IWHW Vaginal Health Test

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1. Do you use douching of the vagina?

Yes

You should know that the vagina is self-cleaning. It is best to let your vagina clean itself naturally by making mucus, which washes away blood, semen, and vaginal discharge. Otherwise the self-cleaning mechanism of the vagina and its microbiota will be impaired.^2,3

References:
2. Cottrell BH. Vaginal douching JOGNN 2003, 32(1): 12-18.
3. Fact sheet on Douching Reviewed by Centers for Disease Control and Prevention (CDC) staff. 2015 Office on Woman Health www.womenshealth.gov

2. Do you often wash your vulva (more than twice a day for example)?

Yes

Be careful, too much hygiene (especially when using classic soap instead of adapted product for intimate hygiene) is as harmful to as poor hygiene. One external wash per day, maximum two is sufficient.¹

References:
1. Chen Y. et al. Role of female intimate hygiene in vulvovaginal health : global hygiene practice and product usage. Women’s health 2017,13 (3)/ 58-67.

3. Do you wipe after miction / defecation from back to front?

Yes

Be careful, the right way to clean the vulva is from front to back (the vulva to the anus) and not the other way. If you do the other way, then the chances of dragging the harmful bacteria to the vulva and the vagina are high.⁴

References:
4. Felix TC et al. Evaluation of vulvovaginitis and hygiene habits of women attended in primary health care units of the family. International Journal of Women’s Health. 2020;12:49-57.

4. Do you use aromatic soap, vaginal deodorant or scented wipes for intimate hygiene?

Yes

You should avoid these products, they can affect the healthy balance of microbiota and pH levels in your vagina and cause irritation. In the event of a pathological odor these products will only cover up odor for a short time without solving the problem. See your doctor if you have vaginal discharge that smells bad.^1,5

References:
1. Chen Y. et al. Role of female intimate hygiene in vulvovaginal health : global hygiene practice and product usage. Women’s health 2017,13 (3)/ 58-67.
5. Keeping your vagina clean and healthy. NHS UK October 2018. www.nhs.uk

5. Do you use tampons and sanitary pads without menses?

Yes

Be careful, these products absorb moisture, therefore natural secretions. They may cause irritations and dryness of your mucosa and modify the composition of your microbiota which is needed for normal protection against infections.¹

References:
1. Chen Y. et al. Role of female intimate hygiene in vulvovaginal health : global hygiene practice and product usage. Women’s health 2017,13 (3)/ 58-67.

6. Do you smoke?

Yes

Cigarette smoking is associated with a vaginal microbiota lacking protective bacteria (Lactobacilli). It damages mucosa and local and systemic immune response. It is strongly associated with an elevated risk of bacterial vaginosis.^6,7

References:
6. Brotman RL. et al. Association between cigarette smoking and the vaginal microbiota : a pilot study BMC Infectious Diseases 2014, 14:471 http://www.biomedcentral.com/1471-2334/14/471
7. Nelson TM. et al. Cigarette smoking is associated with an altered vaginal tract metabolomics profile Nature Scientific Reports 2018, 8:852.

7. Do you have diabetes?

Yes

Diabetes predisposes individuals to bacterial and fungal infections because it interacts with the immune response. Maintaining healthy vaginal microbiota may play an important role in restricting yeast infections.^7,8

References:
7. Nelson TM. et al. Cigarette smoking is associated with an altered vaginal tract metabolomics profile Nature Scientific Reports 2018, 8:852.
8. de Leon EM. et al. Prevalence and risk factors for vaginal candida colonization in woman with type 1 and type 2 diabetes BMC Infectious diseases 2002, 2 (1): 1-6 http://www.biomedcentral.com/1471-2334/2/1

8. Do you take medications like glucocorticoids?

Yes

These medications diminish your immune response and defence possibilities against infections.^9,16

References:
9. Amabebe E. et al. The vaginal microenvironment: the physiologic role of Lactobacilli. Front Med.2018 5:181. doi: 10.3389/fmed.2018.00181
16. Sherrard J, et al. European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) Guideline on the management of vaginal discharge. Int J STD AIDS 2018, Vol. 29(13) 1258-72.

9. Did you take antibiotics during the last weeks?

Yes

Take antibiotics only when needed, because they can kill “good” bacteria in your vagina, modify your microbiota and generate a vaginal microbiota imbalance and vulvovaginal candidiasis.^10,11,12

References:
10. Ahrens P. et al. Changes in the vaginal microbiota following antibiotic treatment for Mycoplasma genitalium, Chlamydia trachomatis and bacterial vaginosis PLOS One 2020,28, 15(7): e0236036. https://doi.org/10.1371/ journal.pone.0236036
11. Sharara SL. et al The Impact of antibiotics on the composition of the vaginal microbiota OFID 2019 :6 (Suppl 2) : A 2572 / S893 www.academic.oup.com
12. Plummer EL et al Sexual practices have a significant impact on the vaginal microbiota of women who have sex with women Nature Reserach Scientific Reports (2019) 9:19749 https://doi.org/10.1038/s41598-019-55929-7

10. Did you have sex with a new partner?

Yes

Remember that you need to use condoms with a new partner or get tested for Sexual Transmitted Infections (STIs). But even in the absence of an STI, intercourse with a new partner or several partners increases the risk of vaginal microbiota imbalance and bacterial vaginosis.¹³

References:
13. Wilson J. Managing recurrent bacterial vaginosis Sex Transm Infect 2004;80:8–11.

11. Do you often have vaginal infections?

Yes

Normally, treatment is effective but recurrence rates of 15–30% within 3 months exist. In a long‐term follow‐up of women who had been successfully treated, 52% had at least one further episode. Only your doctor will be able to select your appropriate treatment.¹³

References:
13. Wilson J. Managing recurrent bacterial vaginosis Sex Transm Infect 2004;80:8–11.

12. Do you often use a vaginal over-the counter medication against yeast infection?

Yes

You may be convinced that it is not necessary to see your doctor every time and it seems easier for you to buy an over-the- counter medication but there is a risk that the treatment will not be suitable.¹⁴

References:
14. Angotti LB. et al Vaginitis : making sense of over the counter treatment options Infectious Diseases in Obstetrics and Gynecology 2007, Article ID 97424, 4 pages doi:10.1155/2007/97424.

13. Did you experience a strong odor or an unusual discharge?

Yes

If you experience a change in color or it starts to smell or itch, it can be a sign of a vaginal infection or a sexual transmitted infection. In any case, avoid self-medication and see your doctor as you might have an infection needing medical management.^15,16

References:
15. Rao VL. , Mahmood T. Vaginal discharge review Obstetrics, gynaecology and reproductive medecine 2019 30.1 : 11-18 Elsevier www.obstetrics–gynaecology-journal.com
16. Sherrard J, et al. European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) Guideline on the management of vaginal discharge. Int J STD AIDS 2018, Vol. 29(13) 1258-72.

14. Did you experience swelling, itching or burning in and around your vagina at several times?

Yes

If you experience such trouble like swelling, itching or burning in and around the vagina, this can be caused by an infection. It is necessary to avoid self-medication and to see a doctor for the right diagnosis and start treatment.^15,16

References:
15. Rao VL. , Mahmood T. Vaginal discharge review Obstetrics, gynaecology and reproductive medecine 2019 30.1 : 11-18 Elsevier www.obstetrics–gynaecology-journal.com
16. Sherrard J, et al. European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) Guideline on the management of vaginal discharge. Int J STD AIDS 2018, Vol. 29(13) 1258-72.

15. Did you experience pain during or after sex?

Yes

Get advice from your doctor if you have pain during or after sex. He will try to find the cause of your problem and be able to tell you whether you need any treatment. For example, vaginal infection or vaginal dryness, often occurring after menopause, can cause pain during intercourse.

Your results:

Your personal risk to have a vaginal infection or recurrence of vaginitis is high.

Your hygiene and intimal life habits need to be corrected/changed because they elevate your risk of vaginal infection. Check with your doctor for advice!

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Your results:

Probably you have to change some hygiene habits in order to prevent infections and intimate troubles. Don't hesitate when you see your doctor to discuss all the questions you want.

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Your results:

You have a healthy vagina because you take care of your body and know/follow intimate hygiene rules. You don't have any major infection risk factors and no symptoms associated with an eventual vaginal infection. Everything works well and your hygiene habits are good and adapted for an effective care.

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