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Vaginal health products are everywhere again, but are they even necessary?

A plethora of new vaginal "health" products that claim to keep your vagina pretty, “fresh,” and healthy have emerged as of late, so much so that media outlets have declared V-care one of the biggest wellness trends of 2019. Fur sells oil for pubic hair and skin, while The Perfect V sells beauty sheets for your vulva. Lady Suite sells a probiotic cleanser. Plenty of other brands sell spritzes, washes, and wipes. Douches and wipes have been pushed on women for a while — but now, brands market these and similar products as “self-care.” Are all these vulvar and vaginal health products really necessary, though? And more importantly, are they safe?

Before this recent explosion of products, consumers posed the same question about douches, products that cleanse the vagina with water and other fluids. It turns out that many doctors advise against douching, since it can disrupt the delicate bacterial ecosystem in the vagina, which in turn maintains the acidic environment needed to prevent irritation and infection. Yet nearly one in five women ages 15 to 44 in the US douches, according to the Office on Women’s Health. Douching persists, as Timeline points out, thanks largely to the longstanding marketing strategy of cashing in on women’s insecurities — namely that their vaginas are smelly and gross.

Nearly a decade after Summer’s Eve drew criticism for employing this very tactic to market its feminine hygiene products, a new cadre of “intimate care” brands have emerged. Many distinguish their products from their older, mainstream counterparts through attractive, millennial-bait packaging, as well as the promise of gentle, naturally-derived, organic ingredients. They focus not only on cleansing, but also on pampering and beautifying — a means of feminist self-care. The Perfect V describes its offerings as “pure, indulgent pampering and love for your ‘V,” while “lady-owned” Lady Suite says it’s “dedicated to helping all ladies fall in love with their bodies” and wants to facilitate “a positive connection between you and your lady parts.”

But are these products really all that different from their predecessors who pandered to patriarchal expectations that women’s bodies constantly be groomed, fragrant, "pretty," and youthful? Experts still believe that their appeal is more so psychological than physical.

“As a general matter, there is no good evidence that women need these products,” says Stacy Lindau, a professor of obstetrics and gynecology at the University of Chicago, about douches, feminine wipes, or any variation of them. For the most part, vaginas and vulvas have evolved to function without their help. Think about the safeguards your other mucosal surfaces have in place, like your nose, which contains hair and mucus to trap germs, or your eyes, which produce tears to keep them lubricated. Your vagina works in a similar way, Lindau explains, with hair on the outside and mucus on the inside.

In fact, these products may even worsen vaginal health, and we have little evidence of their safety, Lindau tells Mic. Washes, soaps, sprays, and other products used to cleanse the vulva or vagina can irritate and break the skin, as well as cause inflammation that prevents bacteria, blood vessels, and nerves from maintaining an acidic environment in the vagina, she adds.

Several patients who have visited her with complaints of vaginal dryness and painful intercourse saw their symptoms improve after they stopped using feminine hygiene products. (She does note that there are some cases in which intimate care products may help, such as for women with breast cancer who have undergone therapy that lowers their estrogen levels. Since reduced estrogen levels can cause vaginal dryness, they may benefit from products that restore its moisture.)

“Any person with a vagina who might want to use these products should look at the ingredient list and ask themselves how many they can pronounce or recognize,” Lindau says. You should also ask yourself whether you would put these ingredients in other mucosal membranes, like your eyes or mouth. If the answer is no, then you probably shouldn’t put them in your vagina, either.

And unless you’ve had a hysterectomy, remember that the vagina connects to the cervix and uterus, and finally, the fallopian tubes, which enter the abdominal cavity — meaning that “we’re putting chemicals into a body part that allows them to essentially travel to the inner cavity of the body,” Lindau says. The abdominal cavity, in turn, houses many other organs, and there’s a chance that douching may carry germs into that cavity.

Many of the newer intimate care products are advertised as “pH-balanced,” which may make you think they won’t throw off your vagina’s pH, but Lindau says that they may still contain ingredients that cause irritation. There’s also no strong evidence to suggest that probiotics — typically live, beneficial bacteria — will restore a healthy bacterial ecosystem in the vagina. Although researchers are trying to understand the human microbiome, “we’re not at the point where we can take early scientific discoveries and translate them to a recommendation.”

So, what are some proven ways to stay healthy down there? First, consider embracing your bush. Lindau says that pubic hair plays an important role in maintaining vulvar and vaginal health. Second, “let your body do its job,” Lindau says. “Avoid soaps, sprays, oils, and creams to the vulva and vaginal area unless there’s a very good reason.” Mucus already expels discharge, blood, and semen from the vagina.

Lastly, body odor is normal, Lindau says. The beneficial bacteria in the body naturally produce some odor. Using soaps and other odor-eliminating products could destroy beneficial bacteria and cause an overgrowth of harmful bacteria. If your vagina smells like baby powder and roses, you’ve probably killed important bacteria that help keep it healthy. A fishy scent or other strong odor may point to a problem, though, especially if you’re also experiencing issues such as itching or discharge, according to the Mayo Clinic. See a doctor if you’re worried about vaginal odor, rather than try to mask or remove it with an intimate care product.

To Lindau, these self-care-gone-south products speak to a larger, problematic obsession with hygiene — “where women feel that they need to use cleansing products in order to be sexually active or to be appealing.” Even if you’re drawn to these products mainly for the wellness they promise, you’ll probably have more luck finding it elsewhere.