By Cora Tomowich, MScPT, Hons B Kin
Calling all ladies! You may or may not have ever heard your health care provider(s) talk to you about your vulva, so let’s clarify things: the vulva is the outer part of the female genitals. It contains the labia majora, the labia minora, the clitoris, and the external openings of the vagina and the urethra. I tend to think about the vulva as everything that exists between the pubic bone and the tailbone (aka coccyx). So, when I talk about vulvar care, I mean showing a little TLC to all structures in this area. Join me now for a brief discussion on how to properly care for “down there”:
1. No Soap for the Vulva
The vulva is a self-cleaning oven and does not require the use of harsh soaps or washes to maintain hygiene. Soap and body wash can actually dry out the vulva and lead to skin irritation, breakage, dryness, redness, itchiness, and pain. Instead, use water to clean the structures of the vulva; this does not mean that you should blast them with the showerhead turned to “jet-speed”. Be gentle.
2. No Creams for the Vulva
Unless your doctor has prescribed a cream, you should avoid using regular body lotions and creams on the vulva. They can be significantly irritating to the skin, causing dryness, irritation, and skin breakage. Instead, you may wish to use coconut or almond oil to provide lubrication and/or soothing relief to the vulva after a wax or shave; just make sure you have no allergies prior to use.
3. Be Mindful of Detergents
Some laundry detergents can cause vulvar skin irritation. When washing your undies, consider using a gentle detergent to avoid vulvar pain, itching, burning, redness, etc.
4. Cotton is Your Friend
Always try to wear cotton underwear, except at night when it is recommended that you wear no underwear at all. This will allow your skin to breathe as you sleep.
5. Be VERY Careful with Pads
Only wear pads if you have to. Many experts advise not using pads or panty-liners to collect normal discharge that women experience. If you are using pads for urinary incontinence you should use ones specifically designed for collecting urine (i.e., Poise). If you wear a pad that is designed for menses (i.e., Always) for incontinence, the urine will end up sitting against the vulva, causing irritation and possible infection. If you are using pads or tampons for menses, I always advise using ones that are made from natural materials and do not have any chemicals or bleach.
6. Wipe Front-to-Back
Unfortunately, many women are not aware of proper post-void hygiene. After using the toilet, ensure you are always wiping from the front of the vulva (pubic bone) to the back (coccyx) in order to reduce the risk of infection. If you have just had a bowel movement and you wipe from back to front, you are likely going to brush fecal bacteria into the vulva and significantly increase your risk of getting a urinary tract infection (UTI). Let’s avoid this ladies… always wipe front-to-back.
7. Don’t Hate… Lubricate!
If you are sexually active and find that you experience vaginal dryness, try using a lubricant that is free of irritants and parabens. I have recommended the use of coconut oil as a vaginal lubricant, however, it is important to note that oils degrade condoms, rendering them ineffective. Be sure to discuss alternative protection with your partner, if necessary. And while we are on the subject of sex, be sure to pee after you are finished. Sexual intercourse is good at stirring things up down there, so a post-coital void will help reduce your risk of UTIs.
8. Take Care of Your Diet
What we eat plays a huge role in our health. Researchers have found certain foods to be very irritating to the vulva. Foods with a high glycemic index, such as sugary or processed foods, tend to promote inflammation and pain. This is not a happy scenario for anyone, not to mention people already living with UTIs or vulvar pain. When it comes to nutrition, always consult with a qualified practitioner if you have any specific questions or concerns.
There are all kinds of exercises that target pelvic floor muscles and vulvar health. If you are experiencing vulvar pain, it would be a good idea to eliminate abrasive activities like biking or swimming in a heavily-chlorinated pool and book a time to see your local pelvic floor physiotherapist!
10. Balance, Balance, Balance!
As the research keeps telling us, a lot of the pain that we experience can be worsened or catastrophized if we are stressed, sleep-deprived, anxious, depressed, etc. Many women experiencing vulvar pain often have other stressors in their lives that make pain worse. If you are experiencing persistent vulvar pain, or really any kind of persistent pain, you may benefit from activities like meditation, Qi Gong, Tai Chi, or Yoga to help you find your ease of breath, manage stress, and attain a sense of positive well-being. You may also benefit from counseling to help develop new coping strategies for any stressors in your life.
These are, of course, only a few general tips to help you with vulvar skin care. If you have any specific questions or if you are noticing any changes to your vulvar health (i.e., skin changes, increased sensitivity, pain, irritation, or abnormal odours/ discharge) consult with your gynecologist to rule-out any infections. Once cleared, come see your pelvic floor physiotherapist to help maintain a healthy and happy vulva.
- Strauhal MJ, Frahm J, Morrison P, et al. Vulvar Pain: A Comprehensive Review. J of Wom Health PT. 2007; 31:3, 6-22
Faghani, N. Pelvic Health Solutions [website] http://pelvichealthsolutions.ca