GENITAL HYGIENE FOR WOMEN

Farida ZubierDepartment Dermato-venereology,

Faculty of Medicine, University of Indonesia Dr Cipto Mangunkusumo Hospital, Jakarta

Introduction

• Female genital hygiene practices are much more complex than expected.

• Understand the female genital anatomy, physiology and immunology

• Identify various feminine hygiene practices• Identify the products used for genital hygiene

WOMEN ARE BOMBARDED WITH ADS of GENITAL PRODUCTS RELATED TO

FRESHNESS BEAUTY INTIMACY

Women becoming obsessed in cleanliness & aroma over cleaning of the vagina HARMFUL

GENITAL HYGIENE (GH) for WOMEN

CULTURAL NORMS

PERSONAL PREFERENCE SOCIAL INFLUENCES

PERSONAL FEMALE HYGIENE PRACTICESincl. Genital Hygiene

Daily Routine Activity

GH for Women• Lack of quality information for women on this subject• Left to women to decide (mother teaching)• The Intimate Feminine Hygiene is ?? Cosmetic that doctors

know little about it • Doctors should know about GH:

– To aid in making decisions about appropriate female genital care. – To present the best advice on the safe use of intimate feminine

hygiene products available in the market. – To offer practical recommendations on harmless feminine hygiene

practices.

GENITAL HYGIENE FOR WOMEN• Proper genital cleaning thoroughly which reduces harmful

microorganisms & eliminates odor --> contributes to overall good health.

• It depends on the age of women– Neonates– Infants/toddlers– Premenarche– Reproductive age– Menopause

GENITAL HYGIENE FOR WOMEN

• Normal/healthy vagina:– Has normal vagina flora– Produces normal secretion that naturally cleanses &

provides protection– Has a natural balance of substances

• Genital area is:– Moist & warm bacteria/microorganisms can grow easily

– Sensitive & any slight change such as menstruation, sexual activity & exercise can disrupts its natural balance itching, redness, odor, infections

Genital Hygiene (GH) in Neonates

• Due to maternal estrogen:– Labial edema– White mucoid discharge -> days – few weeks– Slightly bloody spotting -> will cease within 3-4 weeks

• Cleansed by wiping gently from front to back with damp cloth,

moistened cotton wool.

GH in infants/toddlers

• Managing incontinence urine/feces is the principal genital hygiene.

• Prolonged genital skin contact with urine/feces will cause irritation or infection

• Frequent diaper changes & good genital/perineal hygiene is

recommended.

GH in premenarche

• Poor vulvar hygiene will lead to accumulation of smegma• Routine gentle washing of the vulva & perineal area is

needed.• Need parental supervision teach young girls to consistently

wipe after toileting• Most vulvitis in young girls were caused by improper perineal

hygiene

GH in reproductive age

Menstrual hygiene• Some traditions consider the menstruating woman is

spiritually unclean social, cultural, religious norms influence menstrual hygiene practice

• Menstrual products: - Reusable items - Disposable items

• Reusable items

– Cloth pads : made from layers of absorbent fabrics ( cotton) to absorb the flow of blood from the vagina. After use, they are washed, dried and then reused

– Sea sponge :natural sponges, worn internally like a tampon to absorb menstrual flow.

Menstrual cups :type of cup or barrier worn inside the vagina during menstruation to collect menstrual fluid. Advantages

The capacity 3 times greater than the absorbency of a Super tamponmore cost-efficient and environmentally friendly than tampons

• Disposable items– Sanitary pads: material worn in the underwear to absorb

menstrual flow, often with "wings," pieces that fold around the undergarment and/or an adhesive backing to hold the pad in place. Disposable pads may contain wood pulp or gel products,

– Tampon: disposable cylinders of treated rayon/cotton blends or all-cotton fleece, usually bleached, that are inserted into the vagina to absorb menstrual flow.

– Disposable menstrual cups: a firm, flexible cup-shaped device worn inside the vagina to catch menstrual flow. Disposable cups are made of soft plastic.• The capacity 3 times greater than the absorbency of a Super tampon• more cost-efficient and environmentally friendly than tampons

• Other genital hygiene practices

– Routine perineal hygiene: • is a part of routine bodily cleansing• washing with water/and soap• wet wipes

– Feminine hygiene sprays:• scented feminine hygiene sprays are used to avoid odor

– Douching (vaginal irrigation): • is the insertion of a device into the vagina for flushing into the vaginal

vault• vaginal douches may consist of water mixed with antiseptic• antiseptics may result in an imbalance of the normal flora in the vagina,

and an increased likelihood of infection.

– Perineal powder: • some women apply talcum powder to the perineum daily• epidemiological studies have linked perineal talc exposure to ovarian

cancer controversial

– Pubic hair removal: • is practiced for esthetic reasons• methods: shaving, chemical depilatories, wax epilation, electrolysis, laser

GH in elderly women

Problems:• Urinary incontinence

• may cause vulvar irritation• use pantiliners, menstrual pads, pads design for incontinence protection• pelvic muscle exercises ( Kegel exercises) may help

•All women at all ages are in need of a daily intimate feminine hygiene to keep their genital area clean and dry.

•The vulva and vagina are common areas for contact dermatitis and should be kept away from irritants whether environmental or certain hygienic products.

•It is highly recommended to use hypoallergenic liquid cleansing agents with mild detergent effects and acidic pH ranging between 4,2 and 5,6.

•Bar soaps and bubble baths are of abrasive nature and with high alkaline pH; they should be avoided.

•Childhood genital care starts with good hand wash of the caregiver, using separate towels for children and not to take bath in the same tub with them

Conclusion

•While lactic acid based liquid with low pH have been shown to augment skin homeostasis and helpful in cases of genital infections as an adjuvant therapy but not as a treatment.

• Vaginal douching is not recommended at all for its adverse obstetrical and gynecological outcomes.

•The woman should avoid excessive moisture and allow reasonable ventilation of the genital area by wearing loose fitting cotton underwear and minimize wearing tight clothes.

•Undergarments should be changed frequently.

•Talcum powder should not be used, and perfumes and deodorants should be used sparingly, preferably after allergy testing.

•Menstrual care should include using tampons and sanitary pads, as preferred, but frequent changing is essential.

•Pre and post coital cleansing of the genital area especially the clitoris and the vulvar folds from front to back is recommended.

•Vigorous vulvar cleansing and vaginal irrigation are strongly discouraged.

•Removal of pubic hair should be based on safe technique and with care to avoid sensitivity and scarring.

GENITAL HYGIENE for WOMEN

WOMEN ARE BOMBARDED WITH ADS of PRODUCTS RELATED TO

FRESHNESS BEAUTY INTIMACY

Women becoming obsessed in cleanliness & aroma over -> over cleaning of the vagina -> HARMFUL