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Wipe from front to back always when using the toilet to prevent bringing bacteria near the anus towards the vagina and urethra.

Use protective covering on publicly used or unfamiliar toilets. While sexually transmitted diseases (STD) are categorized as such because they require “body heat” to be transmitted, many other infections can be transmitted to exposed genitalia.

When it comes to bodies of water & vaginal infection, it depends! Chlorinated pools and the ocean are safe. Hot tubs are generally safe unless you have cuts/scratches/open wounds of genital skin, immune compromise (due to illness or simply “you are sick”).

Women in menopause can be vulnerable because they have stopped making the hormones that cause protective discharge, yet the vagina does not reclose (to its prepubertal state).  Do not swim in rivers or lakes because they can accumulate the bacteria that may trigger infection.

Do not place food or fragrance in your vagina for any reason. This includes vaginal douches with fragrance. While occasional (not more than monthly) douching is okay, women should only use natural products (i.e. baking soda or vinegar) with water. While this is a common West Indian culture passed on through generations for good vaginal health, women unfamiliar with douching should not make their own, but rather purchase it pre-prepared to avoid the irritation of use of too much of the natural products.

Develop a consistent habit of condom use with sexual activity. Many generations of women were allowed to develop the belief that monogamy protects us from STD, we now know better. Nine out of ten adults have been exposed to HPV.  There are enough different types to be infected with a new one every time you have a new partner.  The vaccine does not protect against them all. Women have no symptoms of chlamydia or gonorrhea.

And, semen itself (which has a pH that is very different from that of the vagina) can trigger the development of a non-sexually transmitted infection. I am very sad to report that, as a practicing gynecologist, I have noted that married women are more likely to use condoms than single women.

This is because many single women are using other forms of birth control; so, they mistakenly believe themselves to be “covered.”  False! The prevention of unintended pregnancy and the prevention of infection are two entirely different things.

Do not “hold it” when you have to urinate. Bladder infection is  more common amongst women than men. Cranberry juice and drinking (at least 1 liter) water daily both help to prevent bladder infection.  A healthy bladder & a healthy vagina are very closely linked; and women often cannot distinguish which is the source of irritation “down there.”

Health care providers can send cultures, of the vagina and of the urine to detect infections that may not be immediately apparent. You can request that this be done during your visit.

All sexually active women should be regularly tested for STD as a part of their preventive women’s health care.

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Get Well Wednesday: What’s Up ‘Down There’  was originally published on

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