Many people use so-called feminine hygiene products â€” such as intimate cleansers and wipes, douches, and even deodorants â€” hoping to feel clean and fresh. Do these products really help maintain genital health? In this Spotlight feature, we investigate.Is it ever advisable to use ‘feminine hygiene’ products?
In high school, I used to take a class called “education for health,” which was an eclectic mix of general biology and sex education rolled haphazardly into one.
As fun-loving teenagers, many of my classmates would ask questions and recount anecdotes they hoped would spook our long-suffering teacher.
One of their questions, however, genuinely piqued the interest of all the girls in the class.
Her good friend, she said, used intimate cleansers on a daily basis. Despite this, she ended up with a bad vaginal infection. “How was this possible?” my classmate wondered.
Our teacher then explained that overusing cleansers, even ones labeled as “safe” for intimate areas, could upset the delicate intimate balance of the vagina and give rise to infections; but was our teacher right or wrong in her assessment?
So-called feminine hygiene products â€” which include different types of intimate washes, wipes, shaving gels, and lubricants, but also intimate douches and products for alternative care procedures, such as vaginal steaming â€” are popular in many countries around the world.
Statistics show that the feminine hygiene market, on the whole, brought millions of dollars into the economies of dozens of countries in 2017 alone, with China and the United States leading the field.
In the U.S. in 2018, sales for vaginal treatments amounted to over $286 million, and those for douches to $41 million. Meanwhile, other types of feminine hygiene products â€” excluding sanitary napkins, pantyliners, and tampons â€” brought over $309 million into the economy.
Yet in recent years, one mantra has become pervasive across medical and wellness websites and on educational materials discussing vaginal health â€” namely, that “the vagina is a self-cleaning oven.”
This idea refers to the fact that the vagina naturally produces discharge that eliminates dead cells and bacteria, so there is no need to clean it using soaps, washes, or douches.
So if the vagina does not require any additional cleaning, does this mean that the same rule applies to the vulva? And how can different intimate hygiene products affect vulvovaginal health? These are some of the questions that we will tackle in this Spotlight feature.
Vulva and vagina basics
First things first: What is the vagina, what is the vulva, and what is the difference between the two? In medical terms, the vagina refers to the internal muscular tract extending from the cervix to the vaginal opening.
The vulva is the external part of the female genital tract, which includes:
the inner and outer labia (labia minora and majora)
the glans clitoris (the external part of the clitoris) and clitoral hood (the fold of skin protecting the glans clitoris)
the vestibule (which surrounds the vaginal opening)
the urethral opening
To maintain vulvar and vaginal health, a person must ensure that two important aspects remain balanced: their pH, which is a measurement that denotes something’s acidity or alkalinity, and their bacterial balance.
Studies indicate that vulvar pH is usually 3.5â€“4.7, while vaginal pH varies according to a person’s age and the stage of their menstrual cycle.
So, before a person reaches reproductive age and starts menstruating, their vaginal pH will be 7 (neutral), whereas a person of reproductive age may have a vaginal pH of 3.8â€“4.4. At menopause, depending on whether or not a person undertakes hormone replacement therapy, their vaginal pH may be 4.5â€“5 or 6.5â€“7.
When it comes to understanding what constitutes a balanced microbiome in the vagina versus the vulva, however, matters become less clear.
In the vagina, bacterial populations shift depending on the phase of the menstrual cycle and, according to some studies, people of different ethnicities also have different vaginal microbiota.
As for the vulvar microbiota, specialists have conducted only a few studies with the aim of determining what a normal vulvar bacterial population should look like. That said, existing research does suggest that the vulva naturally features bacteria present in the vagina as well as some species present in a person’s feces.
However, as one study that names these characteristics concludes, “the vulva is more complex than originally thought,” as vulvar bacterial populations appear to vary greatly among people.
Which products are unsafe?
Considering we know so little about what a healthy vulvovaginal environment should look like â€” in part because it can differ so much from person to person â€” it can be difficult to outline clear guidelines on what products someone should use when it comes to intimate hygiene.
Using douche syringes and cleansers can upset the vaginal microbiome.
However, studies looking at the connection between feminine hygiene products and the development of vaginal infections have drawn some strong conclusions as to which products and procedures a person should avoid when caring for their vagina and vulva.
Douching involves “flushing” the vagina with water or various cleansers, including homemade solutions of water and vinegar, sometimes with the help of specially designed implements. This technique is as widespread as it is unhealthful.
Several studies have found that douching can upset the natural bacterial balance in the vagina, rendering it more vulnerable to infections â€” including sexually transmitted infections â€” and increasing a person’s risk of cervical cancer and pelvic inflammatory disease.
In 2018, researchers from the University of Guelph in Ontario, Canada, concluded that the use of gel sanitizers was linked with an eightfold increase in a person’s risk of developing a yeast infection, and a nearly 20 times higher risk of getting a bacterial infection.
The same study also found an association between the use of intimate washes and a 3.5 times higher risk of bacterial infections, and a more than twofold higher risk of having a urinary tract infection (UTI). The scientists noticed a similar association between using intimate cleansing wipes and UTIs.
“These products may be preventing the growth of the healthy bacteria required to fight off infection. Our society has constructed female genitalia as unclean, and the marketing of vaginal hygiene products as something women need to attain the ideal is contributing to the problem.”
Lead study author Kieran O’Doherty
An older study in the journal Sexually Transmitted Diseases suggested that people who took bubble baths, applied antiseptic solutions to the vulva or vagina, or used store-bought or homemade solutions and washes to clean the vagina were more likely to have bacterial vaginosis.
Moisturizes and spermicides may also cause harm. According to one 2013 in vitro study, Vagisil feminine moisturizer and a spermicide (Nonoxynol-9) quickly stifled the growth of “good” bacteria (Lactobacillus) usually present in the vagina.
The researchers explain that Nonoxynol-9 “completely killed the bacteria,” while Vagisil significantly suppressed Lactobacillus growth.”
What are some good practices?
When it comes to keeping the vagina clean and healthy, guidelines from the Office on Women’s Health state that “[i]t is best to let your vagina clean itself” through the discharge it naturally produces.
If a person is worried about vaginal discharge changing color or acquiring a particular smell, they should speak to a healthcare provider to check for a potential infection.
Although many people may be concerned about vaginal odor and buy into products that claim to eliminate it, it is normal for vaginas to have a unique, musky scent.
However, if cleaning the vagina is unnecessary and even harmful, what about cleaning the vulva? Evidence regarding whether or not cleaning the vulva is helpful has often been inconclusive.
A 2017 review of specialist literature suggested that a person should regularly clean the skin of the vulva with mild, unfragranced, soap-free washes to prevent the buildup of sweat, menstrual blood, dead cells, and other biological material that could accumulate harmful bacteria.
This advice is based on various official guidelines suggesting the use of “gentle hypoallergenic liquid washes” to clean the vulva. One such set of guidelines is that which the Royal College of Obstetricians and Gynecologists issued in 2013, which say:
“Washing [the vulva] with water and soap may cause dry skin and make itching worse. Using soap substitutes can be soothing and protective, and will stop the skin from becoming as dry and irritated. Aqueous cream (a special type of moisturiser […]) can be used instead of soap.”
However, the guidelines also warn that overwashing the vulva (cleaning it more than once per day) can irritate it and harm its health, and that in cleaning this part of the body, a person should “[a]void using sponges or flannels” and only pat it gently with a soft towel to dry.
In short, the consensus among gynecologists seems to be that vaginas and vulvas are mostly fine by themselves, and that assaulting them with soaps, perfumes, creams, and gels is likely to cause more harm than good.
If you are worried about the shape, look, smell, or feel of your vulva, the best place to go is not the drug store or the internet for anecdotal advice, but to your doctor.
They will give you the correct information you need and will help you decide on the best course of action â€” if any action is necessary at all.
Vitamin D sufficiency may reduce complications of COVID-19
A recent small-scale study has concluded that hospitalized patients with COVID-19 are less likely to have life threatening complications if they have sufficient vitamin D levels.A new study demonstrates that people with sufficient levels of vitamin D are less likely to develop life threatening COVID-19 complications when hospitalized with the disease.The research, published in the…
A recent small-scale study has concluded that hospitalized patients with COVID-19 are less likely to have life threatening complications if they have sufficient vitamin D levels.A new study demonstrates that people with sufficient levels of vitamin D are less likely to develop life threatening COVID-19 complications when hospitalized with the disease.The research, published in the journal PLOS ONE, could be valuable for doctors attempting to reduce the mortality rates of COVID-19 in the absence of an effective vaccine.If further studies back up these findings, vitamin D supplements might offer a cost-effective way to limit the risk of severe COVID-19. It is important to note that this recent study has several limitations, which we address below.Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.Since the sudden emergence of the virus SARS-CoV-2 and the disease that it causes, COVID-19, scientists have paid a great deal of attention to the development of a vaccine. Experts consider a vaccine to be crucial in reducing the effects of the virus, even if it is not yet clear to what extent an initial vaccine would moderate rates of transmission and infection.Alongside the endeavor to develop a vaccine, researchers are also focusing on developing effective COVID-19 treatments. Even if none can make a person immune to the virus, treatments may be able to reduce the disease’s severity.The Food and Drug Administration (FDA) have approved two drugs as treatments for COVID-19: remdesivir and dexamethasone.Another candidate is vitamin D. Research has suggested that it might, in theory, be effective, but corroborating this requires further efforts.Rather than analyzing the effects of vitamin D as COVID-19 treatment, the researchers behind the present study looked at the effects of a person’s vitamin D levels on the severity of the disease.To do so, they analyzed data from patients with confirmed COVID-19 who had been admitted to the Sina Hospital, in Tehran, Iran.Of the 611 people admitted with confirmed COVID-19 before May 1, 2020, there were records of the 25-hydroxyvitamin D levels, an indication of overall vitamin D levels, for 235 patients. Their mean age was 58.7 years, ranging from 20–90 years, and 37.4% were older than 65.The researchers classified the patients into two groups: those with vitamin D levels of at least 30 nanograms per milliliter (ng/ml) — an amount considered sufficient by the Endocrine Society — and those with lower values.They then analyzed the severity of the patients’ COVID-19 signs and symptoms using guidelines from the Centers for Disease Control and Prevention (CDC). Severe or critical disease might involve a range of issues, including shortness of breath, respiratory failure, or a significantly reduced blood oxygen level.After cross-checking the patients’ vitamin D levels with the severity of their COVID-19 symptoms and accounting for confounding factors, the researchers found that having a vitamin D level of above 30 ng/ml was significantly associated with having less severe COVID-19.Among the 235 patients with confirmed COVID-19, only 32.8% had sufficient levels of the vitamin.The researchers also found that the patients with sufficient vitamin D had higher blood lymphocyte counts and lower levels of C-reactive protein in their blood — both of which indicate a positive immune response.The researchers speculate that this may have reduced the likelihood of developing cytokine storm, which can cause acute respiratory distress syndrome in COVID-19 patients, sometimes resulting in death.The findings highlight, the researchers say, that vitamin D sufficiency may be important in the eventuality that people develop COVID-19 alongside another respiratory disease, such as influenza.According to the study’s corresponding author, Dr. Michael F. Holick, director of the General Clinical Research Unit at the medical campus of Boston University, in Massachusetts, “There is great concern that the combination of an influenza infection and a coronal viral infection could substantially increase hospitalizations and death due to complications from these viral infections.”For the researchers, their findings suggest that vitamin D supplementation would be valuable. As Dr. Holick notes: “Because vitamin D deficiency and insufficiency is so widespread in children and adults in the United States and worldwide, especially in the winter months, it is prudent for everyone to take a vitamin D supplement to reduce [the] risk of being infected and having complications from COVID-19.”It is worthing noting the present study’s limitations. First, the researchers only had access to a relatively small number of patients. Before drawing solid conclusions, scientists need to carry out much larger studies.Also, various issues can influence both vitamin D status and COVID-19 severity, such as socioeconomic factors and smoking status. The scientists accounted for neither of these in their analysis.Also, because the study was cross-sectional, the researchers could not prove that vitamin D insufficiency caused an increase in disease severity. To address these limitations, the researchers call for “large-scale studies and randomized clinical trials.”For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.
Video gaming as a child related to improvements in memory
A new study exploring the link between video games and cognition finds that playing video games as a child can improve a person’s working memory years later on specific tasks.Video games can be a contentious topic, particularly among parents or caregivers who may be concerned about the effects of spending hours in front of the…
A new study exploring the link between video games and cognition finds that playing video games as a child can improve a person’s working memory years later on specific tasks.Video games can be a contentious topic, particularly among parents or caregivers who may be concerned about the effects of spending hours in front of the console.Yet, it seems that some video gaming could actually be beneficial. Recent studies have shown that playing video games could improve learning and may even protect against dementia in older adults.The authors of a recent review of the evidence on video games concluded that gaming could have benefits for both cognitive and emotional skills.In a new study, which features in the journal Frontiers in Human Neuroscience, researchers from the Universitat Oberta de Catalunya in Barcelona trained volunteers to play “Super Mario 64” — a game that researchers have previously shown to induce structural changes in parts of the brain associated with executive function and spatial memory.The new study found that people who played video games as children showed greater improvements in their working memory than those who did not, suggesting that video games can have long lasting benefits for cognition.This study combined video game playing with transcranial magnetic stimulation (TMS), a noninvasive form of brain stimulation that scientists have studied as a treatment for mood disorders. In 2008, the Food and Drug Administration (FDA) approved its use for the treatment of major depression when other approaches have failed.Studies have also shown TMS to boost cognitive performance under some conditions, with more than 60 studies reporting that the treatment led to significant improvements in cognition, including in working memory (holding and manipulating information over a short period).The researchers behind the new study wanted to find out whether combining video game training and TMS could enhance cognitive function more than either element alone.They asked 27 healthy volunteers, with an average age of 29 years, to take part in 10 video game training sessions, during each of which they played “Super Mario 64” for an hour and a half.At the end of each session, the researchers applied TMS to part of the prefrontal cortex, which is at the front of the brain and is important for complex cognitive functions, such as working memory and reasoning. The researchers assessed the cognitive function of the participants before the study started, at the end of the 10 sessions, and 15 days after this.They assessed a range of cognitive functions, including reaction time, working memory, attention span, visuospatial skills, and problem-solving.Although the results overall showed very limited changes in cognitive ability, which seemed to result only from the video game training and not the TMS, the researchers did find that participants with early experience of video gaming had improved working memory.“People who were avid gamers before adolescence, despite no longer playing, performed better with the working memory tasks, which require mentally holding and manipulating information to get a result,” explains lead author of the study Dr. Marc Palaus, Ph.D.People with prior experience of playing video games (but not the actual game in the study) also showed improvements in processing and were better able to focus on relevant stimuli during the tasks.“People who played regularly as children performed better from the outset in processing 3D objects, although these differences were mitigated after the period of training in video gaming, when both groups showed similar levels,” adds Dr. Palaus.The results suggest that video games may induce cognitive changes that last for years after people have stopped playing.Dr. Palaus says that video games that provide motivation — making the player want to keep on playing — and also get more difficult to stay challenging require intensive use of brain resources, which makes them ideal for boosting cognitive ability.“Video games are a perfect recipe for strengthening our cognitive skills, almost without our noticing.”– Dr. Marc Palaus, Ph.D. It is important to note that this study included a small number of participants who were all healthy, young, and highly educated, meaning that the findings might not be more widely applicable.Talking about the findings of their study, Dr. Palaus stressed that these improvements only have a limited effect on the performance of other activities not linked to video gaming, as is the case with most cognitive training.
Lax gun laws in neighboring states may increase firearm deaths
A US study suggests strong gun control regulations reduce a state’s firearm deaths, but having neighbors with more lenient laws undermines their effect.Share on PinterestNew research suggests that one state’s lax gun laws could undo the effects of its neighbor’s stricter firearm regulations.In 2017, 39,773 people died from gun-related injuries in the United States, according…
A US study suggests strong gun control regulations reduce a state’s firearm deaths, but having neighbors with more lenient laws undermines their effect.Share on PinterestNew research suggests that one state’s lax gun laws could undo the effects of its neighbor’s stricter firearm regulations.In 2017, 39,773 people died from gun-related injuries in the United States, according to the National Center for Injury Prevention and Control.Overall, research indicates that stronger state laws governing the sale and ownership of firearms reduce firearm-related deaths. However, some states have relatively high rates of gun deaths despite strict regulations. To investigate why this might be the case, scientists at the University of Alabama at Birmingham, and the Boston University School of Public Health at Boston, MA, looked into the effects of firearm laws in neighboring states.They used the Web-based Injury Statistics Query and Reporting System to obtain figures for firearm-related deaths in the 48 adjacent U.S. states from 2000 to 2017. There were 578,022 firearm deaths in total, including homicides and suicides, but excluding deaths due to shootings by police or other law enforcement agents. The scientists also searched the State Firearm Laws Database for laws in each state regarding:background checksgun dealer regulationsbuyer regulationsgun-trafficking lawsThe team used the number of these laws as a proxy for gun control strength in each state.If you would like to check your registration status or register to vote, we have added some useful links at the bottom of this article.Overall, stronger state gun laws were associated with reduced firearm deaths, but having a neighboring state with more permissive laws undermined this protective effect.Larger policy differences across state borders were associated with increased gun-related deaths, suicides, and homicides, though the results were statistically stronger for suicide than homicide.The authors conclude:“This study adds to the growing literature emphasizing the role played by neighboring states’ firearm regulations in addition to own-state firearm regulations in firearm deaths. Failing to account for neighboring states with weaker laws, in some instances, can make a state’s own regulations appear less effective in reducing firearm deaths.”The scientists calculate that, on average, failure to account for weaker firearm laws in neighboring states make it appear as though a state’s laws were about 20% less effective at reducing deaths than they really were.They report their findings in the American Journal of Preventive Medicine.The researchers write that higher prices and strong marketing regulations can lead consumers to purchase firearms in adjacent, relatively unregulated markets. They say these are a frequent source of the guns used in crimes.They believe their work supports the case for more cooperative legislation between neighboring states and at the federal level.“I think the main message of this study is that to solve a nationwide problem we need to think of a nationwide or at least a regional-level (i.e. multistate) approach, like we may also need for the COVID-19 pandemic,” says Dr. Ye Liu, who is a doctoral student in the Department of Health Care Organization and Policy at the University of Alabama and the first author of the study. “An ‘each state on its own’ approach is ultimately inadequate to address one of the biggest public health challenges in this country,” Dr. Liu adds.The authors acknowledge the number of gun-control laws may not perfectly reflect the strictness of a state’s regulations. In addition, they note states may vary in how diligently they enforce these laws.They call for further studies that might use alternative measures of regulatory strength, focus on specific categories of law, or explore the effects of regulations in more distant states. To check your voter registration status, click here to visit VoteAmerica, a nonprofit, nonpartisan organization dedicated to increasing voter turnout. They can also help you register to vote, vote by mail, request an absentee ballot, or find your polling place.