While the groups of microbes that live in your vagina - your vaginal community state type (CST) - are unique to you, there are some things that everyone can do to support their vaginal health.
1. Be mindful with your hygiene practice
When it comes to vaginal health, the vagina is a self-cleaning system.
Washing daily with water is enough, the vagina does the rest thanks to its own mucous secretion [1].
2. Avoid excessive use of soap, cleaning tissues, and scented toilet paper
Soap, cleaning tissues, and scented toilet paper contain chemicals that can affect the beneficial Lactobacillus dominated vaginal microbiome [2]. While these substances can vary per product, the most common ones are:
- Petrochemicals (known also as propylene glycol, polyethylene glycol)
- Parabens (known as methylparaben, propylparaben, and ethylparaben)
- Synthetic glycerin
If you would like to use soap and gels to maintain personal hygiene, choose products with natural ingredients that will keep your vaginal microbiome in check.
3. Steer clear of vaginal douching
Vaginal douching - for example, anytime you might force water, an antiseptic, or vinegar into the vaginal cavity. Sometimes vaginal douching products are sold over-the-counter and other times they’re homemade.
Vaginal douching is often used to manage unpleasant odors and clean menstrual blood. However, an intravaginal shower with vinegar or antiseptics can cause chemical damage to the vaginal microbiome and easily wash away the good Lactobacillus bacteria, leaving the space open for disruptive bacteria or yeast to grow [3], [4], [5].
Remember that odor is normal and unique for each woman. You don’t need to use vaginal douching for it. Simply cleaning with water is enough.
If the odor is very strong and out of the ordinary, consider talking with your healthcare provider. The odor may be caused by disruptive bacteria. In these cases, vaginal douching could do more harm than good and prolong the infection.
4. Be aware of antibiotic overuse
Antibiotics kill both disruptive bacteria and also the protective Lactobacillus species, which may later lead to the development of bacterial vaginosis, yeast infections, or other vaginal infections.
So when possible, avoid unnecessary antibiotic use [6].
5. Don't smoke
You have probably heard this recommendation many times. But there’s one more reason not to smoke: It also appears that smoking can impact the vaginal microbiome.
Women who smoke have a lower number of protective vaginal lactobacilli and a higher chance of overgrowth of disruptive bacteria [7].
6. Practice sex that protects your vaginal health
During sex, we exchange bacteria. This brings the vagina in contact with "unknown" bacteria.
Bacterial vaginosis (BV), although not a sexually transmitted disease, has been associated with sex [8], [9], [10]. This bacterial exchange is reported for both women who have sex with men and women who have sex with women [11] [12].
Condoms can protect yourself from an unwanted bacterial exchange and also from sexually transmitted infections. This is especially true when in contact with a new sexual partner [13], [14].
Avoid scented condoms since they can have a negative impact on your vaginal microbiome.
Remember, if switching from anal to vaginal sex, change the condom or wash your partner’s penis and any toys you may be using. Skipping this important step will bring thousands of anal bacteria to your vagina, which can cause bacterial vaginosis.
If you have contact with the same partner and are trying to get pregnant, use condoms when not ovulating. This will help you maintain a healthy Lactobacillus-dominated microbiome during the non-ovulating period.
Finally, showering and/or peeing after sex can help sweep away disruptive bacteria.
7. When menstruating, change tampons, and sanitary pads regularly
Using tampons for a longer period of time provides a perfect opportunity for disruptive bacteria to grow. This can lead to the development of severe health issues such as toxic shock syndrome [15], [16].
Even if you switch to menstrual cups, reusable sanitary pads, or period underwear, these must be changed regularly too.
8. Wipe from front to back
Your mom might have shared this one with you. We’re saying it too: Wipe front to back.
This prevents the spread of disruptive bacteria from your anus to your vagina.
9. Take a shower after working out
While exercising, sweat can be easily absorbed by your underwear. The wet and warm environment of your underwear may encourage an overgrowth of disruptive bacteria.
So, we suggest: Work out. Shower. Feel fresh.
10. Choose cotton
Preferably use cotton underwear. As a breathable fabric, cotton can help to control moisture and temperature levels. Avoid nylon underwear and avoid panties that are too tight [1], [17].
And be sure to always wash your new cotton underwear before wearing it for the first time.
Conventional cotton is grown using a lot of pesticides, so residues may remain on the fabric. There are no studies specifically testing pesticide residues in cotton underwear, but small traces of pesticides have been found in other cotton products such as tissue paper, cotton surgical face masks, and diapers.
Using a pre-wash detergent may help eliminate any traces from your underwear [18]. If you can, shop for prefer underwear made of GOTS (Global Organic Textile Standard) certified organic cotton, which is pesticide-free. It is still important to wash before the first use, as organic cotton fabric may contain dyes and other chemicals from the manufacturing process.
