09/14/2017 11:15 EDT | Updated 09/14/2017 11:15 EDT

Your Vagina Does Not Need Fancy Hygiene Products To Stay Healthy

I am horrified that they continue to find a place on the market.

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Lolling in front of the TV one evening, I sat bolt upright when a commercial for a "vaginal wash" appeared on the screen. The product contains "LactoPrebiotic" to "help maintain a healthy pH balance to fortify natural defenses." They recommend women "use it every day as an important step towards good feminine health." Shades of perfumed, daily panty liners, here we go again: A healthy vagina should have a "light and fresh scent."

I assumed LactoPrebiotic was an invented term. But no, there is such an animal. WebMD explains, "Probiotics are 'good' bacteria that help keep your digestive system (my emphasis) healthy by controlling growth of harmful bacteria. Prebiotics are carbohydrates that cannot be digested by the human body ... The primary benefit of probiotics and prebiotics appears to be helping you maintain a healthy digestive system (again, my emphasis)."

Their marketers have extrapolated benefits from one body system to another.

I found an article examining one of these "daily care for intimate skin" products, including a detailed examination of the ingredients.

I am horrified that these products continue to find a place on the market.

We know how to look after our vaginas, and countless articles have been written about maintaining good vaginal health. Even this recent article mentions avoiding douching, but it neglects to warn women away from other vaginal cleansing products. There is plenty of good advice, but also some missed opportunities.

Normal vaginal fluids

Vaginal fluids are normal. Mucus produced in the cervix comes out through the vagina throughout the menstrual cycle indicating the most and the least fertile times in the cycle. Vaginal lubrication is produced by the Bartholin glands. Female ejaculate, a clear fluid that is projected from the urethra, is not strictly speaking vaginal but may be perceived as such.

Women who are aware of their normal vaginal fluids will likely be aware when these fluids look, smell or feel different. Over-the-counter (OTC) products encourage women to self-treat when there is a perceived problem. I often see ads for OTC yeast treatments, and recently one for bacterial vaginosis (BV) came across my TV screen. The latter surprised me, because the treatment for symptomatic BV is antibiotics.

The other issue I have with self treating is that there are several sexually transmitted infections (STIs) that produce similar symptoms, like irritation and unusual discharge. If a woman has had unprotected sex with a new partner, male or female, she would be well advised to have a swab taken to diagnose the problem. If she has chlamydia or gonorrhea, she will need to take antibiotics. Her partner(s) should also be treated. Untreated chlamydia or gonorrhea can result in pelvic inflammatory disease (PID) and eventual infertility or ectopic pregnancy.

I acknowledge that a woman who has had yeast infections in the past and is well aware of the symptoms may choose an OTC medication, but symptomatic BV requires an antibiotic. It has also been linked to PID.

My feminist cohorts were railing about this issue from the early 1970s. Have we come a long way, or are we still stuck in the rose bushes hoping we'll smell like one?

Bayer has a product that claims it can "permanently beat bacterial vaginosis." They say it restores the pH balance in the vagina.

There is no guaranteed prevention for BV.

Women coming to the sexual health clinic where I worked would frequently return with symptoms of BV. I followed the research closely for years as scientists looked for a way to encourage and maintain the vaginal production of the necessary lactobacilli. They did, however, discover some reasons why women may produce fewer of these bacteria critical to vaginal health.

"Vaginal douching or other washing practices are frequently cited as a cause of disturbance of the vaginal flora leading to the onset of BV," they wrote.

"In a prospective study, douching was associated with loss of protective H2O2-producing lactobacilli and acquisition of BV. A case-control study ... investigated associations between vulval washing, vaginal washing, and douching and BV ... Use of bubble bath, antiseptic solution, and douching was more common in women with BV ..."

Vaginas should smell like vaginas

Lysol was once used as birth control (nope, didn't work) but also to help women practice "complete feminine hygiene." For decades, women were told they needed to stay fresh, clean and essentially cover up their natural odours. But being aware of our personal odour is what helps us to monitor our vaginal health. My feminist cohorts were railing about this issue from the early 1970s. Have we come a long way, or are we still stuck in the rose bushes hoping we'll smell like one?

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