English Version | To wash or not to wash?

That is the question. We already know that it’s not easy to take care of the female body, but nothing raises as many questions as the (best) way to take care of our intimate parts. Amidst soaps, deodorants, wipes and a multitude of inventions, it’s worth realising which are the real demands of our vulva. 

Feminine intimate hygiene. The topic was mentioned a few days ago, in the office, and it was impossible not to notice the different opinions that came with it. If, on one hand, some of the women involved in the discussion followed a daily routine which was repeated religiously, others had never thought about it until that moment. And it’s interesting to see that that diversity was based on the plurality of perspectives that had been expressed to each of the women by their doctors. It seems like there’s still no great consensus when we arrive at the doctor’s office and ask: “Should we be washing our vulva?” In the words of Ana Isabel Machado, gynaecologist: “It is important [to wash it] because, given the proximity to the perineum, uretra and anus, there’s a greater risk of contamination.” Before we go on, there’s a difference that needs to be highlighted. Notice how, in the previous question, we were referring to the washing of the vulva, not the vagina. That is because, when we are talking about feminine intimate hygiene, it’s for the exterior part of the female genital organ that the solutions are presented. Just like the gynaecologist explains, “you don’t wash the vagina, because it has ability to wash itself.” As a consequence, we should avoid practices such as the “vaginal douches”, since these “can stimulate the growth of other bacteria that can be harmful.” Other bacteria? That is correct. Our vaginal flora is made out of a multitude of bacteria and microorganisms that live in balance. That is why we need to be so careful regarding the products that we apply on our intimate parts, since the slightest of imbalances can result in an infection that will have consequences for our vaginal health. 

Let’s start with the basics, that type of knowledge that should be passed on during those sex education classes that lack so much in schools. Washing the vulva is something that should be made “from front to back” and drying “with a dry, soft towel, without rubbing”, clarifies Ana Isabel Machado. Regarding frequency, it should be “between one to two times a day”, as a way to “clean well without overdo it”. Everything seems right up to here. The problem starts when we introduce the products to be used. There’s at least something that should be taken into account, no matter the chosen option: “We should not use the same shower gel or even soap that we use on the body, since the skin’s characteristics are different from the characteristics of the vaginal mucosa and the external part of the vulva. These products have a different pH and can change the vaginal flora.” Due to the specific needs and demands of our vulva, we should opt for products “with little perfumes” and a pH that goes from “3,5 to 4,5.” However, the feminine intimate hygiene product market is pretty big and seeks to answer some needs that go beyond a simple wash. But are they really beneficial for our health? “The vaginal creams should only be used if needed, and there times in life when it can be really important to use vaginal creams for hydration”, the specialist in gynaecology says, pointing out the menopause, the postpartum and other situations of imbalance caused by a previous infection like some of the moments where using these types of products is important.

According to Ana Isabel Machado, there are two groups of creams made for the female intimate area: the lubricants and the hydrating ones. “The lubricants”, which are also known as “aqueous creams, for having water in the mix”, are used “during sex” and “only hydrate in that moment.” On the opposite side, “when the mucosa is really dry, it’s important to apply a hydrating cream.” Many of the hydrating creams that exist in the market have hyaluronic acid in their composition, which does not only acts in the moment, but also provides a more long-lasting effect. For the gynaecologist, “if it’s during the menopause, many times is to [wear] for the rest of life. If it’s after birth or an infection, it can be simply during a few days or months.” But not always does this routine comes with positive results. In the case of there being an excessive washing, it can “change the vaginal flora”, manifesting itself as an “infection”. The gynaecologist highlights symptoms like an abnormal flow or a bad genital smell as ways to realize when such an imbalance can be happening. In the same way, certain products can be “really aggressive agents”, causing an “erythema”, that happens when “the vulva gets redder and there is a local rash.” When these type of situations take place, Ana Isabel Machado says “that you should go to a general doctor or a gynaecologist”, because these will be the professionals that are able to reestablish vaginal health in the safest way.   

Translated form the original on The Body Issue, from Vogue Portugal, published March 2022.Full stories and credits on the print issue.