It really isn’t supposed to smell like flowers, cake or pie down there.( To douche or not to douche)

Say it with me…feminine…hygiene…products. Whenever I hear a patient say,” Eww. It smells like vagina down there,” I find myself wondering well what the heck is it supposed to smell like for chrissake? It SUPPOSED to smell like vagina….BECAUSE IT IS A VAGINA! C’mon people. Let’s get real here. I would just like to know who first started the trend of convincing women that it shouldn’t.

Let’s go over a few vaginal facts and a few feminine hygiene product facts. Spoiler alert! They are not actually good for you! I am going to attempt to rationally explain why so bare with me please. What you choose to do with this information is completely up to you, but don’t say I never tried to save your hinterlands from ruin.

OK. Here we go. We all know that feminine hygiene products have been around for what seems like forever. I am talking decades at least. There are wipes, washes, deodorants, douches, creams, sprays, etc. You name it. We’ve got it. Everyone of them is geared toward reducing odor, using after intercourse, or cleaning up vaginal discharge. Did you know that there was a study in 2006 that reported that most women start using douches or feminine washes in their teen years, usually between 15 and 19 but some start as early as 10 years old! Whoah. There are mixed results demographically regarding whether Black and African American women tend to douche more than White and Hispanic women. Some studies say yes. Some say no.

You can see how the advertising gets you. Who hasn’t seen a commercial or a ad about getting rid of period funk or that not so fresh feeling? This kind of marketing can easily make some women ashamed of their own natural odor and set up an unrealistic expectation of some flowery fresh scent that is supposed to be down there. It is just one more way that we are potentially messing with a healthy self image. I am not on board with that. I think I have even found some of that stuff in my daughters’ bathroom!

Let’s talk next about what the biological environment of the vagina and vulva are supposed to be like. Vaginal ph changes throughout the lifetime of a woman. Usually during reproductive years, the pH ranges from 3.8 to 4.4. This range is essential because it allows the normal bacteria of the vagina to flourish. Bacteria called Lactobacillus are supposed to be there to protect it. Well, the pH balance in feminine hygiene products, regardless of what they tell you, is widely variable and usually contain ingredients that make the vagina way too acidic. We have studies that show that these products start wiping out the Lactobacilli within 2 hours and can even eliminate them all together by 24 hours! When this happens, an inflammatory reaction occurs because a substance called interleukin-8 starts increasing because the normal healthy bacteria are not there to stop it. This potentially leads to a much more wide varied growth of different bacteria, which in turn leads to bacterial vaginosis, yeast infections, urinary tract infections, generalized itching and discomfort and even a greater risk of sexually transmitted diseases. A lot can happen when we get rid of the vagina’s natural defense system. On top of killing all the normal bacteria, the chemical in some of the products actually breaks down the vaginal wall. Here’s a kicker on top of that. Once women start having itching or discomfort from the products, they think they need more product to stop the itching! It really is a vicious cycle.

This is the last thing that I would like you to think about. Once you have damaged the vaginal environment, it can be very tough to impossible to restore it. Most research indicates that it will require at least two weeks after the last time a woman used an irritant to get any relief. Let me tell you, that is a rough two weeks without out much recourse available. Those are my patients that end up coming in chronically miserable and there is not a lot we can do but wait for all of the product to leave their system.

Listen, I am not about to call out any products by name but I am telling you that I am not a fan of anything out on the market right now. You never know, new items may come out in the future that are more conscientious of the natural vaginal flora. But, in the meantime, I advise you to just say no!.

Dr. Katz

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