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Heads Up, Ladies: There's a Right Way and a Wrong Way to Clean Your Genitals
Should you use soap? What about vaginal deodorant? Our experts explain it all
Confession: I’ve been washing my lady parts incorrectly my entire life. No soap on the vulva — who knew?
This week our sexual health experts talk about vaginal hygiene and so much more. Consider this a teaching moment.
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I’m a woman in my 70s with a small amount of bladder leakage that creates an odor. What is the best way to prepare my genital area for oral sex that won’t turn my partner off? Is it enough to simply wash before sex?
Washing before sex should do it, according to Maureen Slattery, an ob-gyn and certified sexual health counselor. But — get this — there’s a right way and a wrong way to cleanse your genital geography. My conclusion after talking to our experts? Vaginal maintenance should come with its own instruction manual.
First, about that odor. It’s possible that the smell isn’t coming from your urine but your skin, according to ob-gyn Anita Mikkilineni. If you have a lot of fat folds — in the thighs, groin, butt and belly — it’s not uncommon for sweat and bacteria to build up, emitting an odor that you might mistake for urine, she says. There’s even a name for the condition: intertrigo. Mikkilineni says to keep that skin thoroughly cleansed and see if you notice a difference.
The do’s and don’ts of genital hygiene. Mikkilineni recommends against using any scented lotions or soaps. In other words, keep it natural. As she puts it: “It’s not supposed to smell like flowers down there.” And never douche or use soap in the vagina.
Also, stick with water to wash the vulva — including the lips, labia and clitoris, says urogynecologist Padma Kandadai. Why? “The tissue between the labia is sensitive and can become irritated with soap,” she says, adding that it’s fine to use a mild, fragrance-free body soap to wash the pubic hair.
Slattery says you can also use wipes to cleanse the genitals — but to treat them with caution. She suggests trying out wipes made with coconut water. “Just look for something with minimal additives,” she says. “I also would not use them all the time, just after working out or to wash up quickly before sex. Not everyone will tolerate every formulation of them.”
What about vaginal deodorant? Slattery and Mikkilineni both recommend a product called Lume, a deodorant developed by an ob-gyn that can be used on the vulva and elsewhere on the body. It comes in a cream and spray and can be found online and at many grocery and drug stores.
Rule out any infections. Just to be on the safe side, Mikkilineni recommends that you see a health care provider to be checked for vaginitis or a urinary tract infection — both of which can impact how the vagina smells.
Consider your pH balance. Changes in your scent may also be attributable to the pH balance in the tissues in the vagina, which can be thrown off by hormonal changes associated with perimenopause and menopause, says Mikkilineni.
A safe and effective treatment for that is vaginal estrogen, which restores hormones and allows healthy bacterial flora to thrive, she says. The healthy bacteria keep the vaginal pH low, helping to prevent opportunistic infections like a urinary tract infection that can sometimes cause an odor, she adds.
Vaginal estrogen comes in a cream — the most commonly prescribed form — as well as a tablet, suppository, ring and one oral option, she adds.
Don’t tolerate a leaky bladder. If you are experiencing incontinence, Kandadai says you should consult a urogynecologist, a physician who can treat problems affecting the bladder and urethra.
“A lot of women are told, ‘Oh, you’re getting older’ and they end up living with it because that’s what’s supposed to happen,” she says. “You don’t have to live like that.”
And while a leaky bladder experienced by older women is common, Kandadai says, “It’s never normal. It’s not normal to pee on yourself.”
It could be something simple. Some drinks — anything caffeinated or alcohol — can irritate the bladder and cause urgency and leakage, she says, adding that most bladder leakage can be managed by modifying fluid intake and working with a physical therapist to strengthen pelvic muscles.
But depending on the severity of the incontinence, Kandadai says other treatments include medications, urethral filler injections that bulk up the area around the urethra to narrow the opening, and “sling surgery,” where a surgeon places a band under the urethra to support it.
Do you have questions about sex or relationships as a 50-plus adult? Send them to sexafter50@aarp.org.
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