Fresh and feminine

Even when the area between a woman's legs is often described in lurid detail in romance novels, it is still a mystery that is out of sight and out of mind for many women. That is, until something goes wrong.

"Often, women will come in and request for a gynaecology check. But before we start, they will say, you know ... there is something down there but I don't know what it is. Can you have a look at it?" says consultant gynaecologist Dr Tang Boon Nee, who was giving a talk about feminine hygiene at an event organised by pharmaceutical company, sanofi-aventis.

She smiled when she saw a few nods of agreement from the group of women journalists she was addressing.

It is safe to say that all women are worried when they notice or feel changes in their private parts, but their response to it may differ greatly.

Some women rush to the clinic immediately when the itch doesn't go away after a day or two. Others wait until the pain becomes so unbearable they can hardly sit down.

However, both responses stem from women's tendency to ignore, neglect, and not discuss, the very parts that make them women.

"Unfortunately, because it is intimate, women do not want to talk about it. And because of that, we doctors get the backlash of it because we often see patients that come very late," says Dr Tang.

"It is still very taboo, and women are shy about it. But I think it is time to bring it out in the open," she says.

Know thyself

A lot of us may be surprised to find out that the components that make up the structures within a woman's perineal area (the anatomical term for the area between her legs) are the same as the building blocks that make up her face: skin, hair, and mucuous membrane (outer membranes that produce secretion).

From outside, the perineal area extends from the bony area at the front (which is covered by a woman's skin and pubic hair) to the anus at the back.

And between them, there are skin folds that cover the clitoris, the opening to the urethra (where urine is expelled from the bladder) and the opening to the vagina.

As the perineal area is similar to women's faces, conditions that we commonly associate with the face - like pimples, skin tags (harmless skin growths) and rashes - can also happen in the area.

For instance, infections or inflammation in the perineum area can also cause rashes or itchiness, and pimples that grow in there can become quite painful, as the perineal area tends to be more sensitive.

To Dr Tang, getting to know these structures and how they usually look like is the start to better care.

"We teach women to look at (their perineal area) using a mirror," she explains.

While it is common for women to check the perineal area only when they sense something amiss, Dr Tang encourages women to check it once a month.

"It is very much like doing a self-breast examination every month. You want to have a quick look to make sure everything is okay," she says.

Clean and care

Clean and care

Besides getting to know their private area intimately, a woman's personal hygiene is equally important.

One of the good habits women can adopt to keep their perineal area healthy is to clean it daily with a gentle soap or pH balancer.

As the skin in the perineum has hair follicles with sebaceous glands that produce sebum material (an oily substance), it may not be enough for women to clean their bottoms with water alone, says Dr Tang.

Another good habit is to keep the perineal area dry throughout the day. This could be achieved by not keeping the area "wrapped up" all the time with materials that keep moisture in.

"Pantiliners are fantastic, but women must be aware that they keep moisture in," says Dr Tang.

Some women can even develop a mild allergy towards it.

Therefore, women who use pantiliners should change it often and those who experience allergic reactions to them (like itchiness) should change brands or avoid using them.

The same advice applies to sanitary napkins that are used when women are menstruating.

Women should also try to avoid wearing tight clothes all the time as they may irritate the perineal area, and refrain from douching (cleaning out their vaginas with water or fluids) unless they are advised to do so by a doctor, says Dr Tang.

Intimate hygiene

Intimate hygiene

Some of the common complaints Dr Tang comes across include itchiness, pain, swelling, perceived odour, discharge and growths.

Among them, itchiness is the most common.

"While itchiness can be caused by infection, not all itches are due to infection," she says. "However, if you have been cleaning the area with soap or wash and still have it for more than two to three days, you can check with your doctor," she adds.

When there is pain, swelling or a growth, it may be wise to consult a doctor as soon as possible.

But when it comes to discharge or odour, Dr Tang says sometimes it may not be abnormal.

Occasionally, a woman may be more self-conscious about the odour her body is emitting, and a woman's vaginal discharge may change throughout her menstrual cycle.

That is why if the changes in discharge are cyclical, they may not be out of the ordinary.

Regardless of the nature or severity of the problem, Dr Tang stresses that women should not be shy about it.

"If they have a problem, they should ask about it. It may be a small problem, but many women would just want to be reassured," she says.