Is vulvovaginal health being taken more seriously?

More women are discussing vulvovaginal health, but experts advise speaking to a qualified medical professional rather than seeking counsel or products online

How have women gone from speaking in hushed tones about anything happening ‘down there’ to candidly chatting about vulvovaginal health? And why are they shelling out so much money on products? File picture

There appears to be a boom in vulvovaginal health. A Fortune Business Insights report published in June estimated that the global market in women’s intimate care products would reach €47.7bn by 2034.

Vaginal cleansing wipes: €4.99 for a pack of 25. Vaginal moisturising pessaries: €19.99 for a month’s supply. Underwear infused with zinc oxide, claiming to reduce odour-causing bacteria and minimise itchiness: Discounted to €14.

These are some of the products that pop up on my computer screen when I type the words ‘vaginal wellness’ into the search bar. 

There are also websites of people calling themselves ‘vagina coaches’ and ‘vulva whisperers’ as well as links to social media posts featuring women discussing topics ranging from what a healthy vagina should smell like to the symptoms of vulvovaginal conditions like lichen sclerosis.

Why is this happening? Back in 2002, when Eve Ensler’s The Vagina Monologues premiered in Ireland, there may have been sold-out shows but there was also significant discomfort with publicly uttering the v-word.

How have women gone from speaking in hushed tones about anything happening ‘down there’ to candidly chatting about vulvovaginal health? And why are they shelling out so much money on products?

Vaginal douches have been sold to women since the 1850s so the women’s intimate care market isn’t new. What is new, says pharmacist Laura Dowling, is women’s willingness to discuss the most private parts of their bodies.

Dowling is known as @thefabulouspharmacist on social media and has recently published Love Your Vulva, a book that aims to answer questions women have historically been afraid to ask.

She says that “ever since the conversation about menopause blew open, women have become more comfortable talking about other issues to do with vulvas and vaginas". I, for one, welcome this discussion". 

"For too long, women weren’t provided with the knowledge they needed to look after their own bodies. It’s great to hear more of them now talking about the vulvovaginal health issues they face.”

Women’s doctors may have been similarly uneducated about female bodies. A search of the international medical database PubMed proves there has historically been a lack of research into vulvovaginal pain. Out of a total of 608 studies, only 58 were carried out prior to the year 2000.

Laura Dowling. Photo: Moya Nolan

Yet vulvovaginal pain has always affected women. A paper published earlier this year reported that up to 28% of women experience it during their lifetime.

That pain hasn’t always been taken seriously. A 2025 study  found that more than half of patients with vulvovaginal disorders considered stopping care because of feeling dismissed by doctors. Some 41% were advised to relax, while another 20% were referred to mental health services instead of to someone who would address their physical pain.

Given those stats, it wouldn’t be surprising if women who felt let down by medics looked for alternative treatment online.

Online is often unregulated

Dr Suzanne O’Sullivan, a consultant obstetrician and urogynaecologist at Cork University Maternity Hospital, has two messages for women tempted to do so.

One is that women’s health is now taken seriously in Ireland, with professionals trained to diagnose and treat vulvovaginal conditions. The other is that “what you buy online is often unregulated”.

“While online conversation can raise much-needed awareness of women’s health issues, you just don’t know what’s in the products you’re buying,” she said.

Dr Suzanne O'Sullivan: 'Vulvovaginal skin is different to skin in other parts of the body.' Picture: Chani Anderson

The women’s health expert and clinical lead of the National Maternity Hospital’s Complex Menopause Clinic Dr Deirdre Lundy takes issue with the wellness influencers who sell these products. She describes them as “people with limited to no medical training. Their posts should come with a disclaimer saying: I’m not trained, so I don’t know what I’m talking about.”

Lundy also disputes the assumption that the vulva and vagina require products like cleansing wipes. She argues we’re in danger of commercialising parts of the body that are mostly capable of looking after themselves.

“The vagina is gloriously self-sufficient,” she says. “The creamy goop that comes out of it is full of healthy bacteria that cleanses it from the cervix all the way down to the vaginal opening. All you have to do is wipe that away and you’re good to go. 

"There’s usually no need for lotions or potions and if ever something is wrong — a pain, burning sensation or unusual discharge — women should consult a GP, not the online potions shelf.”

O’Sullivan adds that the use of lotions and potions can cause problems, rather than alleviating them.

“Vulvovaginal skin is different to skin in other parts of the body,” she says. “It’s actually a mucus membrane that has its own microbiome containing a delicate balance of healthy bacteria. 

Deirdre Lundy: 'The vagina is gloriously self-sufficient.' Picture: Rolling News

"Products can alter that balance and strip the natural protective bacteria away, causing potential irritation, dryness or pain.”

However, there are times in a woman’s life when she or her doctor may need to take a more proactive approach to vulvovaginal health. Times such as the onset of menstruation.

“Girls should know what to expect from periods: why they get them, how often they should come and how painful they should be,” says Dowling. “No girl should miss school because of period pain or have to change her pad or tampon hourly because her periods are so heavy. 

"Women have put up and shut up for too long and too many have suffered with the likes of undiagnosed or misdiagnosed endometriosis. They need to ask doctors for help with heavy or painful periods.”

Another time women may experience vulvovaginal pain is when they become sexually active. O’Sullivan explains that this pain can be caused by issues such as tight pelvic floor muscles or conditions like lichen sclerosis.

“GPs can recommend treatment for these issues,” she says. “Tight pelvic floor muscles are usually remedied by physiotherapy and lichen sclerosis — an inflammatory condition that causes itchiness of the vulva and the area between the vulva and back passage — is easily treated with topical steroids. So there’s no need to search out cures online.”

Dowling warns women not to “put every itch down to thrush. If what you think is thrush doesn’t resolve with thrush cream, get yourself checked out for the likes of lichen sclerosis or vulval dermatitis.”

Laura Dowling: 'For too long, women weren’t provided with the knowledge they needed to look after their own bodies.'

Some women may be shy about having such conversations with their GP. Lundy calls on them to abandon their embarrassment. “Exploitation happens when you go online for medical information and take advice from people who may not be qualified to give it,” she says.

“Remember that GPs are trained to deal with these sorts of issues and if your GP is not supportive or well-informed enough, you’ll find the help you need at a Well Woman or family planning clinic.”

Sexually active women should take steps to protect their vulvas and vaginas from sexually transmitted infections. O’Sullivan recommends “using barrier forms of contraception like condoms to reduce the risk of transmission and getting STI checks between partners. The HSE now offers a free at-home STI testing kit from www.sh24.ie.”

Pregnancy and menopause

Pregnancy and the postpartum period are two other stages when vulvovaginal health needs to be prioritised. O’Sullivan specialises in incontinence and prolapse, both of which can affect women after they have a baby.

“Incontinence is the unintentional loss of bladder or bowel control and a prolapse is when the bladder, uterus or bowel drops into the vagina. Women shouldn’t suffer with either issue in silence as there is a lot that can be done to treat them,” she says.

The other main life stage when women develop vulvovaginal issues is menopause. O’Sullivan explains that “as oestrogen declines, vulvovaginal skin becomes thinner and drier in a process called atrophy. It can lead to problems such as bleeding, itching, soreness, discomfort during sex and recurrent urinary tract infections (UTIs).”

There is a simple solution. “Vaginal oestrogen can be applied directly to the skin to reverse these symptoms,” says O’Sullivan. “It’s never too late to start taking it and it can be taken by all women, even those who can’t have HRT because of their breast cancer risk.”

Overall, O’Sullivan views the conversation around vulvovaginal health as a positive development. “Women are increasingly more informed about how they can take charge of their own health and are asking questions they wouldn’t have asked before,” she says. 

Deirdre Lundy: 'There’s usually no need for lotions or potions and if ever something is wrong — a pain, burning sensation or unusual discharge — women should consult a GP, not the online potions shelf.' Picture: Rolling News

“But they may not always ask the right people. I’d advise them to be aware that social media influencers may not have the medical expertise required to suggest solutions to women’s health problems and may also have agendas of their own.”

Lundy’s advice is essentially to let the vulva and vagina be and seek medical help “only if they begin to hurt, burn or smell different”.

Knowing when to take action requires women to be familiar with their vulvovaginal area in the first place. A lot of women don’t know what their vulva looks like, says Dowling. “That’s why I suggest they have a feel and get a mirror and take a look. If you know what normal looks and feels like, you’ll be quicker to notice any changes.”

Finally, seek help from a trusted medical practitioner if anything does change. “I’ve seen women retract from society because they’re afraid of leaking, or they’re in constant pain or always itchy,” says Dowling. 

“A healthy vulva and vagina allows a woman to enjoy her sex life, which is important. But vulvovaginal health affects so much more than that. Prioritising it at all stages of life allows women to lead full and healthy lives as they age.”

Mind your vulva

What are the basic principles all women should follow when it comes to maintaining good vulvovaginal health?

Here are our experts’ top tips:

1. Avoid soap and shower gel when washing. Warm water on the external genital area is all that’s needed to keep clean.

2. If you feel the vulvovaginal area is a little dry, you can apply an oily emollient like Hydromol, Epaderm, or coconut oil after you shower.

3. If dryness is a persistent problem, discuss it with your doctor as you may benefit from applying local vaginal oestrogen. Many women find the best time to apply it is just before going to sleep.

4. If dryness during sex is an issue, experiment to find a lubricant that works for you. Lundy recommends a water-based lubricant combined with an oil-based emollient because they make “repeated penetration smoother and more comfortable”. She does warn, however: “Watch out for oil-based lubes and condoms though. They don’t like each other.”

5. Wear loose cotton underwear with a loose cotton gusset. “Studies have confirmed that thongs and UTIs go together,” says O’Sullivan.

6. Only wear pads or pantyliners when necessary. “They increase sweat in the vulvovaginal area, which increases irritation,” says O’Sullivan. “Letting the skin breathe is important.”

7. Bear in mind the vagina is supposed to be moist and is meant to produce discharge. It’s only when that discharge changes in appearance or smell or begins to dry up that you should become concerned.

8. Other causes for concern include internal and external itchiness, soreness, irritation and pain, as well as involuntary urinary leakage.

9. O’Sullivan says there is no need to worry and no need to apply any products if you don’t have one of these problems. And if you do, you can find “supported evidence-based information on the likes of hse.ie and advice and prescriptions for treatment from your doctor, not from social media.”