Worried about what’s normal “down there?”

Women are inundated with ideas about what they should look and feel like in their nether regions. We can help you separate fact from hype.

Ignore marketing and celebrity hype about products and treatments
Debra (Burt) Ames, CNM

Like an ear, a nose or a myriad other body parts, women’s genitalia comes in a variety of shapes and sizes. Unfortunately, due to the proliferation of marketing, celebrity endorsements and societal pressures, it’s become another area of the body for women to feel insecure about.

Like a fingerprint, every woman’s genitalia––including the pubis, labia, clitoris, vulva and vagina––are all different. But more than ever, women are subjected to a wide variety of ideas about what “perfect” looks like, when there’s no such thing. Even many textbooks portray the female genitalia as pink and smooth, with no hair and thin, trim labia; this doesn’t reflect reality.

The result is an increase in the use of unnecessary vaginal products––including douches and cleansers––and unnecessary cosmetic services, like waxing and even surgery. In fact, a recent report by the American Society of Plastic Surgeons showed that labiaplasty (a procedure in which the labia minor is trimmed to tuck up into the labia majora) increased 39 percent from 2015 to 2016.

Here are a few key things to remember:

Size doesn’t matter. There is no standard size and shape of a woman’s external genitalia. Some women have longer or thicker labia, and others are smaller or thinner. Texture can vary tremendously from relatively smooth to very wrinkled or bumpy, with lots of folds. Some women have a more prominent clitoris, and others are more hidden. It’s all fine.

Hair is normal. Currently, our culture seems to encourage women to remove all or most of their pubic hair. It’s fine if that’s what you prefer, but there is no medical reason to do so. Actually, in addition to the time, effort and discomfort involved, hair removal increases the risk of problems like irritation and infection from things like ingrown hairs for nicks from a razor.

Color may vary. The color of genitalia can range from pink to red, brown, or even purplish. Just like skin tone, the color of women’s genitalia varies. It can also change over the course of your lifetime, such as after childbirth.

Vaginas are self-cleaning. There is no need for you to wash the inside of your vagina, or to douche it, steam it, moisturize it or any of many other things we’re currently seeing promoted in the media.

All you really need to do is regularly wash your external genitalia with water, or if preferred, with a very mild soap, and forget the rest. Cleansers can strip the vagina of its healthy flora and increase your risk of yeast and other infections. Fragrances (including scented tampons) can also cause irritation and upset the vagina’s natural pH balance.

The amount of normal vaginal discharge varies from woman to woman, and changes at different points in a woman’s cycle. This is how the vagina cleans itself. The smell and consistency of the discharge will also change throughout your cycle.

When to see a women’s health provider

If you are considering using a new product or treatment for your vaginal area, talk to your women’s health provider first. Tell us your concerns. We will work with you to come up with a solution that won’t do more harm than good.

You should also see your provider if you experience:

  • Pain or discomfort during or after sex or other activities. There are some anatomical issues or conditions that can be corrected if they cause a problem.
  • New lumps or growths. It’s normal to get the occasional pimple or even a bug bite, but if you find a lump or growth, get it checked.
  • Whitish patches or a rash that’s not due to hair removal.
  • Intense itching, burning, or bleeding of the skin.
  • A discharge that is lumpy, gray, yellow or green.
  • Spotting between periods.

There are lots of products and trends out on the market that promise to rejuvenate or enhance women’s genital areas, preying on, or even creating, insecurity and unnecessary worries. However, it’s an area of the body that’s pretty low-maintenance: a daily, gentle, external cleansing with water and regular annual- or semi-annual exams by a women’s health care provider to catch potential problems early.

There is nothing you can ask us that you should be embarrassed about. We pride ourselves on our ability to get to know our patients and address their concerns without judgement so you can feel comfortable talking about anything. A big part of what we do in many cases is to set your mind at ease.

Have questions or concerns? Schedule an appointment online or call us: 413-562-8016 for our Westfield office or 413-736-9978 for our Springfield office.