Intimate hygiene is the intimate care for your genital area. Practicing this properly is an important priority for everyone, especially for women, as this is one of the most sensitive areas. Proper hygiene reduces the risk of some infections in this area (1,2). There are many factors that can affect the health of the vulva-vaginal area (vulva and vagina). Some of these are (3,4):

• Tight underwear.
• Unprotected sex.
• Urinary incontinence or other conditions.
• Certain types of antibiotics.
• Some contraceptives, such as diaphragms, condoms, and spermicides.
• The use of some intimate hygiene products.
• Hormonal changes during menstruation, pregnancy, and menopause.

It is important to highlight that, during these stages of life, taking better care of this area is needed to maintain intimate hygiene. At menopause, for example, oestrogen production ceases, so the tissues of the vulva and vagina become thinner, drier, and less flexible (4,5). Due to this, vaginal atrophy and vaginismus are common. So much so that, good intimate hygiene during menopause, as in the other stages, must be a priority (6,7). It is important to remember that some diseases in the vaginal cavity, especially during and after the menopause, may cause bleeding or haemorrhages, for which uterine curettage is usually the cause; always speak to a medical professional if you experience bleeding (8).

Top tips to practice intimate hygiene self-care during menopause

Don't use douches

This may seem a little counter-intuitive, but for good intimate hygiene do not douche unless recommended by your doctor. Your vagina is an organ that naturally cleans itself by producing a secretion, which helps kill germs and bacteria. Therefore, vaginal douches can alter the natural pH (1, 9,10). In practical terms, douching washes away the beneficial bacteria that make up the vaginal flora. This predisposes you to yeast infections and other types of vaginal infections such as vaginitis, which can be accompanied by pelvic pain, dryness, itching and irritation. Also, in the event you have any of these infections, douching won't cure it, it only hides the smell. If you want to properly wash this area, use only warm water and a mild soap. Remember: it is not necessary to clean the inside of the vagina (1,6). Washing the genitals once a day is recommended. You also may do this twice if you play sports or have sexual intercourse that day (11). Remember also not to remove pubic hair (1).

Eat well to maintain proper intimate hygiene

Maintaining a healthy diet can be beneficial for your vagina. Therefore, what you eat and drink can affect vulva-vaginal health. For example, yogurt contains cultures of beneficial bacteria (probiotics), which help promote healthy vaginal flora. So, in order to maintain good intimate hygiene, start by including foods in your diet that are a source of antioxidants, such as vitamins E and C, as well as omega 3 and 6 (6,12).

Keep your vagina hydrated

When menopause begins, the production of oestrogens and other hormones that favour vaginal discharge are interrupted. As a consequence, the skin in this area loses elasticity and appears dry. For this reason, after menopause, the skin of the vagina may need more hydration. To achieve this, the use of vaginal moisturisers and soaps without perfumes is recommended. You can also purchase supplements to keep your skin hydrated from the inside out and from the outside in. Generally, these products contain among others, vitamin E, vitamin C and collagen protein. It is important to consult your doctor before using one of these, so that he can be the one to recommend the best one for you (6,7,9).

Wear cotton underwear

Cotton or cotton-padded underwear allows the skin to breathe. Man-made fibres do not do this, they can heat the skin, cause irritation and sometimes vulva spots. Also, avoid tight nightwear (1,13). In fact, you could choose not to wear underwear to bed, but baggy pyjama pants instead. For day to day, cotton underwear is the healthiest option. In order to keep your underwear hygienic, wash them separately from other clothes and use a mild detergent (1,14). Similarly, do not use sanitary products unnecessarily, such as wearing sanitary pads and tampons when you do not have your period. This can cause excessive heat and sweating, and consequently pain, itching and irritation. If your vaginal discharge is normal, the only thing recommended is to change your underwear frequently (1). Remember that having good intimate hygiene can have a positive impact on the way you experience menopause. With these tips you can practice it correctly.

References

1. Devon Sexual Health. Genital hygiene: our tips . National Health Service. <cited 2022 Oct 31>. Available from: https://www.devonsexualhealth.nhs.uk/your-sexual-health/genital-hygiene-our-tips/
2. Oxleas. What not to wash. How to look after your genital area . National Health Service; 2014. <cited 2022 Nov 2>. Available from: http://oxleas.nhs.uk/site-media/cms-downloads/What_not_to_wash_web_version.pdf
3. Mayo Clinic. Vagina: what’s typical, what’s not . 2022. <cited 2022 Nov 3>. Available from: https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/vagina/art-20046562
4. Chen Y, Brunning E, Rubino J, Eder SE. Role of female intimate hygiene in vulvovaginal health: Global hygiene practices and product usage. Womens Health (Lond) . 2017. <cited 2022 Nov 4>; 13(3): 58-67. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789027/
5. NAMS. Changes in the vagina and vulva . The North American Menopause Society. <cited 2022 Nov 3>. Available from: https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-the-vagina-and-vulva
6. Mayo Clinic. Vagynal atrophy . 2021. <cited 2022 Oct 31>. Available from: https://www.mayoclinic.org/es-es/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288
7. Smith L. What you need to know about vaginismus . Medical News Today; 2021. <cited 2022 Oct 31>. Available from: https://www.medicalnewstoday.com/articles/175261
8. Mayo Clinic. Dilation and curettage (D&C) . 2021. <cited 2022 Oct 31>. Available from: https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910
9. NHS. Vaginal dryness . 2021. <cited 2022 Nov 2>. Available from: https://www.nhs.uk/conditions/vaginal-dryness/
10. Cleveland Clinic. Vulvar care . 2018. <cited 2022 Oct 31>. Available from: https://my.clevelandclinic.org/health/articles/4976-vulvar-care
11. Ferguson S. How to clean your vagina and vulva . Healthline; 2019. <cited 2022 Nov 2>. Available from: https://www.healthline.com/health/how-to-clean-your-vagina
12. Wilson DR. So-called ‘feminine’ hygiene is important for anyone who has a vagina . Healthline; 2021. <cited 2022 Oct 31>. Available from: https://www.healthline.com/health/feminine-hygiene
13. Mayo Clinic. You don’t need Fancy products for Good feminine hygiene . 2016. <cited 2022 Oct 31>. Available from: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/you-dont-need-fancy-products-for-good-feminine-hygiene
14. Feintuch S. Feminine hygiene tips . Healthy Women; 2018. <cited 2022 Oct 31>. Available from: https://www.healthywomen.org/your-health/feminine-hygiene-tips