Does the Vagina Clean Itself?
Discover how the vagina’s self-cleaning system works, why you should never douche, and when unusual odor means you need medical attention, not washing.
In a Canadian survey of 1,435 people, about 95% had used at least one product in or around the vagina. Washes, wipes, sprays, powders, douches: the list went on, and 64% had used at least one of them inside [1].
So does the vagina clean itself? Yes, and it's very good at it. Here's how it works, why most of those products are working against it, and what's worth your attention instead.
How Does the Vagina Clean Itself?
The short answer: with discharge. That fluid in your underwear isn't a sign that you're dirty. It's the cleaning system itself [2].
Discharge is made of shed cells from the vaginal lining, bacteria and fluid from glands, and it helps protect you from infections [2]. As it flows out, it carries old cells and other debris with it.
Healthy discharge is usually white or clear, with a slight smell that isn't unpleasant [2]. It also changes through your cycle. It's thick and sticky early on, then turns thin and watery around ovulation as estrogen rises [2].
So having more discharge on some days than others is normal, since it's your body doing its job, not something to wash away.
Your Good Bacteria Keep Things Acidic
The second part of the system lives inside you. In most healthy vaginas, Lactobacillus bacteria are in charge, and they make lactic acid [2].
That acid keeps the vagina acidic, which helps protect you from bacteria that cause trouble [2]. You may have read that a healthy vaginal pH is about 3.8 to 4.5.
Here's the part that surprises people: it may be even more acidic than that. In a small study, researchers at Johns Hopkins measured the fluid of 56 women with healthy, Lactobacillus-led bacteria under low-oxygen conditions like those inside the body. The average pH was 3.5 [3].
At that acidity, lactic acid is a strong germ fighter in the lab, so the researchers think a Lactobacillus-led vagina has more built-in protection than earlier studies suggested [3].
Estrogen helps keep this going. After menopause, as estrogen drops, Lactobacillus numbers tend to fall and vaginal pH tends to rise [2].
If Your Vagina Cleans Itself, What Should You Wash?
Just the outside. Your vagina, the canal inside, cleans itself. Your vulva, the outer part you can see, is a different place with different microbes [2], and it's the only part you need to wash.
Warm water is enough for most people. If you like a cleanser, choose a gentle, unscented one, and keep it on the outside.
Why Douching Backfires
Douching is the clearest example of cleaning gone wrong. It's linked to BV, pelvic inflammatory disease and preterm birth, yet a 2023 review estimates that about a third of women in the US douche [2].
The CDC says douching might make BV more likely to come back, and that no data support douching to treat it or ease symptoms [4]. In the Canadian survey, people who had douched in the past six months had 7 times higher odds of reporting a BV diagnosis, though only 45 people were in that group, so the number is rough [1].
Feminine washes and gels weren't off the hook either, with about 3.4 times higher odds of reporting BV [1]. A survey can't show which came first, though. Some people may reach for these products because they already have symptoms [1].
Researchers suspect a harmful cycle: you wash to get rid of itching, odor or discharge, the extra washing upsets your vaginal bacteria, and the symptoms can get worse [2].
What Should a Clean Vagina Smell Like?
Not like nothing: a mild scent is normal and healthy [2]. Many scented feminine products are made to cover up a smell that, in most cases, is completely normal [2].
Your scent can shift a little through your cycle, after a workout or after sex. Here's more on what a healthy vagina smells like.
A strong, fishy smell is different. It's a classic sign of bacterial vaginosis (BV), especially with a thin, milky discharge [4]. BV is the most common cause of vaginal discharge worldwide, yet in a large US survey, most women who had it had no symptoms [4].
Itching with thick, white, clumpy discharge points more toward a yeast infection [2, 4]. Here's how to tell BV from a yeast infection. Whatever the cause, more washing won't fix it.
What About Probiotics?
So far, the CDC says no studies support probiotics as a treatment for BV. One trial stands out: after antibiotics, women who used a vaginal probiotic made from a single Lactobacillus strain had BV come back less often. That product isn't available to buy yet [4].
For yeast infections, the CDC says there's no solid evidence that probiotics help [4].
Supporting a Healthy Vaginal pH
Lactic acid is the same acid your good bacteria make, which is why it shows up in products made to support a healthy, acidic pH. Boric acid has been used in the vagina for decades, and when doctors prescribe it, the usual dose is 600mg [5].
At that dose, boric acid looks safe for women with healthy kidneys who aren't pregnant, but the data is limited, and no study has compared doses [5]. The review's authors feel boric acid should be prescribed by a provider, so check with yours before you start [5].
Neycher's Odor Be Gone suppositories pair lactic acid for your natural acidity with 300mg boric acid, half the 600mg dose doctors usually prescribe [5]. They also contain 20mg hyaluronic acid for moisture, a soothing compound from licorice root, tea tree oil and vitamin E.
They're for freshness and comfort, not a replacement for a doctor's care. If odor keeps coming back, see your provider to check for an infection.
How to use it safely
Use one suppository at bedtime for 10 nights in a row, then as needed, and skip it during your period. Stay lying down for about 30 minutes, and wear a thin pad for any discharge.
It's for vaginal use only, so never swallow it, and keep it away from kids [5].
Boric acid isn't recommended during pregnancy, so if you're pregnant or trying to get pregnant, check with your doctor before use [5]. After giving birth, wait for your checkup and your doctor's okay before you put any product in your vagina. If you're breastfeeding, check with your doctor first.
If you have kidney problems, or sores or broken skin in or around your vagina, talk to your doctor before use, since it's not clear how much boric acid gets absorbed through damaged tissue [5].
If it stings or burns, stop using it. If symptoms don't settle in a few days, check with your doctor.
Using condoms? Read this first
These suppositories have a fatty base plus tea tree oil and vitamin E. Oil-based vaginal products might weaken latex condoms and diaphragms, which can make a condom more likely to break [4].
For a similar oil-based vaginal suppository, the CDC advises not relying on condoms or diaphragms for 72 hours after use [4]. So any time you use them, and for three days after, don't count on latex condoms or diaphragms for birth control or STI protection. If you could get pregnant, use another kind of birth control too.
When Should You See Your Provider?
See your provider if you notice a strong or fishy smell that doesn't go away, discharge that changes color or texture, or itching, burning or pain. The same goes for symptoms that keep coming back after treatment.
Go sooner if you have a fever, pain low in your belly, sores, or a chance you were exposed to an STI. Trichomoniasis, a common STI, can also cause odor and yellow-green discharge [4].
If you're pregnant and notice new discharge or odor, call right away, since BV is linked to pregnancy complications like preterm birth [4].
The rest of the time, your vagina has this handled. Rinse the outside, skip the douche, and let your body do the job it was built for.
This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare provider for any health concerns.
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References
[1] Crann, S. E., Cunningham, S., Albert, A., Money, D. M., & O'Doherty, K. C. (2018). Vaginal health and hygiene practices and product use in Canada: A national cross-sectional survey. BMC Women's Health, 18(1), 52. PMID: 29566756. https://pmc.ncbi.nlm.nih.gov/articles/PMC5865287/
[2] Holdcroft, A. M., Ireland, D. J., & Payne, M. S. (2023). The vaginal microbiome in health and disease: What role do common intimate hygiene practices play? Microorganisms, 11(2), 298. PMID: 36838262. https://pmc.ncbi.nlm.nih.gov/articles/PMC9959050/
[3] O'Hanlon, D. E., Moench, T. R., & Cone, R. A. (2013). Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota. PLoS One, 8(11), e80074. PMID: 24223212. https://pmc.ncbi.nlm.nih.gov/articles/PMC3819307/
[4] Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports, 70(4), 1-187. PMID: 34292926. https://pmc.ncbi.nlm.nih.gov/articles/PMC8344968/
[5] Mittelstaedt, R., Kretz, A., Levine, M., Handa, V. L., Ghanem, K. G., Sobel, J. D., Powell, A., & Tuddenham, S. (2021). Data on safety of intravaginal boric acid use in pregnant and nonpregnant women: A narrative review. Sexually Transmitted Diseases, 48(12), e241-e247. PMID: 34561373. https://pmc.ncbi.nlm.nih.gov/articles/PMC10100571/
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