How to care ”down there “

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How to care ”down there “

On Sunday morning mother and a 6-year-old girl came for the visit. I could guess the anxiety and panicky status of mom.

Before she could tell me anything I started chatting with Lil young lady.

Mom was not at all interested in our chat. She interrupted me and went ahead with her concern. This young girl had to itch down there for most of the day.

After examining the girl I asked mom" Was there any injury down there? "

Her frowned upon look made me realize to correct my question.

I repeated again, I mean like the corner of the table, bicycle ride.

The mother responded immediately “No, not at all”.I calmed her and said it looks like the girl got hurt somewhere and it's bothering her. I gave her antibiotic cream and assured her that it will be taken care of.

Before leaving the cabin I asked mom are you taking any extra effort to clean the girl’s genital area?

And here comes the answer “ Yes doctor, I had kept a cotton cloth to wipe after every pee and also clean with jet water. I am taking all care” So here we come to the so-called “Hyper Hygiene”. The jet pressure and wiping with cloth again and again was the reason for the girl’s injury.

Genital? Vulvovaginal? “Down there?” What exactly are we talking about? When we say genital, we are referring to the internal (vagina) and external (vulva) sexual organs. Sometimes when people say vagina they are actually referring to the vulva, the external female genital area. In fact, many would benefit from a refresher on the basics of the female anatomy. So…briefly….the vagina is a muscular canal inside of the body that connects the vulva to the uterus. From the outside, you can only see the introitus (the opening to the vagina), and, to do this, you would likely need to separate the labia a bit. The vulva includes the mons pubis, labia majora (outer lips) and minora (inner lips), the clitoris, and the urethra.


The shiny or mucosal surfaces of your vulva and your vagina are a self-cleaning system. Think of it as similar to the inside of your nose. This means that, just as you don’t use products to clean the inside of your nose, you don’t need to use any products inside the vagina. Vaginal discharge is normal and can vary throughout the menstrual cycle. Women in menopause also experience some normal discharge. Discharge is part of the vagina’s self-cleaning process and is typically clear or white without a strong odor. Talk to your doctor if you notice a bothersome change in the color, odor, or amount of discharge or if the discharge is accompanied by irritation or itching, or pain.

Abnormal vaginal discharge can be the result of too much washing, but can also have other causes that should be diagnosed by a medical professional. As tempting as it may be, trying to get rid of discharge by washing with soaps can actually make the problem worse. You also don’t need to use any products to clean the external genital area. Don’t be fooled or tempted by the “feminine hygiene” products with fun scents and colors. In fact, avoid using any scented or perfumed soaps, bubble baths, feminine hygiene products, douches, baby wipes, lotions, and powders directly in the genital area. Using these products can cause irritation or infection (hello uncomfortable sexual activity

For menopausal women or women who have undergone treatment with chemotherapy, hormone therapy or radiation for cancer, products that previously were not irritating may become bothersome. The tissues of the vulva and vagina become thinner and more sensitive as the body produces less estrogen. Even shampoos, conditioners, or body washes used elsewhere can run down the body and irritate the vulvar area. As much as possible, choose products with the fewest ingredients you can’t pronounce. And, always rinse the vulva (no scrubbing!) with water to ensure no residue from shampoo, conditioner, or body wash is left in the area and pat (don’t rub) dry.


Always wipe front to back after using the bathroom. Wiping in the opposite direction might transport bacteria from the rectum to the vulva and vagina. Avoid using packaged wipes or scented toilet paper- good old regular toilet paper is all you need.

The Panty liners

Panty liners wick away moisture from the vulvovaginal area that is helpful for comfort and lubrication. If you’re menstruating, try to use tampons, pads, and panty liners that are scent-free, or opt for an environmentally-friendly and cost-effective menstrual cup.


Pubic hair grooming is an entirely personal choice, however, there is no medical or hygienic reason why you should remove the hair “down there.” In fact, hair can help protect your skin from some of the irritants described above. Shaving and waxing can also irritate the skin (personally, we are more than happy to say goodbye to the hold your breath moments prior to the quick but excruciating pain of a bikini wax). If you do remove pubic hair, try to keep hair removal to the bikini line, preserving hair down the midline of the vulva. Just like the inside of your nose and your eyelashes, public hair is there for a reason.

Some women who have gone through cancer treatment experience thinning or loss of pubic hair – if this is the case, ask your doctor if you can expect that it will grow back and stick to the above recommendations to minimize exposure to possible irritants.


You’ve probably heard this one before: urinate soon after intercourse or any type of penetrative activity (like the use of a vibrator or dilator). Urination helps to reduce the number of bacteria in the bladder and prevent urinary tract infections. Again, avoid the use of wipes, extra soaps, or other products after sexual activity. If needed, rinse with water (These tips help to maintain vaginal moisture, avoid irritation, and lay the foundation for pain-free, comfortable, and satisfying sexual activity).

The concept of “sexual self–care” is a bit confusing. It involves more mental health rather than physical care. so then, what the heck is sexual self-care? SEXUAL SELF-CARE MEANS UNDERSTANDING YOUR LIKES, DISLIKES, AND KNOWING THAT IF THOSE CHANGE, IT’S OK. Sexual preferences may change over time because of age, treatment of cancer, and plain old evolution of preference. SEXUAL SELF-CARE MEANS COMMUNICATION.With yourself, your partner, and your doctor.

NO ONE told us how to clean the genital area. Or really… how not to clean the genital area. Turns out, we were doing it all wrong.

Thank you for reading

All queries and suggestions are welcome.

Stay Safe and stay healthy

Dr. Archana Salve

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