Vaginal health is an important part of a woman's overall health as vaginal problems can affect your fertility and so much more. Ongoing vaginal health issues can also impact your self-confidence. So, it is vital for every woman to know the signs and symptoms of vaginal problems and what you can do to protect your vaginal health. Today, we have a special guest to educate us on that! She is an Obstetrician and Gynaecologist from Sunway Medical Centre, also a mother of two boys, Dr. Janani Sivanathan! Q1: How can we differentiate the normal vaginal discharge and the others? Dr Janani: Women in the reproductive age group will have a physiological discharge. So this is a normal discharge that happens during the cycle. As soon as the periods are over, probably there will be like yellowish discharge, then the discharge will stop and in the mid of the cycle, the discharge becomes more watery and clear and it\u2019s more copious in amount. And a few days after that, it will become a bit thicker and white mucus. And after that, it might be a bit yellowish and then you will get your periods. So, physiological discharge is normal and this is related to hormones. Mostly, because of the effect of oestrogen on the vagina. So, the vagina is rich in glycogen and is converted into lactic acid. So, that\u2019s why the vaginal pH is acidic at less than 4.5 pH. It\u2019s called the normal flora which is normal. So, when there\u2019s an imbalance, there\u2019s a tip in the pH, which can be caused by:\u00a0 \tAny illness \tImmunocompromised \tLong term antibiotics \tContraceptive pills Factors That Can Cause Vaginal pH Imbalance And because of that, the bad bacteria starts growing. Because the pH has shifted. And so, the abnormal vaginal discharges occur. "So, What Is Abnormal?" If it\u2019s start itching, there\u2019s a smell, which is different from the usual smell, and if the colour becomes \tGreenish \tFrothy \tGrey \tThick curdy These are all abnormal. 70% of women, at least once in their lifetime, would have had a fungal infection. That is pretty common. And the symptoms would be, generally itchiness, thick curdy like discharge. Generally, it all goes down with the pH of the vagina, is it? Dr Janani: Yes! So, keeping the vagina pH in balance in an acidic environment will maintain the normal flora. So, anything that upsets that, causes the abnormal discharge. Other than that, things like lubricant especially with perfumes or with certain flavours and spermicide, latex or with certain flavours and spermicide, latex can also cause abnormal discharge and cause disruption to the vaginal flora. So, these also can cause discharge in women.\u00a0 Q2: Doctor, every time during my fertile period, I will always have discharge with some blood and it smells. May I know the causes and what should I do? Dr Janani: During the fertile period, the middle of the cycle which is the ovulation period, so some women may have spotting during that time. It is common. This is called ovulation bleed. Some will, unfortunately, will have it together with pain like cramp-like sensation in the middle of the cycle and these are all normal. So, the discharge will increase the physiological discharge. It will increase in the middle of the cycle. And of course, for fertility reasons, the discharge is clear, watery and has a specific smell. Everyone has their specific smells like a pheromones sort of thing. So, that is normal, it\u2019s a normal vaginal smell. Q3: Can feminine wash help us to tackle the vaginal discharge and the itchiness that comes along with it? Because I feel like it\u2019s not clean enough if I don\u2019t use it. Dr Janani: The vagina is self-cleansing. We don\u2019t need to put anything inside the vagina to clean it. That\u2019s really not recommended. So, douching and all are not recommended. Like I\u2019ve mentioned the vaginal flora, the normal one will get disrupted if you put something inside and change the environment. Then, the bad bacteria will take over. No douching. When they say they prefer to use feminine wash because they feel it\u2019s not clean and causes itchiness, normally there shouldn\u2019t be itchiness in the vagina. So, if there\u2019s itching, it sorts of means that there\u2019s something wrong or there\u2019s an infection. So, go and see a doctor and get that sorted. You can use a certain feminine wash just externally. We would just advise using a mild soap and water to wash the external part, which is the vulva and that would be adequate. Q4: What if we use a feminine wash that does not contain sulphates, parabens, alcohols and dyes inside it? Dr Janani: Okay. That\u2019s a good option. It\u2019s more natural, it does not have these extra things in it. That would make it a very mild wash and that should be fine. But then again, it\u2019s only to wash the external parts and the other thing that\u2019s important for female hygiene is to ensure that we wash from front to back. Not back to front. Because most of the time, urinary tract infections that occur, short term UTI, in females, is usually due to bacteria from the gut. From the back passage. So, please maintain certain hygienic practices such as this and washing after sexual intercourse, then it shouldn\u2019t be any issues. This kind of mild feminine wash is absolutely alright. Make sure it\u2019s clean and dry before putting on your undergarments. Q5: Is it true that consuming yoghurt and pineapples are good for vaginal health? If yes, is it the plain one or can it be a flavoured one? Dr Janani: There is no scientific basis to say that pineapples help in vaginal health. From what I read, a lot of people think that it gives a good smell and taste. I\u2019ve heard is pineapple; if you\u2019re having cramps or such and if you want your period to be smooth, you should consume pineapple, so that it comes out smoothly and flows out. Dr Janani: And that actually there\u2019s not so much scientific evidence on that. But this with regards to vaginal health, and the smell and the discharge, apparently supposed to be sweeter with pineapples. That\u2019s the belief. But there\u2019s no scientific evidence on that. So, then we come back to the thing that your vagina is supposed to have that particular smell which is normal, which you\u2019ll have during the mid-cycle which is specific for you and that is all good. If it becomes smelly, fishy then you know that it\u2019s an infection, Then, you should get it sorted.\u00a0 I don\u2019t think you need to be -\u00a0Do not apply perfumes and anything scented because these will also disrupt the environment and cause infection. Right, so it\u2019s important to keep it all natural. Natural as possible. Dr Janani: Yes, that\u2019s right. People are saying that you should apply yoghurt to your feminine area as well as consuming it. Dr Janani: Oh, no no no no no local application! Do not apply the yoghurt there. No! But, you can consume it. So, eating it, not putting it on there.\u00a0 Advice From Dr Janani\u00a0 Parents, especially mums,\u00a0make sure that you get your general gynae routine checkups yearly. Even though you have no issues; for your pap smear and pelvic scans and a mammogram, so that you can make sure that you\u2019re keeping yourselves well. So, take care, stay safe and all the best! https:\/\/www.youtube.com\/watch?vip6jmRPP-6A Thank you to Dr. Janani for such informative knowledge relating to our vaginal health. Mums, please remember that you should get the recommended yearly check-ups and scans for extra precaution and always, take a very good care of yourselves. Throughout International Women's Month, we focus on women's health inside and out! Make sure to check out more videos relating to you and your family's health on AskMeDoctor!. Stay tuned next time for more expert and doctors explaining all about your health.