The vulva and vagina have a "normal flora" of "friendly" microorganisms (including the lactobacillus which turns milk into yoghurt) which help to keep the area healthy. When the normal balance is disturbed, an infection can result.
The generic term for infection of the vagina is vaginitis. Symptoms may include an unusual or unpleasant discharge, itching, or pain during intercourse. But vaginal infections may also be present without any noticeable symptoms.
The following measures are advisable for keeping the vulva and vagina healthy:
Washing once a day or so with water but without soap, since soap disturbs the natural PH balance of the vagina. Other measures are seldom necessary or advisable. Two notable examples: so-called "feminine hygiene sprays" are unnecessary, may be generally harmful, and have been known to cause severe allergic reactions. Vaginal douching is generally not necessary and has been implicated in helping to cause bacterial vaginosis (BV) and candidiasis ("yeast infections").
After using the toilet, wipe from the front toward the back to avoid introducing bacteria from the anal area into the vulva.
Drink plenty of water and urinate frequently and as soon as possible when you feel the need, to help flush bacteria out of the urinary tract and avoid urinary tract infections. For the same reason, try to urinate before and after sex.
Change out of a wet swimsuit or other wet clothes as soon as possible.
Avoid fragrances, colors, and "deodorants" in products that contact the vulva/vagina: sanitary pads, tampons, toilet paper. Some women who are sensitive to these substances should also avoid bubble baths and some fabric detergents and softeners.
Avoid wearing leather trousers, tight jeans, panties made of nylon or other synthetic fabrics, or pantyhose without an all-cottoncrotch (not cotton covered by nylon - cut out the nylon panel if necessary).
Anything which has been in contact with the anal area (see anal sex) should be thoroughly washed with soap and water or a similar disinfectant before coming in contact with the vulva or vagina.
Use condoms, practice safer sex, know your sex partners, ask sex partners to practice basic hygiene (soap and water) of the genitals. Use artificial lubrication during the intercourse if the amount naturally produced is too small.
Be careful with objects inserted inside the vagina. Improper insertion of objects into any body opening can cause damage: infection, cutting, piercing, trauma, blood loss, etc.
Although this may sound strange for doctors who specialize in treating vulvovaginal pain, many of my patients tell me that when they ask their gynecologist about details of sexual activity the doctor becomes visibly uncomfortable.
As it turns out this is simply not the way it works for most vulvovaginal pain sufferers; they do not get back to sex spontaneously after their pain is gone because they have developed powerful habits of sexual avoidance and fear and often have little remaining libido.
Reconnecting to your genitals, exploring them as a source of pleasure, and the extended psychological benefits of self acceptance and self respect are critical aspects in the rehabilitation of all vulvovaginal pain patients.
In the case of recurrent vulvovaginal candidiasis resulting from sexual transmission, whether systemic therapy to decrease the candidal reservoir in the patient or her partner is effective in reducing recurrence is still controversial (8,9).
The cause of vulvodynia is unknown, but some of the many theories suggest chronic irritation from vulvovaginal candidiasis, vestibular papillomatosis caused by human papillomavirus, and reactions to chemicals used to treat condylomata.
Recurrent vulvovaginal candidiasis: a prospective study of the efficacy of maintenance ketoconazole therapy.
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