Intimate care

An area of health where the most common mistake is doing too much. The vagina maintains itself, the vulva needs very little, and a large share of the irritation seen in clinics is caused by products bought to prevent it.

The principle

Two structures, two different requirements. The vagina is an internal canal with its own regulated environment, maintained by bacteria that produce acid and keep the pH low. Nothing needs to go into it to clean it, and anything that does tends to disturb the balance that protects it. The vulva is external skin, and like other skin it can be washed, but it is thinner and more absorbent than skin elsewhere and reacts badly to detergents and fragrance.

Almost everything worth knowing follows from that. The vulval hygiene page sets out the practical routine, and the vaginal microbiome page explains what is happening internally and what does and does not affect it.

Why so much is sold for this

The market for intimate washes, wipes, sprays, deodorants and douches exists because the subject carries shame, and shame sells. The messaging is consistent: that the body is unclean by default and needs correcting. The clinical picture is the opposite. Vulval dermatology clinics see a substantial number of people whose symptoms began with products bought to solve a problem that was not there.

There is a narrower group of products that has a legitimate role: unperfumed emollients used as soap substitutes, barrier preparations for irritated skin, and lubricants used to reduce friction during sex. Those are functional rather than cosmetic, and they are described where relevant on the topic pages.

What normal actually looks like

Vaginal discharge is normal and its character changes through the menstrual cycle: clearer and stretchier around ovulation, thicker afterwards, and different again with hormonal contraception, in pregnancy and after menopause. Volume varies enormously between people.

A mild scent is normal, and it changes across the cycle. The idea that the vulva should smell of nothing, or of flowers, is a marketing invention rather than a health standard.

The vulva itself varies widely in colour, in the size and shape of the inner and outer labia, and in symmetry. Asymmetry is the norm rather than the exception.

When something is genuinely wrong

Itching that persists, soreness, a discharge that has changed in colour or smell, bleeding outside a period, pain with sex, or any lump, ulcer or white patch. Those need an examination. Repeated self treatment for thrush is the most common way that a skin condition such as lichen sclerosus goes undiagnosed for years, and studies of self diagnosis for vaginal symptoms consistently find it unreliable. See thrush and bacterial vaginosis.

Periods

The choice between pads, tampons, cups, discs and absorbent underwear is largely a practical one, and the differences that matter are absorbency, comfort, how long a product can be worn, and how it fits into a day. Safety questions come up repeatedly and deserve a straight answer rather than either alarm or dismissal. See period products.

Hair removal

Entirely a matter of preference, with no health benefit either way. Pubic hair is not unhygienic. Removal methods carry small risks: shaving causes folliculitis and ingrown hairs, waxing causes irritation and occasional burns, and any method that breaks the skin creates a route for infection. Anyone with a vulval skin condition should be more cautious, because trauma to affected skin provokes flares.

Last reviewed: September 2026