat skin disorders (such as lichen sclerosus) or STIs (such as genital warts). Yeast creams, estrogen or testosterone creams, and even numbing agents may be used on the genital skin, or internally, for different reasons, per the advice of one’s healthcare provider. Occasionally, women experience itching, irritation, or feelings of burning, stinging, or pain when they use such creams. If your healthcare provider prescribes a cream or ointment for you to use on your vulva or inside your vagina, ask him or her what kinds of symptoms you can expect and what to do if you experience them (e.g., Stop the medication? Press an ice pack against your vulva to stop the pain?).