Girls, let’s talk about your vagina’s health

Vaginal health is vital for a woman’s health to blossom. Joanna Lee learns from a well-known gynaecologist about the importance of maintaining feminine hygiene and its implications for a woman’s overall health.

It was a healthy and hearty tea time talk about the most sacred (and most taboo part for some parents) of a girl’s body – her vagina and the importance of keeping it clean.

With candid humour and a frank sassiness softened by a motherly tone, Datuk Dr Nor Ashikin Mokhtar, senior consultant obstetrician and gynaecologist as well as founder and executive chairman of PrimaNora Medical Centre educated a small audience of health journalists, both males and females while putting everyone at ease.

The ‘flower’ of vulnerability (thanks, biology)

She began with showing us pictures of the vagina. “The female reproductive system is actually an open system. You can see where the vagina is, which is open on the outside, it leads into the womb, direct into the endometrial cavity”.

“It is important for girls to understand that because of this open system, we are vulnerable to certain conditions,” she cautioned.

“The bacterial colonies from the “neighbours” like the bladder and rectum areas also “visit each other”, Dr. Nor Ashikin explained.

Secretions, the flow of life

“Now, it is natural to have secretions. And depending on the areas where it comes from, the pH or acidity values if it comes from the inside the lining of the uterus or the neck of the womb, it is still alkaline. But as it comes out to the vagina, and the glands outside, this is where it becomes more and more acidic,” she said.

“Secretions happen when you’re having your periods, and there’s a change in the secretions near your ovulation. There’s secretion during the menstrual cycle and especially for pregnancy, during labour, there will be increased secretions. It’s common sense because it’s to plump up the vagina wall so that the baby can go through. There’s also secretion during sexual stimulation,” she said.

What is a healthy vagina?

“The vagina must have an acidic pH. You must have good, friendly bacteria. If you have your friendly neighbours’ bacteria like from the rectum overgrowing there, that’s not going to be healthy,” Dr Nor Ashikin cautioned.

As long as the vagina has an acidity which should not go beyond pH 4.5, the balance between the good and bad bacteria will be maintained.

Beyond pH 4.5, there will be problems for the vagina.

“The lactobacilli bacteria in the vagina produce lactic acid and hydrogen peroxide which can kill the potentially bad bacteria. You really want that so you have more check and balance,” she said.

Why do we have infections?

Changes constantly happen to disrupt the balance of pH and good bacteria in the vagina. “As we grow, and also things like menopause, childbirth, what more if we’ve taken certain medications, such as antibiotics which kill all bacteria (particularly the good lactobacilli),” she said.

Antibiotics kill the bacteria, but it doesn’t kill the fungus and parasites, she reminded the audience.

A person who is immunocompromised like a diabetic person or has been under stressful conditions or has bad eating habits will also have changes to their pH level.

She said some women unknowingly use fragrance products on their vagina which affects the pH balance.

How do we know if we have infections?

“There might be a burning sensation, or there’s a change in the smell, a change in the discharge, and it could give rise to some itching.”

The most common types of infective vaginitis are trichomoniasis where the vaginal discharge is frothy, creamy or yellow-green; vulvovaginal candiadiasis produces thick, cottage cheese type of discharge while bacterial vaginosis causes a milky white, foul, fishy smell.

Why vaginal hygiene is important

“The importance of keeping the intimate area clean goes beyond maintaining good hygiene,” Dr Nor Ashikin emphasised.

Simple preventable infections and vaginal flora abnormalities have been associated with more serious diseases. “If you go for a meeting and you’re itching down there, how can you concentrate?” she asked. “If you have inflammation, you’re going to have painful sex with your husband,” she warned.

“You must have a good environment and good bacteria because it can prevent STDs,” Dr Nor Ashikin said.

“Because the vagina is an open system, an unbalanced environment could lead women to develop pelvic inflammatory diseases because the bacteria goes up and causes inflammation inside the pelvis, the tubes and the ovaries,” she said.

Having premature babies, low birth weight babies or infected babies might be some of the other consequences too. There also might be a longer time of recovery for those who undergo gynaecological operations.

How to keep the vaginal area clean?

  1. Wear cotton underwear, especially for women who have persistently wet vulvas
  2. Thongs – avoid wearing them for long periods.
  3. Change wet underwear immediately after exercise or swimming.
  4. Avoid wearing underwear and pants while sleeping. Better to wear pajamas or sleep naked.
  5. Keep a spare pair of underwear in a small bag or purse for regular change if underwear becomes wet at work or school.
  6. Always clean/wipe the area from front to back.
  7. During monthly periods, it’s important to change sanitary pads often.
  8. Avoid taking unnecessary antibiotics.
  9. Limit the number of sexual partners. After sex, wash the area clean.
  10. Reduce stress

Soaps are NOT for your vagina

“I’m not saying avoid regular soaps. They’re okay for your body, but not your flower. Because again, the pH is acidic. If you use alkaline soap, the pH will change down there.”

She advises instead to use feminine wash, preferably with natural ingredients that support the natural balance and pH of the area that is gentle for everyday use. A fragrance-free feminine wash with the proper pH can help restore the growth of beneficial flora for protection against feminine discomforts.

Lastly, food also affects the health of our reproductive system. She advises strongly against processed foods. A compromised gut can give rise to vaginal candidiasis without one ever having sex.

How moms can talk to daughters about feminine hygiene:

  • Place a feminine wash in common bathrooms in the house where it is visible to your daughter. This makes it a natural part of daily life and may encourage her to ask you questions.
  • Take your daughter shopping for feminine care products, showing her available options and how to choose wisely.
  • Bring your daughter to talks on feminine care.

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