Your Vagina: An Owner’s Guide, Part 2

Tuesday, July 8, 2014

The Oregon Clinic

How to Keep Your Vagina Healthy, or How to Properly Tend Your Vagina Garden

This blog is an excerpt from the book A New Cycle – Your Guide to a Better Period, Naturally.

Read Part 1 Here!

Frequently Asked Questions

What does a healthy vagina/vulva look like?

That’s kind of like asking, “What does a healthy nose look like?” Like women, vaginas come in a variety of shapes, sizes, colors, and styles. Some have narrow outer labia, and others have big juicy lips. Some women have tiny inner labia you can’t see from the outside. Some have very long inner labia that protrude like flower petals from within the outer labia. On average, inner labia are about three-quarters of an inch long to over two inches long at the longest point. But just like the penis, vaginal tissues can change in size when they’re turned on. Arousal brings a tidal wave of blood flow to the area, increasing sensitivity and size. Labial colors can range from black to brown, peachy to pink, purplish-violet to blue! Many women will have some combination of these colors. In addition to being nice window dressing, the vulva serves some pretty useful functions: it acts as a protective screen, keeping unhealthy foreign bacteria out. It also increases friction and lubrication during sex, which for many women increases sexual pleasure.

Many women’s sense of what a vagina is supposed to look like comes from some pretty dubious sources: porn, the locker room, and taking care of babies or small children. Many women worry that there’s something wrong with their inner labia because they “stick out.” Some people feel badly enough about the shape of their vagina that they consider having surgery to “fix” it. This is unfortunate on several levels. First, it shows that many folks think their vagina is shaped wrong, when in reality there is a wide range of normal in terms of vagina shapes. Second, so-called vaginal rejuvenation surgeries can damage the blood and nerve supply. Translation: sex won’t feel as good if you get plastic surgery on your vagina. What’s the good of having a “perfect-looking” vagina if you can’t have as much fun with it?

Which brings me to my next point: what your vagina looks like is less important than what it can DO! Vaginas are pretty amazing: they can bring us sexual pleasure, give sexual pleasure to others, open to bring babies into the world, and give us a sense of connectedness to other women. They are complex and diverse, just like the women to whom they belong. There is an equal degree of diversity among vagina enthusiasts. Some folks find longer, more “flowery” labia to be a huge turn on. Some like a full bush, others prefer trimmed hedges. I invite you to work on loving the unique vagina you were born with and celebrating its unique shape, size, color, and scent.

What should a healthy vagina smell like?

A healthy vagina should smell exactly like a vagina. Just like a good bar of chocolate should smell like…well, chocolate. And the “vagina smell” can be pretty different from lady to lady. Your signature aroma is based on your personal rainforest of bacteria, what you ate for dinner, what type of undies you wear, how and how often you bathe, where you are in your menstrual cycle, and what your glands contribute to the equation. Vaginas are supposed to have a smell; they are a reservoir of scents that help us to attract a mate. An informal poll of folks who have spent a fair amount of time around healthy vaginas yielded the following descriptors: musky, metallic (especially right before a period), pungent, tangy, salty, sweaty, primal, like the ocean, like wet sand, and like “an oyster with a drop of soy sauce on it.” Vaginas are definitely not supposed to smell like perfume, roses, peaches, or spring rain! Perfumed sprays and douches are designed to make vaginas not smell like vaginas. Would you want eat a chocolate bar that smelled like Irish Spring?

Sometimes the vagina can get a funky smell reminiscent of fish, garbage, bread, or bleach. This is often because the normal vaginal balance has gotten out of whack: there’s something in there that usually isn’t. This can be due to a bacterial or fungal infection, the presence of semen after sex, or a sexually transmitted infection. A common response to a funky-smelling vagina is to use a perfumed spray, soap, or douche to cover up the odor. This is problematic in several ways. First, vaginal deodorants don’t get rid of the smell, they just add another smell on top. Second, these products can worsen the imbalances that caused the odor in the first place by killing off the healthy bacteria that keep outside invaders in check. Finally, they will not address any underlying problems that are making your vagina smell funky.

To reduce the likelihood of “bad” vaginal odors, see the previous section on how to care for your healthy vagina. If your vagina smells less like a vagina and more like something gnarly, get it checked out by your health care provider. They can do tests for infection, suggest treatments if needed, or even just reassure you that everything is just as it should be.

Should I shave my pubic hair?

Some ladies prefer more hair, some ladies prefer less hair. It depends on what style you like. That said, the hair down there does serve a purpose: it is one of our bodies’ methods of keeping out harmful bacteria and other unwelcome guests. It also provides a home for the awesome pheromones that are involved in sexual attraction, so consider that before mowing your lawn. Plus, shaving can cause skin irritation, infections, and rashes (none of which are super sexy), and it takes up valuable time, so some people prefer to just skip it. Waxing and laser hair removal hurt like the dickens, and cost loads of money to boot. If you prefer a less-bushy look, you can always just trim your pubic hair, which gets you the benefits of having some hair down there without the irritation, cost, or pain of other hair removal techniques.

Does discharge mean I have an STD or an infection?

Nope. Your vagina is a self-cleaning oven. That discharge is your body’s way of flushing out unhealthy bacteria. Normal discharge can be white, clear, or yellowish. How much vaginal discharge you make varies widely. Normal, healthy women can produce lots of discharge; others are less juicy. As long as you have no itching or odor, and you’re reasonable certain you haven’t been exposed to any STIs, you’re probably just fine. If in doubt, see your friendly, local health care provider.

I keep getting yeast infections! What should I do?

First, make sure it really is a yeast infection. A recent study showed that most women who diagnosed themselves with yeast infections actually had other infections; only 35 percent of women who thought they had yeast actually did (Ferris, 2002). You might protest: “But I’ve had yeast infections before. I know that’s what this is.” However, the same study found that women who had previously been diagnosed with yeast infections were no more likely to correctly diagnose themselves than women who hadn’t had yeast before. Whoa! Be cautious with self-treating your “yeast infection” that keeps coming back.

If you do have true recurrent yeast infections, I’m sorry. Chronic yeast is tough to live with and tough to treat. Try to eliminate conditions that encourage the growth of yeast: avoid scented panty liners, sprays, and douches, wear breathable cotton underwear without panty hose, and reduce sugar and simple carbohydrates in your diet (especially if you are diabetic; yeast loves sugar). If you are on a high-estrogen birth control pill, consider switching to a lower-estrogen brand.

Unfortunately, there is a lack of scientific evidence supporting the effectiveness of various natural treatments for yeast like garlic, probiotics, tea tree oil, and boric acid suppositories. Then again, there are no pharmaceutical companies making millions selling garlic, so this does not mean these methods are ineffective—only that they have not been well studied. There are studies supporting the efficacy of prescription antifungal pills for treating chronic yeast symptoms and reducing the frequency of infections, but these pills need to be taken on an ongoing basis, and 50 percent of women will start getting recurrent yeast infections again once they stop taking them (Sobel, 2004).

I occasionally recommend that women with tough-to-treat, recurrent yeast try one of the natural treatments for yeast, and I have seen varying degrees of improvement. You can buy probiotic pills, which contain large quantities of healthy bacteria, at most natural food stores. Make sure they are refrigerated, or the bacteria won’t survive to do any good. Boric acid suppositories can be purchased at some specialty pharmacies, or you can make your own. In general you can find boric acid powder behind the pharmacy counter (you don’t need a prescription). Buy a bottle of that and some size 0 gelatin capsules, available at natural food and supplement stores or online. Open the capsule, use one half to scoop up the powder, pop the other half on, and put it in your vagina before you go to bed at night for prevention of yeast or three times a day for a week for treatment of yeast or bacterial vaginosis. Wearing a panty liner can be a good idea, as some women experience some watery discharge after use. Boric acid is not safe in pregnancy, should never be taken orally, and is not appropriate for everyone, so check with your health care provider before using this treatment.