Author: Sarah Sentz, Nurse Practictoner at the Arlene Cooper Community Health Center
We frequently talk to patients about body functions and odors. Sometimes we just need to start at the basics. So, how should you clean the genitalia? Should you anal douche before anal sex? Should you use body deodorants and “intimate” wipes? And what if you are really, really smelly?
We can answer that!
How should I clean “down there?”
Keep it simple!
If you have a penis with foreskin (uncircumcised), then you should pull back the foreskin to clean once a day. If you have a penis without foreskin (circumcised), then just clean around the outside. You don’t need to put anything into the urethra (pee hole) for cleaning.
If you have a surgical penis (folks who have had a phalloplasty), follow your surgeon directions for post-surgical and ongoing care. Typically washing is the same=soap and water!
If you have a natal vagina (anatomy from birth), do not put soap inside the vagina itself. The “vulva” speaks to the entire outer genitalia, the vagina is the actual canal where a tampon, penis, sex toy, finger goes. It is not necessary or recommended to douche (flush water, saline, or other fluids) inside a natal vagina. Doing so can lead to disruption of normal bacteria and create an infection. Just clean front (urethra) to back (anus) with mild soap and water.
If you have a neovagina (folks who have undergone vaginoplasty), then make sure to follow your surgeon’s instructions for post-surgical and ongoing care. Most of the time, you will be recommended to douche with water and soap for a period. Your surgeon may also advise you to put other items into the neovagina for dilation.
Those were lots of words, but the main point: mild, unscented soap & water! Unless you are directed otherwise by your surgeon or care provider.
What about the anus?
In general, follow the recommendations above. Wash front to back and use mild soap and water to the outside of the anal area.
Some folks anal douche or use an enema (medication to make them poop) prior to having anal sex. Anal douching or enemas are not required for anyone, even if you are going to have anal sex.
Laxatives (oral or enemas) are not recommended, because anal douching really is cleaning the rectum and not the colon. The colon is where poop is, but this is located higher up where a penis, finger, etc. could not go. Routine laxative use can cause disruption to normal gut bacteria and a variety of other gut-related problems.
The rectum is the area right above the anus (butthole) where a penis, finger, sex toy can go. If you want to clean the rectum prior to anal sex, you can use a saline solution enema safely. These are sold over the counter at a drug store or online.
Douching frequently could cause tears, making it easier to acquire STIs like HIV. So, it is not recommended to douche more than 2-3 times per week at maximum. If tap water, do not douche more than once a week or this could cause electrolyte imbalances. (Planned Parenthood, 2023).
If you do anal douche, do it an hour or two before anal sex. Make sure the anus is relaxed and never force anything into your anus. Go slow and don’t use too much liquid.
Remember, anal douching is just an option prior to anal sex and not a requirement. Poop happens!
What’s the deal with “body deodorants?”
Look, bodies are all different and have different smells. The penis, vagina, and anus are not supposed to smell like lavender and sage.
You should not feel ashamed because of normal body odors!
But body deodorants are increasingly popular on TV and social media ads. They especially appear to target cisgender women of color. Words like “natural” “toxin-free” and “clean beauty” are commonly used. That doesn’t necessarily mean they are “better” products.
Any type of “spray” deodorant in the genitalia can cause irritation, rash, or itching. Additionally, they can throw off the body’s normal bacteria, creating an environment more prone to other infections. The truth is, we really don’t know the health impacts of these sprays especially when it comes to putting them on your genitals.
If you are disposed to sweating or chafing of the thighs or in the groin area (not your genitals), you can use a basic, unscented solid deodorant or chafing stick. Otherwise, keep body deodorant sprays away from your genitals!
Bottom line: Don’t waste your money.
Should I be using “feminine” or “pH” wipes as a person with a vulva?
Short answer? No.
“Feminine wipes” are heavily marketed to people with a vagina despite the name itself being problematic since not everyone who uses them identifies as “feminine.”
Wipes contain many ingredients that have not been studied and are concerning. Patient complaints include allergic reactions, itching, irritation, urinary infections, among other issues after use. Wipes also disproportionately target women of color.
Wipes do not degrade well and do not flush. They aren’t great for the environment, they are expensive, and they tend to cause more harm than good.
There may be situations, like not having access to running water, where wipes are used. In this case, basic unscented wipes are okay with a little research. Another alternative is to use a water bottle (like a small plastic bottle) to squirt water in the genitalia and clean that way.
Otherwise, wipes are rarely recommended for routine use.
“pH” wipes sound fancy and more scientific. In fact, some OBGYNs might even “recommend” them in news articles or on social media. That said, pH wipes are essentially the same thing as any other wipes. And if you are having “pH imbalance” like frequent bacterial vaginosis or yeast infections (especially in people with a vagina), please talk to your healthcare provider for evaluation and further options.
But what if I’m reallllly smelly?
If you are having foul odors, discharge, or itching in the genitals then it is time to see your healthcare provider! This can be indicative of a sexually transmitted infection (gonorrhea, chlamydia, trichomoniasis) or non-sexually transmitted infection (bacterial vaginosis, yeast).
Go back to the basics of mild soap and water. Use clean & free detergents to wash your clothing. Stop using scented products in the genitalia like body washes. This can lead to irritation in the genitalia as well, which can also cause odors.
Wear breathable cotton underwear or briefs instead of synthetic “sports” material. The latter tends to trap in the odors. If you do get sweaty due to work or activity, shower and change soon after. If that isn’t an option, at least changing underwear can be beneficial to keep things dry.
Some people wear pantyliners on a frequent basis. These tend to trap odors more. If you are wearing pantyliners due to irregular bleeding, involuntary loss of urination, or concern with genital discharge please see your medical provider for an evaluation.
If you don’t have access to frequent showering, it can be very tricky to keep things clean.
If you are in Las Vegas, come see us at The Center for resources and information on the weekly shower truck! Mild and unscented body wipes are not ideal, but better than nothing if you have limited options. The water bottle trick works well too.
If you bleed and need bleeding products, please ask about that at The Center too. We’ve got you covered with help from The Marilyn Project.
Simple is Better
You don’t need to do anything fancy to clean your genitals. In fact, less is more. Simple is better. Body odors, including odors from the genitalia, is a normal part of life. But if you have concerns, please see your medical provider at The Center!
New Wellness Clinic Now Open
The Center is excited to announce that we have expanded to meet all of your healthcare needs! In addition to our long-standing Arlene Cooper Community Health Center, we now offer services at a second Primary Care location at 921 S. Las Vegas Blvd, Second Floor.
Our comprehensive services include:
• Gender-affirming care
• Primary care
• HIV Services
• STI Testing & Treatment
• Family Planning
• Contraception
And more!
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About the Author
Sarah Sentz, Nurse Practitioner at the Arlene Cooper Community Health Center, brings a wealth of experience to our team, with over twenty years in the healthcare sector. Since earning her graduate degree as a Family Nurse Practitioner (FNP) in 2017, she has honed her skills in various clinical environments, building upon a solid foundation as a Registered Nurse (RN).
Her professional journey reflects a deep-seated expertise in family practice, with a particular emphasis on reproductive and sexual health medicine. She is passionately committed to community health, offering a spectrum of services that includes primary HIV treatment and prevention, comprehensive reproductive/gynecologic care, and the administration of long-acting reversible contraceptives like IUDs and implants. Additionally, Sarah provides gender-affirming and hormone therapy care, approaching each patient with a holistic mindset that focuses on treating the whole individual, not just the symptoms.
When she’s not at the clinic, Sarah's adventurous spirit leads her on hiking escapades with her husband, often recounted as joyful misadventures. She finds solace in the pages of science fiction novels while swaying in a hammock, and at home, she enjoys the delightful chaos of caring for her quirky felines, Artemis and Andromeda.
