Sex Roles (2018) 78:697–709
DOI 10.1007/s11199-017-0824-1
ORIGINAL ARTICLE
BClean and Fresh^: Understanding Women’s use of Vaginal
Hygiene Products
Amanda L. Jenkins 1 & Sara E. Crann 1 & Deborah M. Money 2 & Kieran C. O’Doherty 1
Published online: 5 September 2017
# Springer Science+Business Media, LLC 2017
Abstract We explore Canadian women’s use of vaginal hy-
giene products including feminine washes, douches, sprays,
deodorants, wipes, and powders. Vaginal hygiene products in
North America are part of a two billion dollar industry, which
focuses on cleanliness and freshness in their advertising
toward women. In interviewing women who were currently
using or had previously used vaginal hygiene products, we
found that vaginal cleanliness and freshness were also
frequently brought up as reasons for using these products.
Using an inductive thematic analysis informed by Braun and
Clarke (2013) we explore how attaining a clean-and-fresh
vagina has become a subjective physical need for the partici-
pants in our study. In a society where female genitalia are
constructed as unclean, we argue the marketing of vaginal
hygiene products contributes to the problematization of
women’s genitalia by suggesting women need to use these
products to attain an ideal (i.e., clean and fresh) vagina. The
reliance on vaginal hygiene products reported by participants
in attaining sensations of vaginal cleanliness and freshness
raises concerns in the context of medical literature suggesting
adverse health risks that may result from using some of these
products. Potential risks include bacterial vaginosis, pelvic
inflammatory disease, and a higher susceptibility to sexually
transmitted infections, among others. We believe that compa-
nies that advertise these products as beneficial for vaginal
* Kieran C. O’Doherty
kieran.odoherty@uoguelph.ca
1
Department of Psychology, University of Guelph, Guelph, ON N1G
2W1, Canada
2
Department of Obstetrics & Gynaecology, University of British
Columbia, Vancouver, BC, Canada
health and hygiene can be perceived as not just misinforming
women but also profiting from products that are harmful.
Keywords Health . Qualitative research . Feminism .
Hygiene . Marketing . Female genitalia . Vagina
Over the counter vaginal hygiene products, including
douches, deodorant sprays, washes, personal wipes, and pow-
ders, are part of a growing market with women in the United
States spending over two billion dollars a year (Nicole 2014).
Advertising and marketing messages for these types of vagi-
nal hygiene products have been said to construct vaginal
cleansing as both desirable and trendy for women (Ogbe and
Leye 2015). Vaginal hygiene products are typically marketed
toward women through the pervasive use of words such as
Bclean,^ Bfresh,^ and Brefreshed^ in product names and de-
scriptions. The names of vaginal hygiene products currently
available, such as Vagisil Clean Scent Feminine Wash,
RepHresh Clean Balance Douche, Summer’s Eve Fresh
Scent Douche, and Femfresh Freshness Deodorant, exemplify
the use of the clean-and-fresh ideal in their product marketing.
Despite the positive associations with words such as clean
and fresh, research on the use of some vaginal hygiene prod-
ucts points to potential health risks associated with their use.
In particular, some medical research suggests douches, lubri-
cants, powders, and deodorant sprays may lead to adverse
health consequences for women’s vaginal health, including a
higher susceptibility to sexually transmitted infections (STIs),
pelvic inflammatory diseases, human immunodeficiency virus
(HIV) infection, bacterial vaginosis, and an increased risk of
ovarian cancer (Fashemi et al. 2013; Hickey 2012; Martino
and Vermund 2002; Rosenblatt et al. 2011). There is growing
interest in the role of the vaginal microbiome in women’s
health, and evidence suggests that perturbations in vaginal
698
microbiota may negatively affect the growth of healthy bacte-
ria, lead to changes in the vaginal pH, and alter the vaginal
immune barrier leading women to be more susceptible to in-
fections (Fashemi et al. 2013). Although more research is
needed, available evidence does suggest that at least some
vaginal hygiene products may cause damage to the vaginal
microbiome and lead to negative health outcomes.
Although there are potential health concerns, vaginal hy-
giene products continue to be marketed and made available to
women over the counter. The success of marketing for vaginal
cleansing products occurs in the context of cultural construc-
tions of vaginas as shameful and disgusting (McKee et al.
2009; Seidman et al. 2006). These negative cultural construc-
tions of women’s genitalia additionally stem from associations
of bodily excretions, particularly menstruation and vaginal
discharge, with uncleanliness (Johnston-Robledo and
Chrisler 2011; Johnston-Robledo and Stubbs 2013; Kama
and Barak-Brandes 2013). Historically, vaginas have also
been perceived as carrying and transmitting STIs (Braun and
Wilkinson 2001), contributing to the construction of female
genitalia as unclean. Although male genitalia are equally ca-
pable of spreading infection, they generally escape being pa-
thologized in ways that the female body is.
Additionally, women face stereotypes around female geni-
talia being portrayed as Bsmelly, dirty, and leaky^ (McDougall
2013, p.776). Women’s bodily fluids, including vaginal dis-
charge, menstrual blood, and breast milk, have been exten-
sively discussed within feminist literature as part of the Bleaky
female body^ (Shildrick 2015, p.102, also see Bobel 2010;
Grosz 1994; Overend 2011; van Amsterdam 2014). In con-
trast to the contained, dry, and hard bodies of men, women are
conceptualized as having bodies that uncontrollably leak liq-
uids associated with childbirth, menstruation, and sexual ex-
citement (Chrisler 2011). These bodily fluids are discussed by
Kristeva (1982, p. 1) as representing the Babject^ in that they
defy boundaries by permeating the body and thus threatening
bodily borders and social order. Women’s bodies, in associa-
tion with these fluids, are further noted by Grosz (1994) as
being linked to the out-of-control female body that society
fears.
These constructions, and women’s internalizations of the
stereotypes associated with vaginas as unpleasant, unattrac-
tive, and odorous, have been associated with women having
feelings of humiliation, shame, embarrassment, and disgust
toward their own vaginas (Fahs 2014; Moran and Lee
2016). Given these negative labels, vaginas are constructed
as a source of concern for women (Fudge and Byers 2016).
In a society that problematizes female genitalia, many women
are unaware of the diversity of Bnormal^ vaginas (Gosse 2015,
p. 2) and may instead strive toward achieving Bideal^ female
genitalia, a Byouthful, tight, rounded vulva, with labia majora,
enclosing the labia minora and clitoris^ (Querna 2008, p. 62).
It is therefore not surprising that more women are seeking
Sex Roles (2018) 78:697–709
cosmetic surgery to address concerns with genitalia regarded
as abnormal (Davis 2009; Liao 2003; Schick et al. 2011).
In the present article, we explore how the growing market
of vaginal hygiene products may further contribute to the
problematization of female genitalia. We draw on a series of
interviews with Canadian women about their use of and prac-
tices involving vaginal hygiene products. Understanding how
women talk about vaginal hygiene and their use of vaginal
hygiene products is important in light of research indicating
women have increasingly negative perceptions of their geni-
talia (Fahs 2014; Moran and Lee 2016). We focus, in particu-
lar, on the notion of clean and fresh which featured promi-
nently in the reasons women gave for their use of vaginal
hygiene products. In examining the construction of the clean
and fresh vagina, we borrow the concept of cultural
imperatives, described by Braun and Kitzinger (2001) as cul-
tural standards of beauty and normality in which women’s
bodies are viewed as sites of improvement. We use this con-
cept to understand how the clean and fresh vagina has come to
be an expectation placed upon many women in Western
culture.
This expectation is one that promotes and accounts for
women’s use of vaginal hygiene products. We further argue
that, for our participants, achieving sensations of being clean
and fresh moved beyond the cultural imperative to that of a
subjective physical need. We present an inductive thematic
analysis informed by Braun and Clarke (2013) to understand
women’s experiences of feeling clean and fresh and the
broader Western cultural expectations of vaginal cleanliness
placed upon women. While genitalia and vagina are often
used interchangeably in feminist literature, we distinguish be-
tween these terms in our analysis due to different body parts
being implicated in women’s use of vaginal hygiene products.
We use the term genitalia to refer to multiple body parts (vul-
va, labia majora and minora, etc.) and the genital area more
broadly in contrast to the more specific anatomical term vagi-
na, which we use to refer to any specific practices associated
with it (e.g., vaginal douching).
Braun and Kitzinger (2001) understand the notion of cul-
tural imperatives as unrealistic standards of beauty within so-
ciety to which women are expected to conform. In explaining
this concept, Braun and Kitzinger draw upon feminist authors
Bordo (1986), Bartky (1988), and Morgan (1991) who argue
that women’s bodies are constructed as sites of self-
surveillance and improvement. In attempting to achieve cul-
tural imperatives, women are expected to improve their bodies
to meet specific societal standards (Braun and Kitzinger
2001). These standards are ones in which a normal body can
only be achieved through body modification (Gimlin 2002).
Other cultural imperatives related to women’s bodies include
the thin body (Brewis 2011), the sexualized body (Northrup
2010), and the ageless body (Urla and Swedlund 1995). Braun
and Kitzinger (2001) argue that improving women’s bodies
Sex Roles (2018) 78:697–709
extends beyond the visible/public body to include the private/
hidden body such as the ideal vagina, described as Ba smooth
curve with no visible labia minora^ (Moran and Lee 2016, p.
2). In their analysis of women’s genitalia, Braun and Kitzinger
(2001) argue that women are faced with the cultural impera-
tive to attain tight vaginas. From their interviews with women,
they reported a concern among participants around having a
loose vagina which they felt was suggestive within society of
being promiscuous or immoral.
Western cultural expectations of having an ideal vagina
also extend to pubic hair. Pubic hair removal has become a
popular and growing phenomenon among women (and more
recently men) who face pressure to trim or entirely remove
pubic hair (Terry and Braun 2011). According to some femi-
nist scholars, part of the pressure women face for removing
pubic hair results from pornography’s idealization of hairless-
ness with an industry standard dictating hairless female geni-
talia as the norm for genital beauty (Cokal 2007; Schick et al.
2011). In addition, publicity around Bdesigner vaginas^ that
promote symmetrical inner labia and hairless, aesthetically
pleasing outer labia has increased women’s insecurity around
their vulva and vaginal appearance (Rodrigues 2012, p.1).
We extend the concept of cultural imperatives to our study
on women’s use of vaginal hygiene products. We conducted
interviews with women who were either currently using or
had previously used vaginal hygiene products including
store-bought and/or homemade douches, cleansing washes,
wipes, powders, deodorant sprays, suppositories, anti-itch
creams, and hair removal products to understand their use
and practices of using these products. During the interviews,
our participants frequently brought up the topic of vaginal
cleanliness and freshness in describing their experiences with
vaginal hygiene products. They frequently used words such as
Bclean^ and Bfresh^ separately and together, conveying a con-
sistent overall message that a clean and fresh vagina was high-
ly desirable. In our analysis, we explore how this notion of
achieving a clean-and-fresh vagina extended beyond a cultural
imperative toward a subjective physical need for some
participants.
Method
Goals and Participants
Forty-nine women from across Toronto and Vancouver were
recruited for interviews as part of the Women’s Health and
Vaginal Microbiome Group Initiative (VOGUE). The
VOGUE Group Initiative involves a Canadian interdisciplin-
ary research team of medical practitioners, scientists, and so-
cial scientists exploring various aspects of the vaginal
microbiome (Albert et al. 2015; Bocking 2015; Reid et al.
2016). A healthy vaginal microbial ecosystem is a vital
699
indication of a woman’s reproductive health and is involved
in quality of life, fertility, and defending against pathogens.
However, disruptions in the balance of vaginal microbiome
through sexual activity, reproduction, birth control, antibiotic
use, or practices such as vaginal douching have been found to
disturb this ecology. One goal of the VOGUE Group
Initiative, and which we explore in the present paper, was to
understand Canadian women’s use of vaginal hygiene prod-
ucts including the reasons and influences for why women are
using them.
Our study consisted of both interviews and a survey com-
pleted by Canadian women. For the present article, we focus
solely on data from the interviews in understanding women’s
reasons for using vaginal hygiene products. Participants were
eligible for an interview if they were 18 years or older, could
read and speak English, and had experience using products or
engaging in practices related to genital/vaginal health and hy-
giene (beyond Bfeminine hygiene^ products for menstruation).
These products included vaginal washes, gels, wipes, pow-
ders, deodorant sprays, suppositories, anti-itch creams, and
douches.
Participants ranged from 18 to 65 years old with a majority
of participants (23 women or 48%) between the ages of 26–
35 years. In addition, 14 (29%) participants were between the
ages of 18–25, 5 women (10%) were between the ages 36–45,
5 (10%) were between the ages of 46–55 and 1 (3%) was
between the ages of 56–65. 34 (71%) participants identified
as White/European with the remaining participants identifying
as East Asian (4 women or 8%), South Asian (2 women or
4%), Southeast Asian (2 women or 4%), Asian (1 woman or
2%), Aboriginal/Indigenous (1 woman or 2%), South
American (1 woman or 2%), West African (1 woman or
2%), African American (1 woman or 2%), and Other (1 wom-
an or 2%). Our sample was predominately heterosexual (41
women or 85%), with some participants identifying as bisex-
ual (6 women or 13%) and queer (1 woman or 2%).
Participants were well-educated with almost half having com-
pleted university degrees (22 women or 46%) and other par-
ticipants having some post-secondary education (10 women
or 21%), college certificates or diplomas (8 women or 17%), a
post-graduate degree (5 women or 10%), or a high school
diploma (3 women or 6%).
Procedure
Interview participants had either previously completed the
survey about vaginal health and hygiene practices as part of
the VOGUE Group Initiative and had agreed to be contacted
about future research or were recruited through study adver-
tisements posted on online classifieds (e.g., Kijiji, Craig’s
List). Interviews were conducted between January 2013 and
May 2014 by the second author and an undergraduate thesis
student JG in Vancouver and Toronto. Following informed
700
consent procedures, interviews were audio-recorded and
lasted between 45 min and 1.5 h. Interviews were primarily
conducted in person aside 6 phone interviews conducted with
participants who were unable to meet in person. Participants
received a $20 Amazon.ca voucher or a $20 cash remunera-
tion. Our study received ethics approval from the University
of Guelph and the University of British Columbia.
As feminist researchers, we approached the interviews with
the understanding that they are co-constructed (Hesse-Biber
2007. All interviews, except for three, were conducted by the
second author, a White Canadian-born woman in her late 20s
during the time of the interviews. JG, a White Canadian born
woman in her early 20s, conducted three interviews with the
guidance of the second author. Although both interviewers
were similar in age and ethnicity to the majority of participants
interviewed, they acknowledged the power and authority im-
bued in their roles as researchers (Hesse-Biber 2007). The
interviewers were mindful of this power differential between
researcher and researched, and participants were viewed as
experts of their lived experiences. Interviews were centered
on eliciting participant’s experiences around their use of vag-
inal hygiene products and to gain insight into their reasons for
using these products. The interviewers also took into account
the sensitivity of the topic which guided the questions asked.
Coding and Analysis
Transcripts were analysed using an inductive thematic analy-
sis informed by Braun and Clarke (2013). Inductive coding
does not fit a pre-existing theoretical framework but rather
seeks to identify concepts as they emerge from the data.
Inductive coding was chosen by the authors to help identify
unexpected patterns in participants’ experiences of using vag-
inal hygiene products. Coding was guided by Braun and
Clarke’s six step process: (a) familiarization with the data,
(b) coding, (c) searching for themes, (d) reviewing themes,
(e) defining and naming themes, and (f) writing the analysis.
This process first began with masked audio recordings being
transcribed verbatim by undergraduate research assistants and
the transcripts being reviewed for transcription errors by the
first and second authors. Transcripts were then read and re-
read by the authors to become fully immersed in the data prior
to coding.
Coding was conducted in NVivo with the authors generat-
ing initial codes for the entire dataset. These initial codes
reflected participants’ reasons and motivations for using vag-
inal hygiene products including using the products before and
after sex, when women perceived there was vaginal odour and
discharge, removing odour associated with menstruation, and,
when they felt unclean. The codes were collapsed into broader
patterns of meaning which generated a tentative list of themes.
This list was further refined by the authors to create a final list
of themes. Although several themes were identified, the
Sex Roles (2018) 78:697–709
overall theme that we focused on here is clean and fresh.
This theme centers around participants’ descriptions and ex-
periences of needing to attain vaginal cleanliness and fresh-
ness through the use of vaginal hygiene products for the pre-
viously identified reasons (sex, menstruation, vaginal odour
and discharge, infections). Five subthemes were refined and
labeled by the authors: (a) achieving clean and fresh, (b) ar-
ticulating clean and fresh, (c) eliminating and masking biolog-
ical processes, (d) consequences of feeling unclean, and (e)
societal messages relating to clean and fresh.
The final phase of Braun and Clarke’s (2013) six-step pro-
cess involved writing the analysis which we contextualized
within existing feminist literature. A social constructionist
(Burr 2003; Potter 1996) framework was taken to understand
how the language used by women in describing their use of
vaginal hygiene products to attain cleanliness and freshness
reflected the broader social and cultural influences of
women’s bodies being constructed as unclean. For example,
language used by participants including Bdirty,^ Bgross,^ and
Bunclean^ in describing female genitalia was deconstructed by
examining how participants used these words in relation to
their use of vaginal hygiene products and connecting this with
Western cultural constructions of women’s genitalia as prob-
lematic. A social constructionist framework further allowed us
to approach the analysis from a critical perspective, in partic-
ular with regard to the gendered messages women receive
around expectations of genital cleanliness. Although Braun
and Clarke’s six-step process is sequential, we note that the
analysis process was recursive where we moved back and
forth between the different phases.
Results
Information about the themes presented in the present paper,
including their frequency across interviews and coding defi-
nitions as well as additional exemplary quotes, can be found in
Table 1. The notion of clean and fresh was used by partici-
pants to describe both their reasons for using vaginal hygiene
products and the sensations they obtained through this use.
Vaginal cleanliness and freshness were discussed in almost
every interview (47 of 49) and was given by these 47 partic-
ipants as the primary reason for using these products. In the
following section, we analyze the construction of the clean-
and-fresh vagina as a Western cultural imperative for our par-
ticipants. We begin our analysis by exploring the various ways
product users used the terms clean and fresh. This is followed
by an analysis of how participants articulated the meanings
they associated with these terms. We then explore the associ-
ations made between notions of clean and fresh and eliminat-
ing or masking biological processes associated with vaginal
odor and discharge. Finally, we analyze societal messages
around vaginal health and hygiene.
Sex Roles (2018) 78:697–709 701

Table 1 Definitions and examples of clean and fresh subthemes

Subtheme Frequency Definition Example quote

of
subtheme

Achieving Clean 47 women Participants’ descriptions of using vaginal hygiene I: Okay and um what were like was your experience like
and Fresh or 96% products to achieve vaginal cleanliness and freshness using the using the wipes?
P: Good, it was good ya and um, its more freshening. And
um, um sometimes you need them when you are out
and doing things and traveling you want to feel just
fresh so you can use it then, they are easy to carry.
(41–45 years-old, Asian, Heterosexual)
Articulating Clean 47 women Descriptions by participants around what clean and/or I: Okay. Umm, and can you sort of describe to me what
and Fresh or 96% fresh felt like after using vaginal hygiene products. um, feeling fresh… feels like?
These descriptions were usually interlinked with what P: Umm, that feeling after you shower [laughs].
not feeling clean and/or fresh felt like I: Okay.
P: Yeah. Um, you know. Yeah. I don’t know else to-
I: Mm hmm.
P: explain it, or in um like not…sweaty or not…or you
don’t, cause you can smell yourself,-
I: Mm hmm.
P: right. You can smell if you’re not fresh. So, yeah.
(26–30 years-old, Asian, Heterosexual)
Eliminating and 36 women Descriptions of participants achieving vaginal cleanliness I: Okay, um, so you mentioned sweaty as something that-
Masking or 73% and freshness related to removing or covering up P: Yeah.
Biological vaginal odor and/or discharge which was viewed as I: is the, I guess the opposite of fresh. Um, are there any
Processes highly undesirable other ways you can think to describe how that would
feel?
P: Umm….um, I guess when you feel like you have
secretions, and you’re not wearing a panty liner. Moist.
Um…
I: Okay.
P: That feeling.
I: Okay and so using the wash helps sort of get rid of that-
P: Yeah. (26–30 years-old, Asian, Heterosexual)
Consequences of 27 women Perceived social and personal consequences described by I: How would you feel if you weren’t feeling clean?
Feeling or 55% participants if they did not have vaginal cleanliness and P: I would feel very self-conscious and not sort of
Unclean freshness confident. I guess I’d be I don’t know worried other
people could tell in some way, I don’t know. Like when
you haven’t showered you feel, I don’t know you just
feel crappy.
I: Okay and is it like the confidence or the
self-consciousness is that mostly related to like
sexually activity and intimacy or is it more of a general
feeling?
P: I guess it’s partially in general, but it would mostly be
for moments of intimacy like you know that’s when
you would notice. You would feel better about it.
(26–30 years-old, White, Heterosexual)
Societal Messages 29 women Messages in society participants felt women were P: I think it comes from things like advertisements and
Relating to or 59% subjected to around needing to having a clean and fresh things like Cosmopolitan and things like that where
Clean and vagina to be acceptable again with the idea where like freshness, or no odor or
Fresh whatever equals good, equals confidence.
(26–30 years-old, White, Heterosexual)

Achieving Clean and Fresh
Although participants reported a range of reasons for using
vaginal hygiene products, one of the most salient and common
reasons was to obtain vaginal cleanliness and freshness. In
fact, women frequently used the terms clean and fresh to
describe various aspects of their product use, such as the rea-
son they use the product, the feeling they hoped to achieve by
using the product, or in describing the type of product they
would use. This is exemplified by the following participant
who described using vaginal wipes as an alternative to
showering during the summer:
702
I would use them if like as the summer comes and I’m
feeling sort of hot and sticky, if I was coming home and
maybe getting changed but not taking a full shower, I
might use them at a time like that…I find it would be
refreshing. And I feel cleaner. (46–60 years-old, White,
heterosexual)
Many participants used the words clean and fresh inter-
changeably, sometimes separately and sometimes together.
The words clean and fresh were used to describe feelings that
could only be obtained from using vaginal hygiene products.
In other words, without the use of vaginal hygiene products,
an idealized state of cleanliness and freshness would not be
achieved. This was noted by a 22–25 year-old, Chinese, het-
erosexual woman who described the clean-and-fresh feeling
she attained through the use of wipes. She described this sen-
sation as Byou feel very, like clean, refreshed, you know,
you’ve kind of washed all the dirt off and that’s kind of the
feeling after using a wipe.^
Notably, product users generally linked these terms with
store-bought rather than with homemade products, with the
exception of homemade douches. Store-bought products were
viewed by participants as being specifically designed for pro-
moting cleanliness and freshness in women’s genital area. In
the following excerpt, a 22–25 year-old, Korean, heterosexual
woman describes why she prefers to use vaginal wash com-
pared to other products or methods of cleansing:
At times when you use the soap at that place at times,
you know that place burns. So with wash that burning is
not there, it gently cleans and this so yeah. I never face
any odor and such as a problem but I thought it was best
to use it to stay fresh and clean.
In addition to preferring products specifically designed for
women’s genital area, this participant’s account highlights
her primary motivation for using this product to achieve clean-
liness and freshness, despite not having Bany odor^ or other
problems beyond a desire to Bstay fresh and clean.^ Connected
to the construction of vaginal hygiene products as necessary to
physically feel clean and fresh was the notion that women’s
Bnatural^ bodies and specifically genitalia are unclean. This
was further reflected by the words participants used when
describing women’s bodies and female genitalia as Bgross,^
Bdirty,^ and Bunclean.^
Articulating Clean and Fresh
Although clean and fresh were commonly used to explain
why they used vaginal hygiene products or the effects of using
these products, our participants were not always able to artic-
ulate what they meant by these terms. This was particularly
noticeable when we directly asked our participants to describe
Sex Roles (2018) 78:697–709
what it felt like to be clean and fresh. For example, a 26–
30 year-old, White, heterosexual woman, who said she used
a vaginal wash to feel fresher, was at a loss to find alternative
words to describe the feeling of clean and fresh: BYeah, [I] just
feel cleaner and yeah fresh. I don’t know.^ When asked if
there was any physical sensation she could use to describe
feeling fresh she described it as Blike a shower without the
water^ but immediately followed her metaphor with laughter
and the statement BI don’t know what you want me to say,^
suggesting that it was not a simple task to articulate the feeling
of vaginal freshness.
Similarly, when asked to describe what feeling fresh felt
like to her, another participant said BI’d just say not carrying
like any kind of odor on you, just…no discharge…just clean
overall and I don’t know how else to say it…^ (26–30 year-
old, White, Bisexual). Again, describing clean and fresh was
challenging. Here, the word clean is used to describe the feel-
ing of vaginal freshness and highlights the often overlapping
construction and interchangeability of these words. Her de-
scription of fresh as a lack of vaginal odor or discharge repre-
sented a common theme and one we explore in greater detail
in the following analysis.
In an effort to articulate the meaning of feeling clean-and-
fresh, participants described it as the feeling one has after
taking a shower. This shower metaphor was often connected
to the idea of removing dirt from the body as a way to cleanse
it. This is noted by the following participant, who, when asked
to describe what clean and fresh meant to her, connects clean
and fresh to showering, removing dirt, and the sensation
achieved through vaginal hygiene products:
Um, I guess the best way to describe that, like out of the
shower…you feel very, like clean, refreshed, you know,
you’ve kind of washed all the dirt off and that’s kind of the
feeling after using a wipe sometimes. Like, it’s just… like
after.. I dunno. (22–25 years-old, Chinese, heterosexual)
In an attempt to help participants articulate clean-and-fresh
during the interviews, we rephrased the question by asking
them what it feels like not to be clean or fresh. However, this
question proved to be just as challenging, as we observed in
the following excerpt from another participant:
Interviewer: Okay, can you try to explain to me a little
bit what, like, not feeling clean feels like?
Participant: Like sticky kind of. You know? Like it feels,
kind of…dirty. Just, it doesn’t feel, doesn’t feel like you’ve
actually cleaned yourself. It just feels like, the same like
you haven’t… I don’t, I don’t know how to really explain
anymore. Yeah, I guess it would just mean,…this is a
really hard question. [laughs] I guess it would just mean
that,… I…I don’t know, it just feels like…yeah, sticky I
guess. Yeah. (22–25 years-old, White, Bisexual)
Sex Roles (2018) 78:697–709
The difficulty our participants had in describing clean and
fresh may not be surprising. Ferranti (2010, p. 604) notes that
feeling clean is the most powerful motive for women to
douche today, yet no Bscientific basis has been established
for this feeling of cleanliness.^ Difficulty in describing the
feelings of clean and fresh may also stem from the marketing
of vaginal hygiene products. In defining the word hygiene,
vaginal hygiene companies often refer to subjective feelings
of cleanliness related to personal well-being rather than objec-
tive indicators of cleanliness related to women’s health
(Ferranti 2010).
Eliminating and Masking Biological Processes
Despite some difficulty in articulating the physiological
sensation and meaning of clean-and-fresh, this concept
was often described in relation to what was being elimi-
nated from the genital region, namely vaginal discharge,
odor, and pubic hair. For some women, having a clean
vagina revolved primarily around a single concept such
as the elimination of vaginal discharge as shown in the
following excerpt:
Participant: Yeah, discharge is a huge one for me be-
cause I don’t think there should be any discharge 90,
you know 99% of the time really. Yeah. No discharge.
Interviewer: So if you were feeling clean it would mean
that there would be no discharge?
Participant: Yeah….absolutely. I mean I don’t think a
healthy, if you know you have a healthy system I don’t
think there should be any in theory right but maybe.
(31–35 years-old, White, heterosexual)
For this participant, as well as for others in our study, vaginal
discharge was viewed as undesirable as exemplified by her
definitive statement of Bno discharge.^
Along with vaginal discharge, odor and pubic hair were
identified by participants as connected to feelings of unclean-
liness. Feeling unclean was thus managed through the use of
vaginal hygiene products to physically feel clean and fresh.
Although odor, moisture, and discharge are often considered
normal and healthy vaginal processes within medical literature
(Beckmann et al. 2010; deWit and Kumagai 2014), many of
our participants suggested these were abnormal phenomena
(BI don’t think there should be any discharge 90, you know,
99% of the time^). This particular understanding of vaginal
cleanliness may reflect the influences of vaginal hygiene mar-
keting that construct vaginal hygiene as being free from vag-
inal odor, discharge, and moisture (Ferranti 2010).
Furthermore, the use of terms such as clean and fresh in prod-
uct names and descriptions suggests to women that use of
such a product is not only advisable but also necessary to
obtain the clean-and-fresh vagina. This combination further
703
highlights societal expectations placed upon women around
the unacceptability of a natural body and the Bpredominance
of a culture of consumption around the aesthetics of female
body parts^ (Gorton and Garde-Hansen 2013, p.153).
Vaginal odor was described by our participants as being
just as, if not more, concerning than vaginal discharge because
it had a greater risk of being detected by others. This is
highlighted in the following excerpt by a 56–60 year-old,
White, heterosexual woman who used several products in-
cluding vaginal wipes, wash, and a douche in attempting to
eliminate vaginal odor resulting from discharge:
It was because I had a discharge and for me personally I
thought it was an offensive discharge and I thought I had
to do something about it because I would die if anybody
could smell something like that near me, you know.
For this participant and for others, it was not simply the pres-
ence of perceived odor that prompted them to use vaginal
hygiene products, but the perceived negative social conse-
quences (i.e., being detected by others, embarrassment,
shame) of vaginal moisture, odor, and/or other normal physi-
ological processes. The prior participant’s statement that she
would Bdie if anybody could smell something like that^ sug-
gests feelings of humiliation and shame. Ussher (1989) argues
that women develop and internalize such feelings about their
genitalia in a culture where female genitalia are pathologized.
In addition to perceived social consequences, vaginal odor
was related to negative consequences within romantic rela-
tionships. This is illustrated by the following participant who
stated Bif you’re not clean you’re not gonna get pleasure down
there, they’re gonna keep their mouths away from that area.^
(31–35 years-old, White, heterosexual).
Vaginal odor was also a particular concern for women dur-
ing menstruation due to feelings of uncleanliness being am-
plified during this time. Odor relating to menstruation was
described by product users as creating feelings of self-con-
sciousness. This also translated into various precautions some
women took during their period to prevent other people from
detecting this odor such as frequently changing pads, washing
the genital area, and using vaginal hygiene products. For a 56–
60 year-old, White, heterosexual woman, using wipes during
her period helped her feel Bconfident that you didn’t emit an
odor^ resulting from menstruation. In addition to using wipes
to help remove odor during menstruation, using vaginal hy-
giene products can help women remove any evidence that
they are menstruating. Removing menstrual odor and blood
fits in with this larger notion of cleanliness as a lack of vaginal
excretions. Associations between vaginal excretions (men-
struation, discharge) and uncleanliness have been linked in
feminist literature as representing broader social discourses
around pathologizing normal bodily processes (e.g., Caplan
and Caplan 2016).
704
Vaginal odor was also attributed to body hair, with many
women describing removal or trimming their pubic hair in an
effort to further reduce vaginal odor. The perceived connec-
tion between pubic hair and vaginal odor, in other words that
pubic hair caused vaginal odor, was often presented by partic-
ipants as accurate Bcommon knowledge.^ Along with the pro-
duction of odor, pubic hair was also discussed as being both-
ersome and unclean as noted by the following participant:
I know the reason for hair down there is to protect from
bacteria entering but I feel like it creates more bacteria
down there. And so I basically I just avoid having, I just
want to be clean and trimmed pretty much I don’t feel
like dealing with in-grown hairs…I don’t even know
how to explain it just feels cleaner. I don’t know, I guess
I find that when I have less hair I have less smell…it
tends to fester down there. (18–21 years-old, White,
bisexual)
The production of bacteria as a result of pubic hair was viewed
as creating undesirable odors that Bfester down there.^ This
suggests the removal of bacteria within the pubic region using
vaginal hygiene products is necessary to not only feel clean
but also be hygienic. Although the quoted participant ac-
knowledges that Bthe reason for hair down there is to protect
from bacteria entering,^ her negative view of hair may reflect
broader cultural values and expectations of women having
hairless genitalia and bodies (Braun et al. 2013). The decision
to remove pubic hair to attain cleanliness and to avoid the
production of bacteria was a common sentiment across our
participants. Therefore, removal of pubic hair along with the
use of vaginal hygiene products was viewed as necessary by
many participants in feeling physically clean and fresh.
Negative social consequences resulting from not feeling or
being physically clean and fresh due to vaginal odor were
described as disconcerting to the point of producing feelings
of preoccupation, worry, and self-consciousness:
In my subconscious it’s always like I’m worried I smell
down there. And also too I’ve just heard so many horror
stories from both guys and girls about that girl stinks…It
just I always get worried and I don’t want to be one of
those girls who smell down there. It just like it’s a self-
conscious thing too. It’s not just for me, but not that I
have a lot of people going down there—it’s not like that,
but I don’t know. I guess who I’m dating right now, it’s
not just being clean for me but him too. (18–21 years-
old, White, Bisexual)
The use of this participant’s language (BI always get wor-
ried^) suggests this is a significant concern and one that
preoccupies her. For this participant, eliminating odor
through the use of vaginal wipes and wash was important
Sex Roles (2018) 78:697–709
to feel physically clean as well as maintaining a standard of
cleanliness for her romantic partner. Her description of
Bgirls who smell down there^ suggests that women with
vaginal odor are Bothered^ to the degree that they become
subjects of negative stories and stereotypes of failed social
identities. Thus, fear of social stigma, and in this case not
wanting to be the subject of negative stories about vaginal
odor, may act as a form of social pressure for women to use
vaginal hygiene products to ensure they are not associated
with having vaginal odor.
Along with feeling self-conscious about vaginal odor,
feelings of shame were discussed by our participants.
Internalized feelings of shame and being unclean were,
however, not necessarily connected to direct experiences
(i.e., a partner telling them they are unclean). From partic-
ipants’ discussions, these feelings often developed from
women’s own concerns of vaginal odor. This need to be
clean and fresh therefore may be powerful enough that
women internalized these feelings of shame even in the
absence of actual experiences of partners or others specifi-
cally telling them of vaginal odor.
Vaginal hygiene products themselves are additional targets
for shame and embarrassment where derogatory terms like
Bdouchebag^ are used as insults. Typically directed toward
men, the term douche or douchebag serves to emasculate
someone by comparing them to an instrument used to clean
women’s genitalia. Vaginal hygiene products have also been
used as sources of ridicule in comedy acts (for example,
Saturday Night Live’s skit on pumpkin spice douche, see
Grossman 2013) for women who choose to use these
products.
For our participants, however, the use of vaginal hy-
giene products was viewed as a necessity or a subjective
physical need rather than a choice. The language used by
some participants including BI had to do something about
it^ (56–60 years-old, White, heterosexual) and Bif there’s a
discharge then you should clean that up^ (46–50 years-old,
White, heterosexual) further suggest an obligation women
feel to be physically clean and fresh. One participant di-
rectly noted this in her interview when she stated women
Bshould always be clean and fresh^ (31–35 years-old,
White, heterosexual). The language of these participants
implies a strict code of conduct regarding vaginal cleanli-
ness and freshness such as Bneed[ing] to be clean^ 31–
35 years-old, White, heterosexual). Management of the
body through vaginal hygiene was therefore seen as nec-
essary (see also Crann et al. 2017) and may also reflect
societal norms according to which women are expected
to conceal their bodies’ biological functions (Roberts
2004). These norms may also include expectations placed
upon women to modify their bodies to what is considered
clean, feminine, and normal (Wical 2006), especially with-
in romantic relationships (Ruth and Marston 2016).
Sex Roles (2018) 78:697–709
Societal Messages Relating to Clean and Fresh
An important aspect of our conversations with participants
related to societal messages about genital hygiene and vag-
inal cleanliness and freshness. Participants described being
aware of such messages in different forms including adver-
tisements, societal expectations around genital hygiene,
and the socialization of girls and women. Advertising in
magazines, the internet, and television was mentioned as
one of the larger influences in constructing messages
around women needing to be clean-and-fresh. These mes-
sages were described as often intentionally making women
feel insecure about their bodies to sell their products by
portraying vaginal odor and discharge as a problem. For
example, the following Participant, a 18–21 year-old,
Vietnamese, Queer woman, describes the power of adver-
tisements in producing this insecurity in women:
Yeah and [I] feel like it’s a really strong force because
you know umm… these messages rely on people to be
really insecure, but they also create more insecurity and
so it’s really challeng- it creates a challenge for us.
Feelings of insecurity and self-consciousness were brought up
by participants in the interviews when describing their per-
ceived vaginal odor and/or discharge. These feelings may be
evoked by advertisements as suggested by Bordo (2003) and
Clarke (2011) who conclude that advertisements geared to-
ward women are deliberately designed to promote insecurity
around the female body. In addition, Piety (2009) argues that
women’s insecurities and feelings of self-consciousness are
used by companies whose main goal is to prevent women
from overcoming these anxieties as a way to increase sales.
Descriptions such as Bstrong force^ as stated by Participant
159 further suggest the power these advertisements may have
on how women perceive their genitalia and bodies in needing
to be clean-and-fresh. Some participants described feeling
more confident after using the products because it was thought
to help remove vaginal odor and/or discharge. Indeed, this
may be additional tactic companies employ by equating con-
fidence with product use (Baxter 2015).
Vaginal hygiene product advertisements were also de-
scribed as conveying vaginal cleanliness and freshness as nec-
essary if women want to be accepted in society:
Well, I guess like, it kind of bothers me that…like
looking at these advertisements they suggest that wom-
en need to…perfume themselves. Like perfume their
vaginas to make them more acceptable to other people.
And this is like the angry feminist in me [laughs] like
coming out, like just like, No! I like it as it is and I’m
okay with it as it is. (22–25 years-old, Chinese,
heterosexual)
705
This participant’s description of women needing to Bperfume
their vaginas to make them more acceptable to other people^
offers one view of advertisements portraying female genitalia
as unacceptable without modification. She rejects this mes-
sage by emphasising her own approval of her body (BI’m okay
with it as it is^).
In contrast, however, many of our participants explicitly
described using vaginal hygiene products to attain
cleanliness and freshness specifically for approval from
others such as romantic partners. Oppliger (2008) suggests
women are pushed to seek validation from others based on
insecurities developed from exposure to media images of per-
fect women. These insecurities are argued by Wolf (1991) as
emerging from the socialization of women and girls to value
unattainable ideals of women’s bodies which prevent them
from being at ease in their own bodies. This was also noted
by some participants who described these unrealistic ideals of
female genitalia being engrained in girls from a young age.
This is conveyed by the following participant, a 31–35 year-
old, White, heterosexual woman, who stated Blittle girls are
told that this is the way your vagina should be sparkling clean
all the time, it should never have discharge nor should it have
any odor.^
Perloff (2014) suggests these ideals represented in both
mass and social media can lead to body dissatisfaction be-
cause many women internalize these beauty standards.
Expectations of having an ideal female body that is odorless
is described by the following participant as coming from
women themselves:
I think it just comes from women always you know, they
are hard on themselves, they’re having to look a certain
way, be a certain size and I think it just goes and speaks
to that feeling that I have to be perfect. I have to look
perfect, be perfect, smell perfect. I have to wear perfume
and my body always has to smell perfect [laughs] and so
as far as the ideal of looking like or smelling like, its just
that overall feeling of I shouldn’t have any odors there…
I don’t know. (36–40 years-old, White, heterosexual)
This participant’s account suggests women striving to look
and smell a certain way are the result of internalized pressures.
She describes these expectations as having to Blook perfect, be
perfect, smell perfect. I have to wear perfume and my body
always has to smell perfect.^ However, this statement is
followed by laughter, suggesting that she acknowledges these
expectations around body and vaginal odor to be unrealistic.
Women with body odor are argued by Kama and Barak-
Brandes (2013) as being shamed within society for not up-
holding a feminine and socially acceptable body. In contrast, a
sweaty male body is one that is constructed as manly, attrac-
tive, and strong (Dewing and Foster 2007). This double stan-
dard is reflected in the growing market of vaginal hygiene
706
products for women and the lack of genital hygiene products
geared toward men which may contribute to gendered ideals
for female bodies such as a clean-and-fresh vagina.
Discussion
Women’s talk about vaginal hygiene products reflected
broader cultural discourses that construct women’s geni-
talia as unclean. Perceived vaginal odor and discharge
were constructed by our participants as abnormal, offen-
sive, and needing to be eliminated through the use of
vaginal hygiene products. These descriptions add to
existing negative cultural perceptions of women’s genita-
lia in Western society where vaginas are pathologized and
problematized (Braun and Kitzinger 2001; Braun and
Tiefer 2010). Women who perceive their genitalia as a
problem may view vaginal hygiene products as a solution.
For many of our participants, vaginal odor, discharge, and
pubic hair were viewed as undesirable and contributing to
feelings of uncleanliness, implying that vaginal discharge
is not seen as a part of Bnormal^ vaginal health. Whereas
this perception conflicts with medical literature on
women’s vaginal health, the normalization of removing
discharge is reflected in the marketing of vaginal hygiene
products.
Since the marketing of vaginal hygiene products to address
vaginal odor in the 1940s, companies continue to capitalize by
marketing these products as solutions for genital cleanliness
and freshness for women (Ferranti 2010). This emphasis on
the clean-and-fresh vagina is often found in feminine and vag-
inal hygiene product advertisements that promote products for
helping to control and regulate female bodily processes like
menstruation and vaginal odor. Many of these products prom-
ise women the removal of Bfeminine odor^ (Walsh 1996) and
an increase in personal hygiene. Additionally, these advertise-
ments portray female bodily processes as socially offensive as
a means to persuade women to buy their products (Kama and
Barak-Brandes 2013). In our interviews, we found partici-
pants’ use of the terms clean and fresh reproduced norms
and expectations of an ideal vagina that is reflected in the
marketing of vaginal hygiene products. The internalization
of societal messages around vaginal cleanliness and freshness
for at least some of our participants demonstrates that to be
clean-and-fresh was a subjective physical need according to
which genitalia are constructed as sites of improvement.
However, some of our participants who used vaginal hygiene
products to attain cleanliness and freshness were also critical
of the messages they received around vaginal hygiene. They
identified these messages as problematic because they present
a certain ideal of women’s bodies that is unattainable.
The desire of achieving sensations of cleanliness and fresh-
ness by participants also evokes further discussion around the
Sex Roles (2018) 78:697–709
Bdirty^ vagina. Conceptualized by participants as emitting
both odor and discharge, the dirty vagina has also been exten-
sively discussed in feminist literature, such as Braun and
Wilkinson’s (2001) discussion on the representation of the
vagina as disgusting. Societal constructions of the vagina as
smelly, disgusting, and unclean (Braun and Wilkinson 2001)
have resulted in some women being brought up to believe
their genitalia are shameful and embarrassing (Calogero and
Thompson 2010. In a society where these messages are dis-
seminated through different media of pop culture, women
may internalize these messages from a young age. This could
explain why participants’ descriptions of feeling dirty were
often connected to imagined rather than to personal experi-
ences of stigmatization. This largely imagined stigmatiza-
tion—mentioned as possibly coming from peers, co-workers,
partners, or strangers—was distressing, and it resulted in
women using vaginal hygiene products as a pre-emptive mea-
sure in avoiding Boffensive^ smells or discharge.
In attempting to avoid or eliminate these bodily functions,
participants’ discussions focused on and emphasized the de-
sire for a clean-and-fresh vagina. This desire may reflect ex-
pectations of women to modify and improve their bodies in
attaining certain societal ideals (Bordo 2003; Crann et al.
2017; Wolf 1991). The language participants used in express-
ing that they wanted to be clean and fresh may further stem
from the advertising of some vaginal hygiene products that
link their products to concepts of confidence and female em-
powerment. For example, marketing campaigns, such as
Summer’s Eve BHail to the V^ (Wershler 2011), position
women who use vaginal hygiene products as empowering
their bodies. However, underlying these messages are insinu-
ations of women who do not use these products as being
disempowered, dirty, and failing to take care of their vaginal
health and hygiene.
Limitations and Future Research Directions
Given that the majority of participants identified as
White/European and heterosexual, a limitation of our
study is the lack of greater representation of different
ethnicities and sexual orientations. Although we recruited
in two diverse Canadian metropolitan cities, the fact that
our sample represented primarily a specific demographic
of women (i.e., White and heterosexual) raises further
questions around the marketing of these products and
who they are targeting. However, broader representation
is important because ethnicity and sexual orientation are
factors in some of the behaviours we examination re-
garding women’s use of vaginal hygiene practices. As
feminist researchers, we also emphasize the importance
of accessing voices of women who are marginalized,
including Women of Colour and women who identify
as sexual minorities. Therefore, future studies exploring
Sex Roles (2018) 78:697–709
women’s vaginal health and hygiene product uses and
practices should focus on oversampling marginalized
groups of women (Li and Braun 2016).
In examining Canadian women’s use of vaginal hygiene
products, our study attempts to address a gap in the feminist
literature around understanding women’s vaginal hygiene
practices beyond douching. With the growing popularity of
vaginal wipes and sprays by women in Canada (Boesveld
2016), further research needs to be conducted on the reasons
why women use these products. In addition, most of the liter-
ature on vaginal hygiene practices, specifically douching, has
focused on women who live in the United States. Given the
ethnic and cultural diversity of Canada, further research ad-
dressing Canadian women’s vaginal hygiene product uses and
practices is important.
Practice Implications
The marketing of these products as promoting vaginal hy-
giene (i.e., a clean-and-fresh vagina) is concerning because
medical and scientific research suggests that the use of
some of these products may be harmful to women’s health
(Cottrell 2010; Ekpenyong et al. 2014; Yanikkerem and
Yasayan 2016). The potential risks of some vaginal hygiene
products for vaginal health is supported by emerging med-
ical research that link the disruption of vaginal microbial
ecosystems with negative health outcomes (Reid 2016).
Some companies producing vaginal hygiene products may
therefore be advertising products which could be detrimen-
tal to women’s health. This conflicts with the marketing
promise of these products as beneficial to women’s vaginal
hygiene and health by emphasizing cleanliness and fresh-
ness. As authors, we were surprised by the lack of attention
in participants’ accounts to the potential health concerns
linked to the use of these products. Rather, participants’
concerns were largely focused on achieving vaginal clean-
liness and freshness.
Participants’ descriptions of clean-and-fresh as the ab-
sence of vaginal odor and discharge raises additional con-
cerns around the marketing of vaginal hygiene products
and how they frame Bnormal^ vaginal health. Vaginal
hygiene-product advertising, which claims that the remov-
al of odor-causing bacteria and moisture are essential for
vaginal health and hygiene, perpetuates cultural construc-
tions of women’s genitalia as unclean. With medical stud-
ies often written for a practitioner audience, information
about vaginal hygiene products may be inaccessible to
many women who use these products. Therefore, provid-
ing information about these products that is accessible to
a lay audience is important to support women in making
decisions about their bodies regarding vaginal health and
hygiene.
707
Conclusion
For many of our participants, achieving sensations of cleanliness
and freshness was a subjective physical need. Needing to be
clean-and-fresh was viewed as necessary for participants who
perceived social consequences such as stigmatization as possible
ramifications for having vaginal odor and discharge. Notions of
clean-and-fresh not only were influential for using vaginal hy-
giene products but also reflected broader societal messages
around female genital hygiene being dirty, leaky, and shameful.
The pervasive use of the terms clean-and-fresh in the marketing
of vaginal hygiene products further benefit companies which
profit through women’s internalization of these negative mes-
sages regarding female genitalia. Challenging this notion of
clean-and-fresh is critical then in exposing the tactics some com-
panies use to sell vaginal hygiene products and which perpetuate
cultural constructions of women’s bodies as unclean.
Acknowledgements We would like to thank the VOGUE research
team for valuable input on this project. We also thank our undergraduate
research assistants, with a special thank-you to Jessica Gibson, who
helped with conducting, transcribing and coding the interviews and mem-
bers of the Discourse, Science, and Publics research group for their valu-
able comments on an earlier version of our paper. We also thank the editor
and three reviewers for helpful comments for the development of this
article.
The present study was funded by the Canadian Institute for Health
Research (CIHR) and Genome British Columbia.
Compliance with Ethical Standards This research was approved by
the University of Guelph Research Ethics Board.
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