A healthy vaginal microbiota is not "clean" in the way we generally understand the term. It is alive, acidic, and populated by bacteria that are actively working to protect you.
Most of the "intimate hygiene" advice found online looks the same: water, mild soap, wiping front-to-back. While useful, they miss the point: what really protects the vaginal area is not the absence of bacteria, but the right bacteria, in the right quantity.
A microbiota, not a zone to be disinfected
The vagina naturally houses a flora dominated by lactobacilli—notably Lactobacillus crispatus, considered the best marker of a healthy microbiota. These bacteria produce lactic acid, which maintains an acidic pH and prevents the proliferation of undesirable bacteria. The vagina is constantly self-cleaning: it needs no outside help to be "clean" on the inside.
According to epidemiological studies compiled by Muzny et al. (2019, Journal of Infectious Diseases), bacterial vaginosis—the most common imbalance of the vaginal microbiota—is estimated to affect between 23 and 29% of reproductive-age women worldwide.
What disrupts the balance
Internal vaginal douching is the primary preventable cause of imbalance: even with plain water, it washes away the protective lactobacilli along with everything else. Scented soaps, broad-spectrum antibiotics, and hormonal fluctuations (periods, pregnancy, menopause) can also weaken this balance.
Wash only the outside of the vulva with lukewarm water or a pH-balanced external intimate cleanser, never the inside. The vagina requires no internal cleaning, not even with water alone.
Probiotics: between promise and caution
A systematic review and meta-analysis (López-Moreno & Aguilera, 2021, Journal of Clinical Medicine) examined the efficacy of lactobacilli-based vaginal probiotics. The conclusion was nuanced: they show promising results in preventing and supporting the management of recurrent bacterial vaginosis, but far less so for yeast infections (candidiasis). No studies have reported any major safety concerns.
What this means in practice: probiotics can be a helpful supplement for prevention, but they never replace a medical diagnosis or treatment in the event of a confirmed infection.
Common misconceptions, once and for all
"A vaginal douche with plain water is risk-free"
No: even using water alone disrupts the protective flora by washing it away along with everything else.
"The more you wash, the better it is"
It’s the opposite: excessive intimate cleansing can weaken the natural barrier and promote irritation.
"Probiotics replace medical treatment"
No: in the case of a confirmed infection, they may support treatment, but they do not replace it.
The best thing you can do for your vaginal microbiota is often to do as little as possible: fewer products, fewer internal interventions, and consulting a doctor as soon as a sign deviates from the ordinary.
0 comments