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The surface of the intimate area is organic, a complex ecosystem

It is very convenient to think that the more times you clean, the better the hygiene with a higher frequency of bidet (washing) possible. This principle is valid for perfectly sanitizing a non-organic surface, such as a floor or a shelf, where cleaning the dirt is eliminated and the bacterial content is reduced.

But when we talk about organic surfaces, it’s another story because these surfaces are much more complex. Within them, there are cells of the wall, which produce secretions, media substances of information, physical and chemical means of defense; bacteria and other microorganisms that interact symbiotically and “collaborate” for a good ecosystem. A good ecosystem is the result of complex interactions which adapt to the changing conditions of the environment.

Every organic surface is different, so you need to evaluate the type of surface to understand how often should be cleaned.

Specificity of the female external genital area

In the case of the female genital area, we must distinguish between the internal area and the external are. The vagina, the internal part of the female genitalia and which is not in contact with the outside,  has its own bacteria does not need “maintenance” in the sense of cleanliness. It is rich in bacteria (bacilli of Doederlein) useful to protect against infections and irritations.  The vulva (the internal part of the female genitalia) on the other hand, is rich in sweat sebaceous and vestibular glands that produce large amounts of secretions: if they are not removed cyclically there is a risk that they act as fertile soil for infections.

Best possible compromise

The best compromise for intimate hygiene is to do wash once a day – this removes secretions but does not eliminate the majority of “good” bacteria that guarantee the healthy function of the vulvar ecosystem. If we increase the number of cleaning sessions several times a day, we will progressively reduce the number of good bacteria that protect the vulva. As a consequence, superinfections may occur paradoxically worsening vulvar health.

So for proper hygiene: a bidet a day removes the hassle of coming back!

What kind of soap do you use?

The degree of acidity of the vagina changes during a woman’s life, passing from the typical pH=4 during fertile age, and lowers in pregnancy until it culminates to pH=7 during menopause. Responsible for this variability is the hormonal structure, which when supported by estrogen, the female hormones, tends to maintain a degree of acidity that acts as a protective barrier. At any age, the soap to use should therefore have the acidity appropriate for a woman’s age, respectively more acidic when younger and a less acidic with increasing age.

How to wash

It is important to always remember the direction of washing which is anterior-posterior (from front to back) and not the other way around. This is done so as to avoid/prevent fecal bacteria from the posterior area to reach the urethra or vagina. Lavenders and irrigations are generally not recommended and should only be carried out by prescription.

https://www.ncbi.nlm.nih.gov/pubmed/28934912

Dr. Giulia Fornasier, Midwife.

Igiene intima femminile #2: quanti bidet in un giorno?