Improving and maintaining vulval health is all a bit…embarrassing? Pointless? Dirty?

Nope, none of the above! Read on for my best tips to look after your lady bits and avoid annoying irritations, infections and discomfort at every stage in life.

Firstly, The Sciencey Bit

The vulva and vagina are unique parts of our bodies as they are teeming with bacterial bugs living in beautiful harmony with each other…most of the time. Our Down There is built with an army of allied bugs to fend off some of the others that can cause disease, particularly if they were able to get up into the womb where the area is essentially sterile (no bugs at all). It’s robust in some ways, but harmony exists in a delicate balance so it’s up to us to give our bugs the best chance of keeping the peace.

There are many modern day irritants to the vulval and vaginal skin including commercial products for bathing, feminine hygiene and fragrances used in sanitary protection. Swimming in chlorinated pools, urine leakage and irritation from semen are other common sources of chronic inflammation.

Once the vulval skin becomes irritated it starts to get itchy… itchy, you scratch and it makes it even more delicate…but you continue to wash thinking is dirty….And so a vicious itch/scratch/treat cycle begins. This process only gets worse as you transition through menopause and beyond as oestrogen levels drop and the effects of ageing thin the skin further. Many creams you’ll have grown up with like Sudocrem or Germolene can actually make vulval skin problems worse so its really important you see your GP before using these – or at least try my top tips below to save yourself a visit!

Tip #1 – Let them breeeeathe! 

• Opt for loose fitting silk/cotton pale coloured underwear (yep, granny pants are THE BEST) as synthetic, dark coloured fabrics are more likely to cause irritation/low grade allergy. 
• Think LOOSE in general- avoid tights, cycling shorts, tight trousers/leggings and opt for skirts, loose fitting trousers etc. Make sure your vulva can breathe overnight too- avoid wearing pants overnight.

Tip #2 – Wash gently and moisturise often.

• Washing in the shower (with a soap substitute only) no more than once daily will keep things feeling fresh but not lead to further irritation. Follow each wash with a moisturising routine (like you would the rest of your body/face/hands) and maintain moisturisation throughout the day or at least twice daily.
• In our busy lives it is easy to apply moisturiser morning and evening but less easy during the day.  Try keeping your cream next to the toilet; firstly you will see it and remember to use it every time you  go, secondly, you will already be half undressed and it will be easy to apply. 
• Decant some into a smaller pot to carry in your handbag. This means you will never be without relief, wherever you are. Travel pots can be bought from Boots, Superdrug and sometimes Primark very  cheaply. 
• Continue with the soap substitutes and moisturising even when your symptoms have settled as this  is what helps keep the condition under control. It is particularly important to continue after a course  of steroid ointment. Most symptoms reoccur when you stop using the treatments regularly, so its important to build into your routine.
• If you normally wash your hair in the bath- switch to having a shower before or after so you’re not sitting in the hair products for any length of time. When washing your hair in the shower, keep your legs together then wash the intimate area separately with warm water/soap substitute. Dab dry with a towel rather than rubbing. 

Tip #3 – Break the itch/scratch cycle

• Itching causes scratching…and scratching causes more itching. It can be a difficult cycle to break, so if you think this is perhaps half the problem, try an antihistamine in the evening. It will have a slightly sedating effect to help you sleep and reduce the intensity of the itch. 
• You can also buy a hydrocortisone 1% ointment (not cream as this contains preservatives than can irritate the delicate skin further) or get a prescription from your GP to break that cycle and reduce inflammation. The ointment provides a barrier to other irritants and moisturises too. Use for up to 2 weeks before seeing your GP if the symptoms don’t sufficiently improve.
• Keeping your moisturiser in the fridge can offer instant soothing relief if you’re in the early stages of treating an itch/scratch flare.
• Remember the skin has a certain ‘turnover time’ too. In younger women this tends to be shorter at about 4-6 weeks but this can extend to more like 8-10 weeks with advancing age. Whatever skin treatments you stop/start, they will take this length of time to have a full effect. 

Tip #4 – Avoid common irritants

• Creams– Often household creams we’ve grown up with are not suitable for vulval skin, particularly as we go through the menopause transition and beyond. Baby products, nappy creams (can be very drying), thrush treatments (if it’s not working, it’s probably not thrush…)
• Clothing– avoid biological washing powders and fabric conditioners
• Chlorine – apply a barrier ointment before swimming/hot tubs. 
• Toilet paper
• Feminine pads/liners
• Hair removal products/procedures
• Condoms/semen/spermicides
• Pressure/saddle– of a bike or horse! 
• Friction/Sweat- from running/high impact exercise.

Hopefully reading this has given you some new avenues to explore if you’re not getting anywhere with your GP or tried at home treatments. Remember, it’s important to insist on a physical exam if your symptoms aren’t improving or are getting worse despite your best efforts.

If you’re in the Lincolnshire area and you’d like me to take a look, I’d be happy to help.