User:Kezibae/Feminine hygiene

Cleansing products

 * Douches: A fluid used to flush out the inside of the vagina.
 * Feminine wipes: A moist, sometimes scented cloth used to wipe the vulva.

Feminine hygiene products that are meant to cleanse may lead to allergic reaction and irritation, as the vagina naturally flushes out bacteria. Many health professionals advise against douching because it can change the balance of vaginal flora and acidity.Research shows that the vagina's features allow it to naturally defend itself from harmful microorganisms. The innate defense mechanisms against vulvovaginal infections encompass the normal vaginal flora, acidic vaginal pH, and vaginal discharge. Resident bacteria play a crucial role in maintaining an acidic pH and outcompeting external pathogens for adhesion to the vaginal mucosa. Additionally, these bacteria defend against pathogens by generating antimicrobial compounds like bacteriocin. In vitro analysis of vaginal fluids from five women demonstrated activity against non-resident bacterial species, including Escherichia coli and Group B Streptococcus. This protection against Group B Streptococcus holds particular significance for pregnant women, as it commonly colonizes the vagina via the gastrointestinal tract, elevating the risk of preterm delivery, neonatal meningitis, and fetal death. Moreover, it may lead to asymptomatic bacteriuria, urinary tract infections, upper genital tract infections, and postpartum endometritis.

Risks
The different products may carry some health risks, some of which might be proven, others speculative.


 * Toxic shock syndrome: A rare illness that may occur when tampons are worn for long periods of time, although not directly linked to tampon use but caused by poison linked to bacteria of the Streptococcus pyogenes or Staphylococcus aureus type.
 * Irritation: Can be caused by fragrances, neomycin (adhesive on pads), tea tree oil, benzocaine. Inflammation can also be a risk associated with some products.
 * Yeast infection: A fungus.
 * Bacterial vaginosis: Overgrowth of naturally occurring bacteria in the vagina that leads to a type of vaginal inflammation. The imbalance of bacteria from its natural state has been connected to bacterial vaginosis. Bacterial vaginosis manifests as a uniform white/gray layer on the vaginal walls and vulva, accompanied by a fishy odor and a vaginal pH exceeding 4.5. The challenge of recurrence arises from the adaptive mechanisms of the bacteria and the inadequate re-establishment of normal vaginal flora.


 * Exposure to chemicals: some period underwear companies (like Thinx, Ruby Love, and Knix) are facing class action lawsuits for products containing harmful toxins like per- and polyfluoroalkyl substances (PFAS) which may be linked to adverse health outcomes like cancer.

The vulvovaginal area
The vulva acts as the initial defense line, shielding the genital tract from infections. Often, contaminants accumulate in the folds of the vulva, and factors like increased moisture, sweating, menstruation, and hormonal fluctuations can impact the growth and balance of microbial species, potentially leading to odor and vulvovaginal infections.

Distinct from other skin areas, vulvar skin exhibits variations in hydration, friction, permeability, and visible irritation. It is more susceptible to topical agents compared to forearm skin due to increased hydration, occlusion, and friction. The non-keratinized vulvar vestibule is likely more permeable than keratinized skin. Notably, genital skin is unique with a thin stratum corneum and large hair follicles, making it easier for microbes and substances to permeate.

The vagina, a fibromuscular canal extending from its external opening in the vulva to the cervix, is primarily composed of smooth muscle covered by a non-keratinized epithelial lining. This lining, until menopause, remains thick, kept moist by fluid from the vaginal wall and mucus from cervical and vestibular glands.

Vaginal discharge
Before reaching puberty until after menopause, women typically experience a natural and healthy occurrence of vaginal discharge. This discharge comprises bacteria, desquamated epithelial cells shedding from the vaginal walls, along with mucus and fluid (plasma) produced by the cervix and vagina. Throughout the menstrual cycle, the quantity and consistency of the discharge undergo variations. At the start and end of the cycle when estrogen levels are low, the discharge is dense, adhesive, and unwelcoming to sperm. As estrogen levels increase before ovulation, the discharge gradually becomes clearer, more liquid, and stretchier.

Discrepancies in various ethnic groups
Feminine hygiene presents discrepancies in various ethnic groups. Differences in feminine hygiene practices are often associated with varying cultural beliefs and religious customs. Research indicates that Afro-Caribbean immigrants, in contrast to Caucasian women, are more inclined to cleanse the vulva with bubble bath or antiseptic. This practice aligns with the belief in the necessity of thorough body cleansing for health and well-being. Among Orthodox Jewish women, a ritual bath known as mikveh is performed after menstrual periods or childbirth to achieve ritual purity. In the Muslim faith, both men and women partake in a bathing ritual called full ablution (ghusl) after sexual intercourse or menstruation as a purification practice. In regions like Mozambique and South Africa, certain women opt for internal cleansing of their vaginas using substances such as lemon juice, saltwater, or vinegar with the intention of eliminating vaginal discharge and "treating" sexually transmitted diseases.

A research study involving 500 women in Iran revealed a notable association between bacterial vaginosis and inadequate menstrual and vaginal hygiene practices. Additionally, findings from a household survey conducted by Anand et al. indicated that women employing unhygienic methods during menstruation—excluding sanitary pads or locally prepared napkins—were 1.04 times more likely to report symptoms of reproductive tract infections. Furthermore, these women were 1.3 times more likely to experience abnormal vaginal discharge, encompassing symptoms like itching, vulvar irritation, lower abdomen pain, pain during urination or defecation, and low back pain. In another investigation, findings revealed that women engaging in the use of bubble bath on the vulva exhibited a twofold increase in the likelihood of experiencing bacterial vaginosis, in contrast to those who refrained from using this product. Furthermore, the occurrence of bacterial vaginosis was three times greater among women who applied antiseptic solutions to the vulva or within the vagina. Additionally, the frequency of bacterial vaginosis was six times higher in women utilizing a douching agent. When it comes to bacterial vaginosis, African American women are 2.9 times more likely to be diagnosed with bacterial vaginosis compared to women of European ancestry, possibly due to variations in their "normal" vaginal flora.

Menstrual Hygiene : the adolescent girl
To observe the menstrual hygiene in adolescent women a study was conducted in a secondary school in Singur West Bengal. Conducted as a descriptive, cross-sectional study involving 160 girls in West Bengal, the findings revealed that a significant portion of respondents became aware of menstruation before menarche, with mothers being the primary source of information. While the majority recognized menstruation as a physiological process, knowledge and usage of sanitary pads were limited. Most girls employed soap and water for cleaning purposes, and a considerable percentage observed various restrictions during menstruation. Among the 160 respondents, 108 (67.5%) girls were aware of menstruation before experiencing menarche. Mothers were the primary source of information for 60 (37.5%) girls. A majority, 138 (86.25%), considered menstruation a physiological process. Only 78 (48.75%) girls were familiar with the use of sanitary pads during menstruation. In terms of practices, merely 18 (11.25%) girls used sanitary pads during menstruation. For cleaning purposes, 156 (97.5%) girls utilized both soap and water. Regarding restrictions, 136 (85%) girls adhered to various restrictions during menstruation.