Important facts every woman should know about a healthy vagina

The sexual organs of a female are situated both inside and outside the body.

The former includes the uterus, ovaries, fallopian tubes and vagina.

The latter is called the vulva, and includes the outer and inner lips (labia) which surround the vaginal opening.

The clitoris is located at the front where both labia meet. The perineum is the area between the vaginal opening and the anus.

The vagina is a muscular tube that extends from the neck of the uterus (cervix) to the vulva where it opens between the legs. It is very elastic and distensible, enabling it to accommodate the male penis and the baby during labour.

Its shape, size and colour vary. Some are small while others are large, with the latter more common in women who have given birth. The colours vary from light pink to deep brownish red.

The cervix produces colourless or whitish mucous that is discharged from the vagina. The amount and nature of the discharge varies with different phases of the menstrual cycle.

Around the time when an egg is released by the ovary, the discharge becomes thick and stretchable, with the appearance of the white of a raw egg.

Normal discharge is colourless and has no smell. There may be some wetness felt, but there is no itchiness or soreness around the vaginal opening.

Normal bacteria

The bowel contains the most bacteria in the body. Next to it is the vagina, which contains bacteria that maintains vaginal health.

This bacteria is called lactobacilli. They produce acid which keeps the vaginal pH acidic (less than 4.5). They also have natural antibodies which kill or reduce harmful bacteria that may enter the vagina, and a substance which prevents any invading bacteria from sticking to the vaginal walls.

The amount and quality of the lactobacilli decreases with any increase in the vaginal pH (i.e. when it becomes less acidic). When this happens, other microorganisms multiply, leading to infections like bacterial vaginosis and candidiasis (thrush).

These infections cause symptoms which include abnormal vaginal discharge, vulval itchiness and vulval irritation.

The vagina cleans itself naturally with its secretions, which appears as a discharge, the amount and quality of which varies with different women, and even with the same woman at different phases of her menstrual cycle.

Gentle washing of the vulva with water and plain bath soaps daily is all that is necessary. During the time of the menses, it may be advisable to wash more than once a day. It is also important to keep the perineum clean by washing it during bath time at least once daily.

It is advisable to only use plain bath soaps that are non-allergenic. Many women use perfumed soaps, gels and antiseptics because of a mistaken belief that it keeps their vulva and perineum clean, and prevents infections.

The truth of the matter is that these compounds affect the healthy balance of bacteria and cause the vaginal pH levels to change, leading to irritation and infections.

What is well intentioned can have deleterious consequences.

Vaginal douching

This refers to the practice of washing or flushing the vagina with water or other liquids. The douches are available, in pharmacies and supermarkets, pre-packed with water usually mixed with various compounds including vinegar, baking soda or antiseptics.

Many women douche because of their belief that there are health benefits i.e. cleaning the vagina, getting rid of menstrual blood, getting rid of odours, and even prevention of infections and pregnancy.

There is no basis to these beliefs.

On the contrary, douching disrupts the balance of bacteria in the vagina and can change the normal vaginal pH. The change in the normal bacterial composition of the vagina leads to an increased risk of infections. Douching can also lead to the spread of harmful bacteria further up into the genital tract if there is already an existing vaginal infection.

There is no evidence that douching protects against pregnancy. Neither does it protect against vaginal infections, including sexually transmitted infections (STI). In fact, it increases the chances of infections including STI.

Gynaecologists do not recommend douching because there is no circumstance in which it is helpful. All that douching does is to wash out everything in the vagina, including the lacobacilli.

Perfumed soaps, gels, wipes, deodorants and antiseptics

Perfumed soaps, gels, wipes, deodorants and antiseptics are used by many women who believe that the vagina and its secretions should have specific odours.

Had Nature intended it to be so, it would have made it so.

It is normal for the vagina and its secretions to have an odour. The odour changes with the different phases of the menstrual cycle. Washing with water and plain, non-allergenic bath soap is all that is necessary to keep the vagina healthy.

If the vaginal odour is unpleasant, it should not be covered up by using perfumed soaps, gels, wipes, deodorants or antiseptics.

Instead, a consultation with the doctor is advisable as there is the possibility of an infection that needs treatment.

The most common cause of an abnormal vaginal discharge is bacterial vaginosis, which has a fishy odour. This condition is treatable with a course of antibiotics prescribed by the doctor.