Caution: Four things to avoid for your vaginal health.

Some things are true about your vaginal health: your vulva and vagina are delicate and deserve to be taken care of. Also true is that our society and sometimes our cultures can create toxic narratives about how you should take care of yourself.

Let’s be real. You’ve either had your abuela tell you to douche daily, had a lover tell you that your vagina needed to smell less like “vagina”, or have fallen victim to Snake Oil Salesman Gwenyth Paltrow’s dangerous vaginal health recommendations. Clearly, vulvovaginal care can take on many forms. But most of those can actually cause harm. Let’s get into it by diving into four things that you should avoid for your vaginal health.

1. Douching.

I still remember my first time…seeing my mom’s douche under the sink, that is. I also remember my grandmother’s bottle of herbs suspended in water at the side of her tub, presumably used for cleansing. Two generations of unrelated Cuban women, having been duped into thinking there was something about them that needed to be sterilized. You see, douching is as old as time. Literally — the practice dates back to ancient times. And the history is fascinating.

To douche is to squirt a liquid into the vaginal cavity in an attempt to eliminate odor, prevent pregnancy, treat an infection, or cleanse after intercourse or menses. For birth control, ancient women would douche with olive oil, honey or wine. And because infections were so rampant, medieval prostitutes would douche between clients*. But it really entered American consciousness in the 19th century. Physicians had been telling women to douche for hygiene purposes for years, but it took on a whole new life when they began to recommend douching as a contraception method. In fact, Dr. Charles Knowlton published his book on marriage in 1832 where he advised to douche with a concoction of ‘sulphate of zinc, alum, pearls, or any salt that acts chemically on the semen’ to avoid pregnancy. This is when douching got serious*.

By the late 19th century, medical journals (ahem, New England Journal of Medicine) were writing about the need to disinfect a vagina with a “corrosive sublimate solution” if it was found to be “foul” smelling after a vaginal delivery. And the ‘Monthly Retrospect of Medicine & Pharmacy’ published a list of “fluids to be used for vaginal douching,” which included: chloride, carbolic acid, iodine, mercury, zinc and Lysol disinfectant. That’s right, Lysol*.

Although today’s Lysol is very much different than yesteryear’s, it was explicitly marketed in the 1920s for feminine hygiene and as a contraceptive douching agent*. It should go without saying that this was incredibly harmful — doctors had already reported 193 poisonings and 5 deaths from Lysol douching before 1911*. Still douching persisted. By the 1940s, douching was the most popular method of birth control. But then came the advent of the birth control pill, so advertisers doubled down on douching for hygiene, which then had sales soaring through the ’70s and ’80s*.

Which brings us to today. Look how deeply rooted douching has been in our culture. It’s no wonder that 1 in 5 women still douche*. It’s especially prevalent among adolescents, African-American women, and Hispanic women*. Though they may not contain the incredibly harsh and corrosive solutions they used to, douching is still dangerous.

You see, the vagina is incredibly smart (at least I’d like to think so). It is not only self-cleansing, but it maintains its own normal flora, preventing the overgrowth of unwanted bacteria. When this flora is disrupted, like through douching, an infection of bacterial vaginosis (BV) may develop. Though treatable with antibiotics, bacterial vaginosis increases a woman’s risk of acquiring STIs such as gonorrhea, chlamydia and HIV. If you’re pregnant, BV may cause preterm birth or a low-birth weight baby*.

Not only does douching disrupt the natural microbiome of the vagina, but it may provide a fluid vehicle for pathogens to be flushed up the vagina and colonize the uterus, Fallopian tubes and the abdomen. This can then lead to infections of the uterus (endometritis), chronic pelvic pain, pelvic inflammatory disease, and most seriously, infertility*.

There is never a situation when douching is recommended. And it certainly should even be hinted at by a physician!

2. Feminine Washes.

If the vagina is a self-cleaning organ, why are there so many hygiene products targeted at women? Well, it’s all business. If there is nothing to fix, there would be nothing to sell. And what better way to sell feminine washes than to convince women their natural odor or discharge means there is something inherently dirty about them? And from a vaginal health perspective, feminine washes can wreak havoc!

Feminine hygiene products contain a lot of fragrances and dyes that can be harmful to your vulvovaginal health, as they can cause irritations and allergic reactions. Some of their products even claim that they are “fragrance-free”, but still may contain harmful chemicals like essential oils and parabens. Because of all these chemicals, products like Summer’s Eve and Vagisil disrupt the vagina’s normal pH. The normal vaginal pH is acidic, and usually lives anywhere between 3.5 and 4.5. This is the pH range that the good bacteria that keeps us healthy, Lactobacillus, likes to live at. Anything higher (more basic), and bad bacteria and parasites can take over. This disruption of the normal bacteria of your vagina, can lead to discharge and odor, and even bacterial vaginosis. In fact, Vagisil has even been demonstrated to directly kill Lactobacillus.

So how do you cleanse your vulva? Use warm water! Really, that’s all you need.

3. Steaming.

Oh, vaginal steaming. As if your vulva was a vegetable. Also known as Yoni Steaming, vaginal steaming is when a woman sits over steaming water infused with herbs, like mugwort, chamomile, basil, oregano and wormwood. This herb steam then is said to cleanse the vagina and uterus, ease period cramps, decrease bloating, regulate menstruation, and improve fertility and sexual pleasure*.

Though common practice in many corners of the world (Africa, Asia, South America…), it got a bump in popularity in the United States by the Goop herself, Gwenyth Paltrow. In 2015, her website quoted her gushing about vaginal steaming at an LA spa, stating, “The real golden ticket here is the Mugworth V-Steam: You sit on what is essentially a mini-throne, and a combination of infrared and mugwort steam cleanses your uterus, et al. It is an energetic release — not just a steam douche — that balances female hormone levels. If you’re in LA, you have to do it.” I could no longer find the reference on her website, but it was quoted and loosely discredited here. And in true terrible-gifts-that-keep-on-giving fashion, Harper’s Bazaar resurrected her recommendation in this 2021 article. Eye roll.

The thing about steaming is that it actually has no scientifically-proven benefit for your vaginal health. And while innocuous enough, vaginal steaming can actually be harmful. First of all, it can cause some serious burns. A 62-year-old woman in Canada sustained second-degree burns during a vaginal steam to treat pelvic organ prolapse. Imagine burning your delicate vulva, or even your urethra. *shudders*. Secondly, steaming with herbs, just like any other unnatural cleansing of the vulva and vagina (like douching!) can throw off your natural bacteria. This can then cause overgrowth of pathogens and bam! you have BV (hey, we have a running theme here!).

So yeah, don’t get burned by vaginal steaming. See what I did there?

4. CO2 Vaginal Lasers.

I’m sure you’ve heard of them. If you live in Miami then your Ob/Gyn’s office likely has one. Vaginal lasers are increasing in popularity for “vaginal rejuvenation” and treatment of postmenopausal vaginal symptoms like dryness and itching. There is a tiny problem with these CO2 lasers, though. They’re not, in fact, FDA-approved for the conditions listed above.

CO2 lasers like the MonaLisa Touch were cleared in 2014 by the FDA “for use in general and plastic surgery and in dermatology.” This clearance, however, was how the manufacturer registered the device. It was not an actual approval by traditional standards, like how the FDA clears medications for use. What’s more is that they are classified as a Class II device, not a Class III device that actually needs pre-market approval from the FDA. Four years later, the FDA issued a warning to providers and patients explaining that the safety of the devices had not been established for cosmetic procedures on the vulva and vagina, and had actually caused “numerous cases of vaginal burns, scarring, pain during sexual intercourse, and recurring or chronic pain.*”

There’s also a lack of evidence to support their use. Earlier research trials reported high treatment response rates, but they were not randomized, bringing into question their true success. Published in JAMA in October 21, this sham-controlled, double-blinded randomized control trial demonstrated that there were no significant differences in symptoms between women in the fractional carbon dioxide laser group and those women who received the sham treatment. The laser literally provided no benefit.

Besides there being no demonstrable benefit, these machines have been demonstrated to cause vaginal pain, scarring, and painful sex*. And for this one patient who had treatment with the MonaLisa Touch for the prevention of UTIs, her bladder pain became so severe that she contemplated suicide.

It should go without saying that no treatment method for any malady should do you harm. There are much safer treatments for vaginal dryness, itching and painful intercourse, especially if you’re postmenopausal. Make sure to have a chat with your Ob/Gyn at your next visit if you’re having these symptoms!

Vaginal health tl;dr:

Your vaginal health is important, but needs much less for it to remain healthy than what we think! Always use warm water to cleanse, and absolutely avoid douching, feminine washes, steaming and CO2 lasers. When in doubt throw it out, and definitely have a conversation with your Ob/Gyn about it!

If you’re in the Miami area and are looking for a new Ob/Gyn to talk to about these topics, you can always make an appointment with me by calling the clinic or booking online. I explore this and other subjects on my Instagram, so make sure to follow along!

Disclaimer: All content is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis or medication treatment of a qualified physician. Should the reader have any health concerns, promptly seek a consultation with your physician.