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Meet Doctor Sara, our go-to gynaecologist. An expert for over 20 years, she’s passionate about educating women on the importance of gynaecological wellbeing and is our specialist when it comes to caring for your intimate area. Check out her top tips and advice on caring for down there.
1. So, talk us through the differences between the internal and external intimate organs?
The vulva is the external sexual organ of a woman’s body and its main purpose is to protect the inner sexual organs, including the vagina and the urethra (opening for urination). The vulva is the external skin which consists of the mons pubis (the top area towards the lower abdomen) and this is the main hair bearing part. The labia majora or outer labia/lips, run down both sides and are also hair bearing. The labia minora, inner labia/ lips usually lack hair and can be particularly sensitive. This area forms the transition between the inner vagina and the outer vulva.
Should we add an illustration here to explain? Not sure if it would be right, but might make it easier? Want to make it really clear that the vagina is the internal organ.
2. Why should I be thinking about pH-balance when it comes to my intimate skin?
pH is simply the measure of how acidic or alkaline something is, based on a numerical scale ranging from 0 to 14 - anything below 7 is acidic, anything above 7 is alkaline. Pure water has a pH of 7, which is neutral but you may not realise that your skin does not have a neutral pH. Your skin has a normal pH between 5.4 and 5.9, however the intimate skin has a normalised pH less than 4.5. This is regulated by good bacteria in the vagina called lactobacilli, which helps to prevent the growth of harmful organisms. If the pH of the vagina increases (making it less acidic) the quality or amount of lactobacilli can fall and other harmful bacteria can multiply which can lead to infections such as bacterial vaginosis or thrush.
3. What can upset my intimate pH-balance and how do I know if my pH levels have become unbalanced?
pH levels change with age - before puberty and then again with the onset of the menopause. In between, there are a number of factors that can cause your pH to fluctuate which can make you more prone to infections. Below are some of the more common triggers that can cause a change in your natural balance.
- Perfumed or high pH shower gels
- Allergy triggers such as washing powder
- During your monthly cycle, hormonal changes alter the pH-balance. It’s least acidic on the days just before and during your period leaving you more prone to infection.
- The contraceptive pill provides constant hormone levels so some women experience irritation during the week they don’t take the pill.
- Being on antibiotics can sometimes lessen the good bacteria therefore disrupting your natural pH-balance and leaving you at an increased risk of infection
- Non-breathable underwear or sanitary protection products can also be irritants, especially if they are worn all day
- Heat and sweat caused from wearing tight underwear or jeans, exercise, and sex.
- Disturbance and friction during sex can be an irritant
- Some men have alkaline sperm which can also disrupt the female pH
- The most common symptom of a change in your pH is itching on the vulval skin.
Other symptoms include:
- More frequent discharge which is a different colour and/or smell to your usual discharge (If this is the case, contact your GP).
- Discomfort during sex
- Occasionally, it can exhibit itself as discomfort when going to the toilet
4. What’s the best way to maintain a balanced intimate pH level? Do I need to use an intimate wash to achieve this?
Using an intimate wash is a personal choice and for women who want to use anything more than water, it is important to choose a product that works in harmony with your body. femfresh is great because it’s specially designed to maintain the natural pH-balance of the intimate skin.
If you have a tendency to skin irritation, maintaining a healthy pH-balance is very important for you, so using femfresh intimate washes is a good choice to help you achieve this. If you have an active lifestyle and often go back to work after the gym, the femfresh intimate wipes are brilliant as a temporary solution to remove sweat without disrupting the pH balance.
5. Isn’t water enough? And why can’t I use my regular shower gel to cleanse my intimate skin? Isn’t all skin the same?
It’s a personal preference; I personally would recommend using a pH-balanced wash to ensure you are cleaning your vulval skin thoroughly without disrupting your natural pH-balance. Using water alone will not harm the intimate balance however many women also want the added benefits of cleansing, soothing and moisturising the skin. When talking about intimate washes, it is important to recognise that we aren’t talking about douching at all. femfresh is not a douche and I never recommend cleaning inside the vagina.
6. Sometimes I find my intimate skin gets quite itchy. What could be causing this?
Itchiness can be caused by inflammation, infection or as a result of an allergy so it’s important to identify what could be causing this. There are over 60 different reasons why you could be experiencing itchiness in your intimate area with the below being some common triggers:
- Non pH-balanced shower gels
- Washing powder
- Panty liners
- Tampon or sanitary towel
- Creams / lotions
- Laser or wax
- Contraceptive pill
- Infections such as Thrush
- Being sexually active more than usual
It is also important to look at your intimate skin to see whether you have a rash, any swelling, spots or ulcers. If you do you should consult your doctor.
7. Why are some women more prone to irritation and/or discomfort than others?
Some women find that there are different times when they are more prone to irritation than others, which is largely to do with a change in the pH of your vagina. If you take part in activities which are likely to disrupt your natural balance for example through sweating when working out, it’s a good idea to counteract that with pH balancing washes or wipes. Some women are prone to skin issues such as eczema and that can also make them more likely to experience intimate irritation.
8. Why is irritation more common in pregnant and menopausal women?
The simple answer is changes in your hormones. Throughout pregnancy the surge of hormones and estrogen can change the pH levels which then makes pregnant women more prone to infection – this is extremely common. In menopausal women, the decrease in estrogen changes the intimate skin so it becomes thinner which can change the pH-balance, making the skin more sensitive and prone to infection.
9. What is vaginal douching and is it safe?
Vaginal douching involves using a syringe to insert a solution the consistency of water into the vagina itself (internal organ). femfresh is not a douche and I never recommend doing this as it is not safe. Should you have an infection, it will not solve the issue in fact, it’s more likely to cause irritation as douching disrupts your natural intimate pH balance.
10. Is white vaginal discharge normal?
Yes, it is completely normal. Discharge changes throughout the month. Just after your period you will notice that there isn’t a lot of discharge but as you are coming up to ovulation you will notice clear discharge (similar to egg whites). This is a sign that ovulation is about to happen. After ovulation you will notice white discharge with either no smell or a mild smell.
11. Does a change in the odour of my vaginal discharge mean I have an infection and if so what could it be?
A change in odour is dependent on hormones and sometimes can be due to dehydration. However, if the discharge has a strong odour, I would recommend seeing your doctor who will be able to investigate.
12. What is the cause of irritation after sex and what is the best way to reduce this?
After sex, you may feel some immediate irritation which is normal and is usually caused by friction, particularly if you haven’t had sex for a while. In some cases, irritation may even be caused by the sperm itself, which is alkaline. Some women find that using a natural lubricant during sex can help reduce this irritation. Going to the toilet and having a wash or using a pH-balanced intimate wipe immediately after sex can also help to reduce irritation by restoring your natural balance.
If irritation continues 7-10 days after sex, it may mean that you have an infection so I’d recommend going to see your doctor who will be able to investigate the cause of irritation. Other causes of long term irritation can be Cystitis or due to an allergy to the condom.
13. What is cystitis and if I have it once, am I more likely to get it again?
Cystitis is a bladder infection which commonly happens after sex although it can occur in women who don’t have sex. I suggest drinking plenty of water, going to the toilet and having a quick wash immediately after sex to help flush through any bad bacteria that may have entered the vagina during sex. Using femfresh intimate washes or wipes are great as they can help to maintain your natural pH-balance.
Cystitis is usually treatable with re-hydration but sometimes does need to be treated with antibiotics.
14. What would you recommend as the best way to relieve symptoms of dryness/irritation?
Whatever the cause or severity of dryness/irritation there are things you can do to relieve the symptoms. You can see your GP to discuss prescriptive remedies, but there are some steps you can take yourself to help.
- Hygiene – make sure you keep everything clean and dry.
- Use a pH appropriate wash in your intimate area.
- If necessary, apply a hypoallergenic emollient cream
- Take in lots more water than usual to ensure you are suitably hydrated. Avoid any dehydrating products like alcohol and caffeine.
- Avoid strongly perfumed washing powders - Opt for the most sensitive on the market.
- Use a natural lubricant during sex.
- Avoid any intimate irritants, like perfumed shower gels, soaps or bath oils. Opt for femfresh Ultimate care Soothing Wash which is hypoallergenic and at the right pH-balance for the intimate vulval skin.
15. What is Bacterial Vaginosis and can femfresh help to eliminate BV?
Bacterial Vaginosis is a common infection caused by an imbalance of the bacteria that are present inside the vagina. Symptoms typically include a greenish discharge and a fishy odour. femfresh is not a treatment for BV and it won’t mask the odour. If you think you might have Bacterial Vaginosis, you will need to see your doctor who will be able to diagnose the problem and prescribe specific treatment.
16. Can I use femfresh products if I have Thrush?
Yes of course. femfresh products are great because they’re much less likely to irritate the skin. When you have thrush there’s a baseline inflammation of the skin which can cause discomfort and itching. Therefore using a soothing solution to wash the intimate area is ideal. Again, it won’t treat the thrush but it may help to soothe and ease the itching.
17. Can I use femfresh products if I’m trying to conceive?
Absolutely. You can also use them whilst pregnant.
18. Do I need to use a specialist product to wash during my period?
Highlight that this is a time when women may prefer to use a product specifically designed for intimate skin for example the femfresh range including intimate washes, wipes and deodorants.
You don’t need to use a specialist product during your period and it is a personal choice. However, if you want to use more than water, I recommend using a pH-balanced formula specifically designed to clean your vulval skin. The femfresh range is great this time of the month when you may feel like using more than just water for example to remove blood from your vulval skin. Using the wipes can clear the blood more efficiently than toilet paper and because they are hypoallergenic, won’t disrupt your pH balance.
19. What are the benefits of using the femfresh range and is it important to use?
Opportunity to talk about the ‘specially designed’ formulas. Need to be clear that using femfresh is a choice for some women who want to use more than just water
All femfresh products are pH-balanced and they work in harmony with your intimate area. The addition of ingredients such as lactic acid and probiotics across the range help to maintain your natural pH-balance. Using a specialist product is a personal choice, however if you do choose to use more than just water to clean your intimate area, it’s important to use a product which is specifically designed to clean your vulval skin to avoid upsetting your natural intimate balance.