The vagina is a tube of muscle inside a woman's body that runs from the cervix (the opening of the womb) to the vaginal opening. The external sex organs, which are called the vulva, surround the vaginal opening.
Looking after your everyday health can help keep your vagina in good shape, says Dr Suzy Elneil, consultant in urogynaecology at University College Hospital, London, and spokesperson for Wellbeing of Women.
"Generally, good vaginal health is maintained by making sure you're in good general health," she explains. "This includes a healthy diet and exercise. Normal exercise helps maintain good vaginal function, as walking and running helps the pelvic floor to tone up and ensure good general health."
Find out more about having a healthy diet, exercise and keeping fit, and pelvic floor exercises.
Vaginal secretions or discharge
Other than your period as part of your natural menstrual cycle, it's normal to produce clear or white secretions (discharge) from your vagina. This mucus is produced naturally from the neck of the womb, known as the cervix.
"Vaginal discharge is not 'always a bad sign'," says Dr Elneil. "There is a myth that copious clear or white discharge is associated with sexually transmitted infections. Changes in the amount of discharge can be 100% hormonal – in other words, linked to the menstrual cycle, pregnancy or menopause."
The character and amount of vaginal discharge varies throughout your menstrual cycle. Around the time your ovary releases an egg (ovulation), your discharge usually becomes thicker and stretchy, like raw egg white.
Healthy discharge doesn't have a strong smell or colour. You may feel an uncomfortable wetness, but you shouldn't have any itching or soreness around your vagina.
If there are any changes to your discharge that aren't normal for you, such as a change in colour or if it starts to smell or itch, see your GP as you might have an infection.
Find out more about vaginal discharge, pregnancy and the menopause.
Bacteria in the vagina
There are lots of bacteria inside the vagina, and they're there to protect it. Professor Ronnie Lamont, spokesperson for the Royal College of Obstetricians and Gynaecologists, says: "The vagina contains more bacteria than anywhere else in the body after the bowel, but the bacteria are there for a reason."
The good bacteria inside the vagina:
- provide "numerical dominance" – they outnumber other potential harmful bacteria that might enter the vagina
- help keep the vagina's pH balance (how acidic the vagina is) at an even level, which helps keep the balance of bacteria healthy
- can produce bacteriocins (naturally occurring antibiotics) to reduce or kill other bacteria entering the vagina
- produce a substance that stops invading bacteria sticking to the vagina walls, which prevents bacteria invading the tissues
If the balance of bacteria is disturbed, this can lead to infection and inflammation. Bacteria called lactobacilli help keep the vagina's pH balance at its normal low level (less than pH 4.5), which also prevents the growth of other organisms.
If the pH of the vagina increases – it gets less acidic – the quality or amount of lactobacilli can fall and other bacteria can multiply. This can result in infections such as bacterial vaginosis or thrush, which can cause symptoms including itching, irritation and abnormal discharge.
Washing your vagina
It's a good idea to avoid perfumed soaps, gels and antiseptics as these can affect the healthy balance of bacteria and pH levels in the vagina and cause irritation.
Use plain, unperfumed soaps to wash the area around the vagina (the vulva) gently every day. The vagina will clean itself inside your body with natural vaginal secretions (discharge).
"During your period, washing more than once a day may be helpful," says Dr Elneil, who points out that keeping the perineal area between the vagina and anus clean is important, too. "Good perineal hygiene is necessary by washing that area at least once a day using your normal bathing routines."
"All women are different," says Professor Lamont. "Some may wash with perfumed soap and not notice any problems. But if a woman has vulval irritation or symptoms, one of the first things you can do is use non-allergenic, plain soaps to see if that helps."
A douche flushes water up into the vagina, clearing out vaginal secretions. Some women use a douche to "clean" the vagina, but using a douche can disrupt the normal vaginal bacteria, so it isn't recommended that you use one.
"I can't think of any circumstances where douches are helpful, because all they do is wash out everything that's in the vagina, including all the healthy bacteria," explains Professor Lamont.
There is no evidence douching protects against STIs or vaginal infections, and it may even increase the risk.
Scented wipes and vaginal deodorants
These perfumed products can disrupt the vagina's healthy natural balance. "If nature had intended the vagina to smell like roses or lavender, it would have made the vagina smell like roses or lavender," says Professor Lamont.
Washing with water and a plain soap should be all you need to keep your vagina healthy. It's normal for the vagina to have a scent. "Vaginal odour can change at different times of the reproductive cycle and shouldn't always be thought of as being a sign of infection or illness," says Dr Elneil.
If you're worried about the way your vagina smells, the smell is unpleasant, or you're using perfumed products to cover up your vagina's smell, you should see your GP. You might have an infection that needs treatment.
The most common cause of unusual vaginal discharge is bacterial vaginosis, which can cause an unpleasant smell. It's easily treated with antibiotics, so see your GP if you're worried.
Find out more about symptoms of bacterial vaginosis, symptoms of thrush, and symptoms that could signal a sexually transmitted infection.
Some bacteria and viruses can get into the vagina during sex. These include the bugs that cause chlamydia, gonorrhoea, genital herpes, genital warts, syphilis and HIV. You can protect your vagina against these infections by using a condom every time you have sex.
Find out some tips about using condoms.
All women aged from 25 to 64 are invited for cervical screening. Being screened regularly means any abnormal changes in the cervix can be identified early on and, if necessary, treated to stop cancer developing.
Find out more about cervical screening.