Women's Health Week wraps up in Aotearoa today.
Seven days, seven topics. Periods, reproductive health, mental health, menopause, cancers, sexual health, fitness and nutrition.
Six of those get talked about reasonably openly now. One of them still doesn't.
Saturday's topic was sexual health, and it's the one that tends to get the shortest conversation and the longest silence. So while the week is still running, I wanted to write something about it.
Why this one matters to me
I took over Come Clean earlier this year.
I came into it from a background in holistic health work, and a deep passion for better for you products.
Intimate health is where I see the most putting-up-with-it comments both with people I work with and conversations with friends.
Dryness that women assume is a personal failing. Discomfort that's been going on for years. Products chosen off a supermarket shelf without a glance at the label, because nobody ever told them there was anything to look for.
So here are five things I think are worth knowing.
1. Your body is already doing most of the work
The vagina is self-cleaning.
It works hard to hold an acidic environment, usually somewhere around pH 3.5 to 4.5, and that acidity is largely the work of lactobacilli, the dominant bacteria in most healthy vaginal microbiomes.
They keep things stable. They make the environment less hospitable to the organisms behind a lot of irritation and infection.
Which means washes, douches and scented products aimed at the inside are working against a system that was managing fine on its own.
The vulva, meaning everything on the outside, is a bit different. Warm water is genuinely enough for most people.
And if something smells or seems noticeably different or feels off, that's your body telling you something. Follow it up with your healthcare provider or Naturopath.
2. Dryness is not only a menopause thing
Dryness gets filed under menopause.
It does become much more common through perimenopause and after, so that association isn't wrong.
But it turns up long before that too.
In the Study of Women's Health Across the Nation, close to one in five women in the pre and early perimenopausal stages reported vaginal dryness in the previous fortnight.
The usual contributors are hormonal. Breastfeeding. Hormonal contraception. The postpartum months. Some medications, including certain antidepressants.
Stress and exhaustion play a part as well, because arousal isn't something the body can be talked into.
None of this is a reflection on you, your relationship, or how much you want to be there.
It's physiology and its possible to work through.
3. The ingredient list is worth a look
Vulval and vaginal tissue is thin, well supplied with blood vessels, and more permeable than the skin on your arm.
That doesn't make every ingredient dangerous, and I have no interest in adding to the pile of content telling women to be frightened of their bathroom cabinet.
It does mean the label is worth reading and choosing intentionally is encouraged.
Two things I'd check first.
Fragrance. A common cause of contact irritation, and a single word on a label that can stand in for a long list of undisclosed components.
Glycerin. A sugar alcohol used to hold moisture, which makes many water-based lubricants far more concentrated than the body's own fluids. Research using laboratory tissue models and animal studies has found these high-concentration (hyperosmolar) formulas can draw water out of the cells lining the vagina, stressing the tissue and disturbing those helpful lactobacilli. The World Health Organization suggests looking for products under 380 mOsm/kg. A lot of what's on the supermarket shelf sits well above it.
This is exactly why Come Clean was formulated without either of them.
4. Using lube doesn't mean something has gone wrong
There's a stubborn idea that reaching for lubricant is an admission of failure.
Natural lubrication shifts with your cycle, your stress load, your sleep, your medications, your life stage, and of course, what kind of sex you are having!
Using something to make sex more comfortable is no more remarkable than using a moisturiser when your skin is dry.
Comfort matters physically too, not only for enjoyment. Friction on delicate tissue causes micro-tears and irritation. Pain during sex teaches the body to brace, which makes the next time harder.
One practical note. If you use condoms, water-based is the safe pairing. Oils degrade latex.
5. Pain and recurring symptoms deserve a proper look
Discomfort during sex is common. Common is not the same as normal.
Persistent pain, recurring thrush or bacterial vaginosis, bleeding after sex, or dryness that doesn't shift with a decent lubricant are all worth a conversation with your GP, Naturopath or sexual health service.
There are real treatments. Topical oestrogen for genitourinary symptoms of menopause. Pelvic floor physiotherapy where muscle tension is part of the picture. Proper investigation for conditions like vulvodynia, lichen sclerosus or endometriosis.
A good lubricant makes things more comfortable.
Where to start
There's no right way to take this on.
You could read the label on whatever you're currently using and see what's actually in it.
You could send this to a friend who's been quietly wondering about one of these.
Or, if you've been putting up with discomfort for a while, you could book the appointment you've been postponing.
If you're joining the conversation online this week, the campaign tag is #WHWNZ.
About Come Clean
Come Clean is a water-based personal lubricant made in New Zealand with aloe vera and organic hemp seed. No glycerin. No fragrance. pH balanced. Vegan.
Here's to talking about this one a bit more openly. Stay groovy x
Laura is a Holistic Health Practitioner and Health Educator based in Aotearoa. She runs Live Well Holistic Health.