Vaginal Health

Everyone’s body is different, so the things that lead to Bacterial Vaginosis for some people don’t always cause problems for others. But in general, anything that changes the chemical balance in your vagina can lead to BV.
Allergic reactions or sensitivity to different products, materials, or activities can also cause vaginitis. Here are a few ways to keep your vulva and vagina healthy:

1. Avoid potentially irritating feminine products: Don’t use scented tampons and pads, vaginal deodorants, and perfumed “feminine hygiene” products. If you’re worried about the way your vagina smells, your doctor can let you know if it’s normal or not.
2. Stop using any perfumed bath products: Products like soap or bubble bath, laundry products, and scented or colored toilet paper can irritate your skin.
3. Don’t douche: Douching can disrupt your vagina’s natural balance and if you already have an infection, douching can make it worse. Vaginas are self-cleaning, so you don’t need to clean the inside of your vagina. Washing your vulva with mild, unscented soap or just plain water and immediately drying yourself after washing is the healthiest way to clean your genitals. Bacterial Vaginosis has nothing to do with how clean you are, so bathing or douching won’t cure vaginitis.
4. Keep your Genital Area Dry: Bacterial Vaginosis develops more quickly when your vulva is moist, so keep your genital area as dry as possible. Don’t sit around in a wet bathing suit or damp clothes, and don’t wear pants that are uncomfortably tight.
5. Wear cotton or cotton-crotch underwear: Natural fabrics like cotton breathe better and are less likely to hold moisture, making it more difficult for smell-producing bacteria to build up. Keep in mind, it is also important to change your underwear daily.
6. Avoid tight-fitting clothing: Tight-fitting clothing, including thongs, can collect fecal matter that can reach the vagina and cause infections and odors.
7. Menstrual Products: Sanitary napkins, tampons, and pantyliners are disposable feminine hygiene products and should be changed every 4-8 hours. Menstrual cups, cloth menstrual pads, period panties, and sponges are reusable feminine hygiene which must be washed carefully according to their instructions.
8. Wipe from front to back: Doing so after urinating and after a bowel movement helps keep bacteria around the anus from getting into the vagina or urethra and causing an infection. If a finger, sex toy, or penis goes into your butt, wash it carefully before it touches your vagina (or use a new condom over it).
9. Condoms & Contraceptive Devices: The use of a condom prevents contact between semen and vaginal fluids which can disrupt the vaginal pH and trigger odors. In addition, Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth and cause irritation. Stop using them or try a different brand if you have a reaction. If you’re allergic to latex, you can use polyurethane, polyisoprene, or nitrile condoms (they’re made from soft plastics and are latex-free).
10. Wash your genital area before and after intercourse: Sex introduces bacteria, as well as foreign substances like lubrication and spermicide from condoms. Wash before and after sex to help maintain natural bacteria levels.
11. Get to know your genitals: Look at your vulva with a mirror, and pay attention to your regular smells and vaginal discharge. It’s normal for discharge to change a little bit throughout your menstrual cycle. But knowing your body well is the best way to tell if something’s wrong, so you can get treatment as soon as possible if you need it.
12. Consider a vaginal pH regulator product: Over-the-counter (OTC) products, such as GYNALAC, may be helpful for restoring your vagina’s natural pH. If you try one and the odor remains or grows worse, make an appointment with your doctor. You might need to see your doctor for another treatable infection.

When left untreated, Bacterial Vaginosis can cause serious complications and health risks, including:

• Pregnancy complications: Pregnant women with Bacterial Vaginosis are more likely to have a premature or low birth weight baby. They also have a greater chance of developing another type of infection after delivery.
• Sexually transmitted infections: Bacterial Vaginosis increases your risk of getting sexually transmitted infections, including the herpes simplex virus, chlamydia, and HIV.
• Pelvic inflammatory disease: In some cases, Bacterial Vaginosis may lead to pelvic inflammatory disease, an infection of the reproductive organs in women. This condition can increase the risk of infertility.
• Post surgical infections: Bacterial Vaginosis puts you at a higher risk for infections after surgeries affecting the reproductive system. These include hysterectomies, abortions, and caesarean deliveries.

There are a variety of effective treatment options available to treat Bacterial Vaginosis, including over the counter vaginal gels, prescription antibiotics, and alternative remedies. These will help to reduce the risk of experiencing any complications caused by the infection or recurrence.

How Does BV Impact My Overall Vaginal Health?

BV impacts the vagina’s immune responses. Women with BV have an increase in vaginal chemicals associated with inflammation, called interleukins. The white blood cells that fight infection are also compromised, making them more prone to other vaginal infections. The BV-type bacteria also produce the bad smelling chemicals that women experience as unwanted vaginal odor often described as fishy or ammonia-like.

Antimicrobial peptides (AMPs) that fight invading bacteria are normally made by the vaginal mucosal cells. In women with BV, AMP levels are decreased. Iron, zinc and manganese are required micronutrients for the healthy vaginal ecosystem. Abnormal levels of these nutrients (from dietary causes) may increase BV risk. Women with BV have reduced levels of amylase in the vagina, so that glycogen for lactobacillus to eat becomes limited and the good lactic acid bacteria can’t grow. A helpful diagram and discussion about vaginal ecosystem health can be found here.

For about 90% of women that get BV, it develops following a transient and then persistent loss of lactic acid producing bacteria in the vagina. If conditions that favor lactic acid producing bacteria reoccur, the unhealthy BV state will reverse. However, if the bad bacteria populations continue to grow, there won’t be enough glycogen or manganese to feed the healthy lactobacillus species of bacteria. The BV bacteria then make a biofilm at an elevated pH that coats and protects these bad bacteria, making it difficult for the lactobacillus to return to healthy levels.

What Is Vaginal Douching?

The word ”douche” is French for ”wash” or ”soak.” It is a method to wash out the vagina, usually with a mixture of water and vinegar. Douches that are sold in drugstores and supermarkets contain antiseptics and fragrances. A douche comes in a bottle or bag and is sprayed through a tube upward into the vagina. Vaginal douching has become prevalent among women, mostly due to aggressive marketing campaigns which claim that it helps to keep the vagina clean.

Problems Caused by Vaginal Douching

Douches may contain ingredients such as iodine, baking soda, vinegar and other chemicals that can upset the delicate balance in the vaginal ecosystem. Some of the disorders that can be caused by it are mentioned as follows:

Bacterial vaginosis: Douching upsets the natural balance of bacteria in the vagina (called vaginal flora). These changes make the environment more favorable for the growth of bacteria that cause infection. Studies have found that women who stopped douching were less likely to have bacterial vaginosis. Having bacterial vaginosis can increase the risk of preterm labor and sexually transmitted infections.

Bacterial Vaginosis is also the most common vaginal infection and douching has been deemed as one of the leading causes for it.

Yeast infections: Similar to how bacterial infections occur, in this case, yeast known as ‘candida’ can proliferate within the vagina. This fungus is normally present within the vagina, but douching can reduce the bacteria that keep its growth in check, resulting in rapid growth of Candida.

Pelvic inflammatory diseases (PID): PID is an infection of the uterus, fallopian tubes, and/or ovaries. Research has found that women who douche may have a 73% higher risk of getting PID.

Pregnancy related problems: Women who douche more than once a week have more difficulty getting pregnant than those who don’t douche. Douching may also increase the risk of ectopic pregnancy by as much as 76%. With an ectopic pregnancy, the embryo implants outside the uterus. The more a woman douches, the greater the risk of having an ectopic pregnancy. A myth has been floating around that if a woman performs douching after sexual intercourse, it will wash away the sperm and hence prevent her from getting pregnant. In fact, the reverse is true. Douching can often push the sperm up into the uterus causing pregnancy.

Irritation and vaginal dryness: Douching will result in vaginal drying which in turn will cause irritation and itching.

In Summary

According to health experts, including those at the American College of Obstetricians and Gynecologists (ACOG) and the Society of Obstetricians and Gynecologists of Canada (SOGC), you should avoid douching. Having some vaginal odor is normal. However, if you notice a very strong odor, it could be a sign of infection. The acidity of the vagina will naturally control bacteria, and simply washing the vagina with warm water and mild soap is enough to keep clean.