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Farida Zubier Department Dermato-venereology, Faculty of Medicine, University of Indonesia Dr Cipto Mangunkusumo Hospital, Jakarta
Introduction
Female genital hygiene practices are much more complex than expected. Understand the female genital anatomy, physiology and immunology Identify various feminine hygiene practices Identify the products used for genital hygiene
FRESHNESS
BEAUTY
INTIMACY
Women becoming obsessed in cleanliness & aroma over cleaning of the vagina HARMFUL
CULTURAL NORMS
PERSONAL PREFERENCE
SOCIAL INFLUENCES
GH for Women
Lack of quality information for women on this subject Left to women to decide (mother teaching) The Intimate Feminine Hygiene is ?? Cosmetic that doctors know little about it Doctors should know about GH:
To aid in making decisions about appropriate female genital care. To present the best advice on the safe use of intimate feminine hygiene products available in the market. To offer practical recommendations on harmless feminine hygiene practices.
GH in infants/toddlers
Managing incontinence urine/feces is the principal genital hygiene. Prolonged genital skin contact with urine/feces will cause irritation or infection Frequent diaper changes & good genital/perineal hygiene is recommended.
GH in premenarche
Poor vulvar hygiene will lead to accumulation of smegma Routine gentle washing of the vulva & perineal area is needed. Need parental supervision teach young girls to consistently wipe after toileting Most vulvitis in young girls were caused by improper perineal hygiene
GH in reproductive age
Menstrual hygiene
Some traditions consider the menstruating woman is spiritually unclean social, cultural, religious norms influence menstrual hygiene practice Menstrual products: - Reusable items - Disposable items
Reusable items
Cloth pads : made from layers of absorbent fabrics ( cotton) to absorb the flow of blood from the vagina. After use, they are washed, dried and then reused
Sea sponge :natural sponges, worn internally like a tampon to absorb menstrual flow.
Disposable items
Sanitary pads: material worn in the underwear to absorb menstrual flow, often with "wings," pieces that fold around the undergarment and/or an adhesive backing to hold the pad in place. Disposable pads may contain wood pulp or gel products, Tampon: disposable cylinders of treated rayon/cotton blends or all-cotton fleece, usually bleached, that are inserted into the vagina to absorb menstrual flow. Disposable menstrual cups: a firm, flexible cup-shaped device worn inside the vagina to catch menstrual flow. Disposable cups are made of soft plastic.
The capacity 3 times greater than the absorbency of a Super tampon more cost-efficient and environmentally friendly than tampons
Perineal powder:
some women apply talcum powder to the perineum daily epidemiological studies have linked perineal talc exposure to ovarian cancer controversial
GH in elderly women
Problems: Urinary incontinence
may cause vulvar irritation use pantiliners, menstrual pads, pads design for incontinence protection pelvic muscle exercises ( Kegel exercises) may help
Conclusion
All women at all ages are in need of a daily intimate feminine hygiene to keep their genital area clean and dry. The vulva and vagina are common areas for contact dermatitis and should be kept away from irritants whether environmental or certain hygienic products. It is highly recommended to use hypoallergenic liquid cleansing agents with mild detergent effects and acidic pH ranging between 4,2 and 5,6. Bar soaps and bubble baths are of abrasive nature and with high alkaline pH; they should be avoided. Childhood genital care starts with good hand wash of the caregiver, using separate towels for children and not to take bath in the same tub with them
While lactic acid based liquid with low pH have been shown to augment skin homeostasis and helpful in cases of genital infections as an adjuvant therapy but not as a treatment. Vaginal douching is not recommended at all for its adverse obstetrical and gynecological outcomes. The woman should avoid excessive moisture and allow reasonable ventilation of the genital area by wearing loose fitting cotton underwear and minimize wearing tight clothes. Undergarments should be changed frequently.
Talcum powder should not be used, and perfumes and deodorants should be used sparingly, preferably after allergy testing. Menstrual care should include using tampons and sanitary pads, as preferred, but frequent changing is essential. Pre and post coital cleansing of the genital area especially the clitoris and the vulvar folds from front to back is recommended. Vigorous vulvar cleansing and vaginal irrigation are strongly discouraged. Removal of pubic hair should be based on safe technique and with care to avoid sensitivity and scarring.
FRESHNESS
BEAUTY
INTIMACY
Women becoming obsessed in cleanliness & aroma over -> over cleaning of the vagina -> HARMFUL