Bush is back, baby…

A few years ago this was the headline of an article I read in a magazine whilst sitting in a dentist waiting room here in Somerset west. I was, most obviously, quite impressed that this dentist would provide such impressive holistic reading material in his patient sitting area as I have, admittedly, not yet considered having present a jar of free toothpastes in my gynae practice. The article sported an image of a female pubic area covered in lush green grass overgrowth.

So what’s the fuss, doctor?

All patients I have seen know that I am an avid promotor of good vaginal health and most ardently a discourager of bad vaginal habits. My epic secretary, for one of my birthdays, bestowed on me the much treasured gift of personalised “vaginal warrior” socks! ( I wear them at home, bietjie skaam vir by die werk…)

On a daily basis I see patients who complain of chronic vaginal irritation, recurrent bladder infections and many who on a whole just simply are too often made aware of their vaginas, when not intended.

We have to start with some basics: Normal flora is the name we give to the normal bacteria that is supposed to colonize different parts of our body. My discipline is interested in vaginal flora and what we can do to advance their health and functioning in your body. Why? They are designed to protect our sensitive vajayjays and prevent all of the previously mentioned ill-desired symptoms. The main aim is to prevent altering of the microbiome. That is, to avoid disturbing the little home/living environment that she is, because she was fine until we started meddling!

So firstly, was my vagina disturbed to begin with?! Unfortunately, yes! Instead of teaching our people (and sadly, our children) EASY good vaginal health habits, our ladies are encouraged and almost coerced to wax, shave, douche, wear tight clothes at all times and for some reason made to believe that they are not clean.

Have causative factors like big scale advertising campaigns (money), unsavoury sexually objectifying movements on the internet, religious rites or cultural ways and the ever-evangelized concept of taking control pressed average females to do themselves harm? I do suspect so…

Well, enough speculation: What does the evidence say? You have to understand that research usually needs concrete tests to work from, i.e. the woman who just says that she is ‘often irritated down there’ would probably not be concrete enough a measure to evaluate. But a positive test for bacterial vaginosis (BV) is. This is a bacterium that is often present when women have symptoms like recurrent itch, foul-smelling discharge, irregular spotting, and frequently coinciding with yeast infections etc. And this condition arises when the pH of the vaginal micro-biome is increased. Risk factors for this are:

  • high calory diet
  • increased body weight
  • low folate, vit E and calcium levels
  • vaginal douching
  • cigarette smoking
  • pubic hair grooming and even more so with higher frequency of pubic hair grooming. Excess grooming also increased the susceptibility to STD’s.

But, most people do not have BV, and BV can eliminate itself with time, that is, does not always have to be treated with antibiotics. In my 10 years private practice experience I have had many women who are complaining of ‘often being irritated down there’, without BV positive tests. So I am going to extrapolate (extend) some of the BV research recommendations to my “irritated but negative test” patients. I do, though, have ample experiential knowledge with which to guide patients.

Common sense and feedback from patients over the years prove that certain habits detrimentally influenced their vaginal health. All of these were culprits:

  • G-strings, lycra and lacy panties
  • Excessive washing, washing with cloths or sponges
  • Wet wipes
  • Persistent wearing of tight garments and too small size underwear

I have also found that more people have skin allergies down there than is commonly suspected. Many of my patients with recurrent problems stop the use of wet wipes, panty liners and abrasive standard off-rack detergents, and then find that their frequent urinary tract infections disappear! Lycra and lace garments also fall in this irritant category. When people switch to cotton their problems often disappear. Oh, and please go a size up, girls…NO-ONE HAS TO KNOW!

Remember, too, that moistening a vagina does not happen with regular washing or applying cream, but by drinking water and decreasing caffeine intake.

So, quite a lot to do less of, isn’t it? What to do more of? Loose fitting, loose fitting, loose fitting clothes, luckily back in fashion. Time for some new panty shopping. Consider female probiotics. And stop washing yourself so often…

So, as you can see…I am trying to give you a holiday… stop fussing down there and enjoy being a woman! You are beautiful, accepted and lovely. Let us enjoy our bodies, keep them private and know that they do not have to measure up to rules made up by the internet… because the evidence and the experience of gynaecologists who have seen thousands of females point to BUSH BEING BACK, baby!

Now I declare you to to be a vaginal warrior! Please share the news and live vagina friendly..


Pubic Hair Grooming and Sexually Transmitted Infections: A Clinic-Based Cross-Sectional Survey

Thomas W Gaither 1Kirkpatrick Fergus 2Siobhan Sutcliffe 3Benjamin Cedars 1Anthony Enriquez 1Austin Lee 1Nnenaya Mmonu 1Stephanie Cohen 4Benjamin Breyer

Pubic hair grooming practices in KwaZulu-Natal, South Africa: prevalence, side effects and association with sexually transmitted infections

Mags Beksinska 1Bethel Lulie 2Ivana Beesham 1Jenni Smit 1

Sexually Transmitted Infections Treatment Guidelines, 2021. AU         Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA , MMWR Recomm Rep. 2021;70(4):1. Epub 2021 Jul 23.