5 common questions about vaginas answered

A sexual health nurse reveals all

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[W]e don’t often bring up genitals in polite conversation but learning more about vaginas can empower women to make the right decisions about their general and sexual health – and know when to seek medical advice.

Helen Knox, a clinical nurse specialist in contraception and sexual health – and founder of Sexplained – shares the vaginal health questions she hears most frequently and the advice she gives women about how best to care for their most intimate area:

1. Is my vaginal normal?

“I often get asked if the smell or discharge a woman is experiencing is ‘normal’. Firstly, normal is what is normal to you. Your vagina will have its own smell, regular discharge and shape. If you notice a change from your norm such as a change in discharge, smell or discomfort, then there may be something up. But don’t be embarrassed about it and do nothing. You can ask your pharmacist to help you work out what might be going on and give you an over the counter treatment. But if you are in pain, are bleeding abnormally or have persistent symptoms then you must see your GP.”

2. What should my vagina smell like?

“Your vulva and your vagina should smell like you, if this smell changes then something might be up. Your healthy vagina is all about balance: it is home to millions of micro-organisms, and is normally good at keeping them in balance.”

“When this balance gets disrupted, you’ll start to notice things aren’t quite right and you could be developing bacterial vaginosis (BV) which is a very common condition that often causes a fishy smell. BV is in fact two times more common than thrush and like thrush it can be simply treated with an over the counter treatment. Lactic acid based products such as Balance Activ (available at Amazon.co.uk) help to rebalance the healthy bacterial conditions within the vagina, to gently and effectively treat the symptoms of BV by restoring normal pH and vaginal flora.”

3. What should my vagina look like?

“Just like the rest of our bodies, our vaginas are all unique. The only part you can see is the vulva, and these come in all shapes and sizes. If you are experiencing any soreness, itching or other changes there may be a problem that needs checking out. In general, adding anything to your vagina such as glitters or perfumes is going to upset your natural balance and encourage conditions like BV, so I really wouldn’t recommend it.”

“You can’t see your vagina, as it is inside you, and it runs from your vulva, up to your cervix, but as long as you’re not experiencing any unusual smells or discomfort, it’s very likely to be looking after itself – and doesn’t need to be messed about with.”

4. Is my discharge normal?

“The vagina is a relatively acidic environment which keeps itself healthy by producing a range of secretions, so women will experience natural changes in discharge throughout their monthly cycle.”

A period generally lasts for 4-5 days, followed by slight dryness and then an increase in discharge. This will normally be white at first and then change to a clear, stretchy consistency during peak fertility. After ovulation, it changes to a dryer, thicker white or creamy mucus, which sperm won’t be able to swim through. If you’re pregnant this doesn’t change. If you’re not, it’s back to the next period.”

“Even in a healthy vagina, there will be a variety of changes to your ‘normal’ discharge, and these can also vary depending on your age and other factors. A change in discharge to it becoming really thin and watery, or thick and cottage cheese like, or a fishy or unpleasant smell may be a sign that something is wrong and your natural balance has been upset – you can check your symptoms at via the online symptom checker or speak to your doctor, pharmacist or sexual health clinic if you are worried.”

5. How do I keep my vagina clean?

Your vagina cleans itself. It is a common misconception that having conditions like BV means you are not clean – in fact when women notice an unpleasant smell (especially after sex) they will often reach for the soap or perfumed shower gel – this can actually make things worse! There’s a delicate eco-system up there, working hard to keep a balance of bacteria so douching or washing with perfumed products can upset this balance and cause BV. As part of your daily cleaning routine, washing once a day with just water around the vulva, which is the skin around the opening, is fine.”

“By understanding your own normal and staying in tune with your body it will help you determine whether you have any issues. If you notice any changes, don’t sit with on-going symptoms wishing them way, discuss them with your Pharmacist who will happily help you, or make an appointment to discuss them with your GP. The chances are it will be something easily treated and managed.”

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