The vagina is likened to a delicate flower for a reason; it needs particular care and attention to keep it happy and healthy. Regular washing may seem like enough but there is so much more you can do to be comfortable and generally healthier in your nether regions. We talk to Dr Vanessa Mackay, a consultant obstetrician and gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists, who shares 14 top tips on how to keep your vagina healthy.

Avoid douching – the vagina is self-cleansing!

It’s a myth that the vagina needs extensive cleaning with perfumed soaps or feminine hygiene products. The vagina is designed to clean itself with natural secretions. It contains good bacteria, which are there to protect it. If these bacteria are disturbed it can lead to infection, such as bacterial vaginosis or thrush, and inflammation.

It’s a good idea to avoid perfumed soaps, gels, and antiseptics as these can affect the healthy balance of bacteria and pH levels in the vagina and cause irritation. Use plain, unperfumed soaps to wash the area around the vagina (the vulva), not inside it, gently, every day. During your period, washing more than once a day may be helpful.

Exercise your vagina

The pelvic floor muscles hold the uterus (womb), vagina, bowel and bladder in place. As women age, their pelvic floor muscles weaken. This can also be exacerbated by pregnancy, childbirth, obesity, chronic constipation, or any other activity that causes high impact on the pelvic floor muscles.

Doing regular pelvic floor exercises can help improve muscle tone, bladder, and bowel control and sensitivity during sex. If you are pregnant, or planning to get pregnant, you should start doing pelvic floor exercises as soon as possible as this will reduce the risk of experiencing incontinence after childbirth.

To exercise the pelvic floor muscles, sit or stand comfortably with knees slightly apart and then draw up the pelvic floor muscles as if trying to avoid passing urine or wind. It is important not to tighten the stomach, buttock or thigh muscles during the exercises. Do ten slow contractions, holding them for about 10 seconds each. The length of time can be increased gradually and the slow contractions can then be followed by a set of quick contractions. The whole process should be carried out three or four times a day.

Keep your pubic hair

Pubic hair actually has a purpose!

Pubic hair offers a natural barrier to keep things clean, to decrease contact with viruses and bacteria, and to protect the tender skin of the area. While protecting against diseases and skin problems, public hair also prevents foreign particles like dust and pathogenic bacteria from entering the body, and helps to control the moisture of the area which decreases the chances of yeast infections.

Shaving your pubic hair puts you at higher risk of contracting venereal disease, like genital warts. Although pubic hair doesn’t completely prevent STIs, it helps avoid skin on skin contact with someone who may already have it.

Removing pubic hair also irritates and inflames the hair follicles left behind, leaving microscopic open wounds. When that irritation is combined with the warm moist environment of the genitals, it becomes a happy culture medium for bacterial pathogens.

Seek help for extreme period pain

More than half of women who have regular periods experience pain for 1-2 days each month, and for some women the pain can be severe and last throughout their period. This can be extremely debilitating and dramatically impact a woman’s quality of everyday life.

Women should not suffer in silence and we’d advise any woman experiencing severe pain to seek advice from their GP as there are several treatment options available to help alleviate symptoms.

Seek help for vaginal dryness

Vaginal dryness is a common but treatable problem that many women experience at some point in their lives. It can be caused by the menopause, breastfeeding, childbirth, not being aroused before sex, some types of contraception and cancer treatment.

There are several self-help treatments for vaginal dryness including lubricants and vaginal moisturisers. If these aren’t effective, or if symptoms are severe, women should seek advice from a healthcare professional who may recommend vaginal oestrogen or hormone replacement therapy.

Keep an eye on discharge

It is normal and healthy for women to produce a clear or white discharge from their vagina. This mucus is produced naturally from the neck of the womb, known as the cervix. The amount of vaginal discharge varies throughout a women’s menstrual cycle, and most pregnant women will get a pregnancy discharge. Healthy discharge doesn’t have a strong smell or colour, but women may feel an uncomfortable wetness.

Any sudden change in your discharge may indicate a vaginal infection. Women should be aware of how their discharge naturally varies throughout their cycles and what isn’t normal. The warning signs of infection include a change in colour or consistency, a sudden bad smell, an unusually large amount of discharge, itching outside the vagina or pain in the pelvis or tummy, or unexpected bleeding from the vagina. If you aren’t sure whether your discharge is normal, visit a GP, practice nurse or pharmacist.

Sleep naked

Sleeping without underwear may be beneficial to women with vaginitis, which is inflammation of the vagina, and those who suffer from thrush, a common yeast infection. Thrush thrives in warm, moist parts of the body, so avoiding tight-fitting underwear or tights can help prevent the infection. If you have vaginitis, wearing loose-fitting cotton underwear or not wearing underwear while you sleep, may improve the condition.

Don’t be embarrassed about vaginal flatulence

Vaginal flatulence is caused when air is pushed inside the vagina. This can happen during sex or other sex acts by a man’s penis, a finger, or a sex toy. A deep thrust or body movement can cause the air to be released. The air is also expelled as the vagina returns to its pre-aroused state.

Vaginal flatulence can also happen during a pelvic exam, when women insert a female condom, menstrual cup or tampon, or during exercise. It can also be caused by weak pelvic floor muscles.

Don’t ignore any abnormal symptoms

Bleeding or ‘spotting’ between periods is a common side effect of the contraceptive pill. It can also be caused by stress, injury to the vagina or vaginal dryness, but may be something more serious such as an STI or cervical or womb cancer. Spotting cancer early is important as it means treatment is more likely to be successful. If women are concerned by bleeding between periods, they should be checked out by a doctor.

Any sudden change in a woman’s discharge may indicate a vaginal infection, so women should take note of how their discharge naturally varies throughout their cycles. The warning signs of infection include a change in colour or consistency, a sudden bad smell, an unusually large amount of discharge, itching outside the vagina, or pain in the pelvis or tummy, or unexpected bleeding from the vagina. If a woman isn’t sure whether her discharge is normal, she should visit her GP, practice nurse or pharmacist.

Attend your cervical screening appointment

A cervical screening test, or smear test, is used to detect abnormal cells on the cervix; the entrance to the womb from the vagina. As part of the NHS Cervical Screening Programme, women aged 25 to 49 are invited to be screened every three years, and then every five years until they are 65. You should receive an invite in the post from your GP.

If a woman has abnormal results following a cervical screening test, she may have borderline or cell changes (low-grade) or, moderate or severe cell changes (high-grade). This doesn’t mean she has or will get cancer. It just means some of the cells are abnormal, and if they’re not treated they may develop into cervical cancer. Early detection greatly improves the chances of successful treatment and can prevent any early cervical cell changes from becoming cancerous.

Protect yourself against STIs

Sexually transmitted infections (STIs) are passed from one person to another through unprotected sexual contact, including vaginal, anal, and oral sex. Many people with STIs don’t get symptoms, so if you have had unprotected sex but feel fine, it’s worth getting tested.

Use whatever period product feels best for you

Decisions around which type of period product to use should be based on whatever a woman feels most comfortable using, however, women who have concerns about their menstrual hygiene or vaginal health should seek advice from their GP, practice nurse or pharmacist.

Change your tampon regularly

Toxic shock syndrome (TSS) is a rare but life-threatening bacterial infection caused by taphylococcus aureus and Streptococcus pyogenes bacteria. While scientists recognise a link between TSS and tampon use, there is no proven evidence as to why this occurs. It’s believed that leaving a tampon in your vagina for a prolonged time can create a breeding ground for bacteria.

Tampons should be changed every four to six hours, or when it’s saturated with blood, and should not be left in the vagina for more than eight hours as this can increase the risk of TSS. It’s also important to use a tampon with the right absorbency according to how heavy a woman’s menstrual flow is.

Learn to love your vagina

Every woman’s vagina is different in colour, size and shape. Labia are as individual as women themselves and vary in appearance and colour. Women must know that every vagina is unique and that variation in appearance is normal in the vast majority of cases.

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