How to Maintain Proper Intimate Hygiene: Tips and Guidelines - Dr Harpreet Kaur

Intimate hygiene involves maintaining a clean private area to prevent disease. Many women overlook essential practices due to confusion between regular and intimate hygiene. Proper intimate hygiene helps reduce the spread of harmful microorganisms and promotes overall vaginal health.

A little about Vulvovaginal area:

The vulva serves as the genital tract's initial line of defence against infection. Vulvar skin differs from other skin sites in hydration, friction, permeability, and visually discernible irritation and is more affected by topical agents than forearm skin because of its increased hydration, occlusion, and frictional properties.

Contaminants often collect in the vulvar folds, and increased moisture, sweating, menses, and hormonal fluctuations influence local microbial growth, potentially resulting in odour and vulvovaginal infection.

The vagina is the fibromuscular canal extending from its external opening in the vulva to the cervix and is composed mainly of smooth muscle covered with an epithelial lining, which, is thick and moist until the menopause, with mucus from the cervical and vestibular glands and fluid secreted through the vaginal wall keeping the folds wet.

The composition of the vaginal microflora fluctuates a result of internal variables (age, changes in hormones e.g. during menarche, menses, and pregnancy), and infections and various external factors (e.g. sexual activity, using antibiotics, maintaining good hygiene, and hormone replacement treatment).

For a year or two before puberty, until after menopause, a vaginal discharge, consisting of healthy bacteria and desquamated epithelial cells is secreted. The quantity and texture of this change during the menstrual cycle: thick, sticky, at the beginning and end of the menstrual cycle gets progressively clearer, watery, and stretcher This discharge is a natural way to clear the Vagina and keep it healthy and moist.

Following menopause, and as hormone levels fall, vaginal pH increases, and this alkaline pH is associated with increased colonization with infection causing microbes and so Vulvar skin disorders are also more prevalent after the menopause.

Multiple causes are frequently the cause of vulvovaginal illnesses

• Immune Deficiency: More susceptible to infections by bacteria and fungi.
• Hormonal Changes: Causes changes in the vaginal microflora and discharge.
• Stress: Predisposes to diseases since it affects immunity and hormones.
• Use of Vaginal Douche or Soap: Affects the vaginal microflora.
• Vulva: Prone to dermatitis and other dermatological problems, especially when the normal vulvar environment of moisture (urine, vaginal discharge), enzymes (stool residue), friction, and heat damage the skin's barrier function.

Signs and symptoms of vulvovaginal disorders

• Itching: The most common symptom and can sometimes disturb sleep.
• Pain and Discomfort: Due to inflammation.
• Changes in Skin Colour and Texture: Skin can turn red and become thick.
• Malodorous Vaginal Discharge: An odourless, white, curdy discharge with local irritation is also common during the reproductive years. Triggers for symptomatic infection include pregnancy, poorly controlled diabetes, and recent antibiotic use.

How to care for Intimate Areas?

• The vulva is susceptible to contact dermatitis. Take care to avoid contact with irritants, bar soaps and bubble bath wipes. Use a hypoallergenic liquid wash with mild detergency and pH 4.2 to 5.6. Lactic acid–based liquids with an Acidic pH has been demonstrated to be beneficial as an adjuvant therapy, but not as a treatment, for vaginal infections and may improve skin homeostasis.
• Clean the vulva only once a day. Over cleaning can aggravate vulvar symptoms (e.g. symptoms of contact dermatitis). An emollient may be helpful.
• Avoid using sponges or flannels. Just use of hands. Gently pat dry with a soft towel.
• Wear loose-fitting silk or cotton underwear. Put on loose-fitting skirts or pants and use stockings instead of tights.
• Avoid fabric conditioners and biological washing powders. Take into consideration using a non-biological laundry detergent to wash knickers separately.
• Avoid vaginal douching that is spraying water in the vagina that disturbs the vaginal flora.
• Certain over-the-counter lotions, such as those for babies or nappies, herbal creams (such tea tree oil and aloe Vera), and remedies for "thrush," could contain irritants.
• Refrain from often using sanitary towels or panty liners. The use of conventional panty liners (i.e. with a non-breathable back sheet) is a common technique, but it can drastically alter the vulva's microclimate by raising the skin's temperature, surface moisture content, and pH.
• Steer clear of antiseptic in the vulvar area (either as a lotion or applied to bathe water).
• Wear white or light coloured underwear. Dark textile dyes (black, navy) may cause an allergy, but if new underwear is washed before use, it will be less likely to cause a problem.
• Avoid using coloured toilet paper.
• If you are prone to skin irritation, stay away from applying nail polish on your fingernails. To maintain a clean genital area, women of all ages need to practise daily intimate hygiene.
• If you are prone to skin irritation, stay away from applying nail polish on your fingernails. To maintain a clean genital area, women of all ages need to practise daily intimate hygiene.
• Do not use talcum powder.
• Change tampons and sanitary pads frequently, at least every 4–6 hrs. Menstrual cups should also be cleaned every6 hrs.
• Cleanse the vulva from front to back, paying specific attention to the clitoris and vulval folds, both before and after sexual activity.
• After passing Stools also clean from front to back to avoid contamination
• To remove pubic hair safely, take precautions to prevent sensitivity and scars. Hair removal may cause skin microtrauma and subsequent spread of infectious agents throughout the pubic area.
• Pads should be used as needed, and frequent washing and drying should be part of post-partum care. Maintain dryness over any sutures. Do not use any creams.
• Wash hands prior to children’s genital care. Use separate towels.

Intimate hygiene is an essential part of general hygiene and should not be ignored.