Taking care of and getting to know your vagina

The vagina is an important part of a woman’s body – if we pay so much attention to our face, hands and feet, why shouldn’t we do the same for the vagina?

AS an obstetrician and gynaecologist, it saddens me that many Malaysian women take such little notice of their vaginal health.

In fact, very few women are familiar with the conditions of their vagina, or even feel comfortable talking about it. This could be largely due to our cultural taboos regarding sex and sexual health.

Women should not let such outdated thinking hinder them from being aware of their vaginal health. The vagina is an important part of a woman’s body – if we pay so much attention to our face, hands and feet, why shouldn’t we do the same for the vagina?

The first step towards good vaginal health is knowing what is normal for your vagina and what is not. In this article, you can learn about the signs and symptoms of common vaginal problems, as well as what you can do to keep it healthy.

Getting to know your vagina

The vagina is the passageway that links your external female genitals to your womb. It is actually a narrow muscular canal that extends from the vulva (the outside of the genital area) to the cervix (the neck of the uterus).

The vagina has several sexual reproductive functions. It receives the penis during sexual intercourse, and serves as the birth canal through which the baby passes through during childbirth.

It is also the passageway through which menstrual blood flows from the uterus out of the body.

The vagina is made out of muscle, with a soft, flexible lining on the walls to provide lubrication and sensation.

When something is not right with the vagina – whether due to infection, growths or weak pelvic floor muscles – it can affect your overall health and well-being.

Without a doubt, vaginal problems will primarily affect your fertility, desire for sex and ability to reach orgasm. But if these problems persist without being treated, they can also have a negative impact on other areas of your life, such as your relationship, daily well-being and self-confidence.

You should be aware of certain characteristics of your vagina, such as its discharge (colour, smell and amount), bleeding (your flow during menstruation), and sensations (whether there is itching, irritation, swelling or pain during sex). When problems occur, these characteristics will most likely appear different from their normal state.

Factors affecting vaginal health

Considering that the vagina is a part of the body that we pay so little attention to, there are surprisingly a lot of factors that can affect the state of the vagina and increase the risk of problems.

Sexual practices are, of course, the most obvious factors. Unprotected sex could cause sexually transmitted infections, which produces symptoms in the vagina. Injuries to the pelvic area, brought on by an accident or sexual abuse, can cause trauma to the vagina.

A lot of the daily products and medications that women use can also affect their vagina. For instance, prolonged use of antibiotics upsets the balance between good and bad bacteria in the vagina, increasing the risk of a vaginal yeast infection. Certain antihistamines can cause dryness of the vagina, which makes intercourse painful.

Women used to get toxic shock syndrome from using super-absorbent tampons (especially if they left them in the vagina for too long), although this is less common now. Even certain birth control devices, like a diaphragm or contraceptive sponge, could pose a risk of toxic shock syndrome due to the possibility of bacteria entering the system.

Using spermicide or a vaginal ring for contraception can also cause irritation to the vagina.

Pregnancy and childbirth will cause obvious changes to the vagina. During pregnancy, the amount of discharge from the vagina will increase, even though there is no menstrual bleeding.

Then, during childbirth, there will most likely be tearing of the vagina. Some women may need an episiotomy (a small cut made in the tissue between the vaginal opening and the anus) during delivery, which has a long recovery period.

Childbirth, menopause and increasing age cause the muscles of the vagina to become weaker and less “elastic” – as we will see later, this can lead to some serious problems.

The vagina plays a central role in ensuring a woman’s pleasure during sex. Unfortunately, certain factors can reduce the lubrication in the vagina, causing painful sex. Hormones are one of the factors – oestrogen levels reduce after childbirth, during breastfeeding and after menopause, which causes the lining of the vaginal wall to become thinner, making sex painful.

Common vaginal problems

On top of the list of common vaginal problems are sexually transmitted infections, which include genital warts, syphilis and genital herpes. These infections cause symptoms like abnormal discharge and sores on the genital area, so keep an eye out for changes in your discharge and genitals.

Infections and changes in the normal balance of bacteria can also cause the vagina to become inflamed (a condition called vaginitis).

The inflammation could be due to bacterial vaginosis (abnormal growth of bacteria that is usually present in the vagina), yeast infections (caused by a fungus called Candida albicans) or trichomoniasis (caused by a parasite). Again, look to the vaginal discharge for clues, as well as any itching or pain in the area.

Vaginal problems can also be linked to sexual issues. If you experience pain in the genital area during penetration or after sex, this is a strong sign that something is not right in the vagina.

Prolapse of the vagina is a common condition that occurs to women who have gone through childbirth. This happens when the pelvic floor muscles are weak and become less able to support the uterus, bladder or rectum. These three organs may slip down into the vagina, and in serious cases, cause the vagina to protrude out of the body.

Less common problems are cysts in the vagina or cancer. The signs and symptoms, including pain during sex, bleeding after sex or menopause, are shared by other conditions as well, so you should always get them checked out by your doctor.

Care for your vagina

Women get manicures for their hands and pedicures for their feet, but hardly take a moment to think about their vaginas until something is wrong. We should change this attitude and be more proactive in protecting our vaginal health.

One of the most important and fundamental steps is to practise good personal hygiene. Keep your genital area clean and do not use douches or perfumed soaps. You should also avoid feminine sprays and scented tampons.

Practise safe sex by using condoms. The best decision is to stay in a mutually monogamous relationship with your partner, so that there is no risk of sexually transmitted infections.

Vaccinations can help to protect vaginal health as well. The HPV vaccine protects you from infection by the human papillomavirus, which can cause cervical cancer and genital warts. Hepatitis B vaccinations protect you from liver infections that can spread through sexual contact.

Strengthen your pelvic floor muscles with Kegel exercises – tighten your pelvic muscles as if you’re stopping the flow of urine, at least three sets of 10 repetitions a day. This will help to prevent the uterus from collapsing into the vagina.

Most importantly, get to know your vagina. This way, you will be sensitive to any changes that occur, whether it is due to an infection, a medication that you are taking, or some other underlying condition.

Do not be shy or embarrassed to talk to your doctor about your vaginal health – it is as much a part of you as any other organ or limb in your body. - By Dr NOR ASHIKIN MOKHTAR

~ Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.