As someone who suffers from chronic hives and has a hormonally driven health condition, I have been on a mission to remove risky chemicals from my hygiene regimen. Phasing out toxic chemicals from my hair and beauty routine was fairly straightforward, as “clean beauty” products abound in the makeup aisle these days. But recently, I started assessing another category of products that left me with more questions than answers: the so-called world of “feminine hygiene”.
This broad swath of products marketed towards women includes everything from menstrual products like pads and tampons – to cosmetic products aimed at reducing vaginal odors, like scented wipes, powders and douches. The latter category can still be found on drugstore shelves, even though researchers have documented adverse health effects from the use of vaginal cleansing products since the 1980s.
Specifically, much has been said about the health risks that come with douching. But a growing body of research has also begun to examine the effects of vaginal wipes and washes – which, unlike douching, are designed to cleanse the exterior vulva, rather than inside the vagina itself.
The chief concern with vaginal cleaners is how they affect the vagina’s microbiome. “The vagina is a self-cleaning oven with its own pH level. When we start adding antibacterial soaps, you kill off the bacteria that creates the ecosystem for the vagina, and controls the acidity,” Dr Jacqueline Walters told Essence magazine in 2020.
Growing up, no one in my household used vaginal deodorants, but once I became aware of them, it seemed like they were everywhere. In college, it wasn’t unusual to see vaginal wipes next to the free menstrual products offered on campus, and I remember the early buzz around The Honey Pot, a new intimate care company, when it launched in 2014 with something I hadn’t seen before.
Beatrice Dixon, a Black woman and founder of the company, has talked openly about using natural ingredients to treat her case of bacterial vaginosis, inspiring her to bring plant-based hygiene products to the masses. The Honey Pot’s branding is laden with diverse images of Black, trans and queer folks happily using their vaginal washes and wipes.
The Honey Pot makes it clear that it does not advocate for douching, but it certainly encourages “cleansing” as part of vaginal wellness. Here was a Black entrepreneur promising “plant-derived” cleansers that balance vaginal pH and “minimize odor”. I never thought I needed to use such products, but the Honey Pot’s marketing made them seem additive to my self-care, not harmful. I struggled to reconcile messages from my own online research and guidance from my OB-GYN, who advised against the use of vaginal cleansers, as I surveyed this new wave of products seemingly designed for people just like me. I thought, if vaginal wipes, powders and cleansers are really that bad, why aren’t more people – especially the women in my life – talking about it?
“Vaginal cleansers and the associated risks have gotten such little attention over the years, and it has a lot to do with social taboos around talking about vaginal health,” says Alex Scranton, director of science and research at Women’s Voices for the Earth, an environmental organization. This taboo may well be a global phenomenon; a 2006 study of women from 13 countries found that less than half were comfortable talking with healthcare providers about vaginal health issues.
But these taboos may carry even more weight and more risk for Black women. In the US, about one in five women aged 15 to 44 douche. One study from 2015 found that a higher rate of Black women – nearly 40% – reported douching, compared with white and Mexican American women. The same study found Black women had 48% higher levels of a metabolite of diethyl phthalate – a toxic, endocrine-disrupting chemical used to extend the life of fragrances in products – in their urine, compared with white women. The researchers concluded that vaginal douching may be a source of DEP exposure for women.
According to Scranton, the endocrine-disrupting chemicals lurking in vaginal cleansers should give more consumers pause. A meta-review of several studies from 2002 found a positive relationship between vaginal douching and certain cancers. Another study from 2022 suggests that high exposure to phthalates (a fragrance additive) and phenols (a class of antimicrobial chemicals) in vaginal wipes is associated with a number of pregnancy and fertility issues, including polycystic ovary syndrome. A national, cross-sectional study of women in Canada published in 2018, which examined vaginal hygiene routines, found that participants who reported using feminine wipes were almost twice as likely to report a previous diagnosis of a UTI as those who had not used wipes. Those who reported using feminine washes or gels had odds 2.5 times higher of reporting a previous UTI, and 3.5 times higher of reporting a previous diagnosis of bacterial vaginosis.
So why do Black women still use vaginal cleansers at higher rates than other groups? The legacy of racist advertising and cultural norms passed down through generations may be the cause.
“Black women are overexposed and underprotected, when it comes to environmental health risks,” says Astrid Williams from Black Women for Wellness, a Los Angeles-based non-profit. “In focus groups, we’ve learned that Black women are socialized to believe we need to smell better, by using highly fragranced products – odor discrimination is definitely at play.”
Manufacturers of these products have always relied on cultural constructions of vaginas as inherently unclean and “leaky”, Margrit Shildrick theorizes in her book, Leaky Bodies and Boundaries. Then these companies assert that products like douches are essential to maintaining their freshness.
Through the 1930s, it was common for both white and Black women to douche as it was then believed to have contraceptive benefits. As Black communities gained more purchasing power in post-secondworld war society and sought better jobs through the Great Migration, advertisers tapped this new market of upwardly mobile consumers. One such ad targeting Black readers of the Chicago Defender touted Lysol products as suitable for vaginal douching, promising to leave users “sweet”, “clean” and “dainty”.
D Parke Gibson, the founder of a notable Black-owned press relations firm, observed increasing use of soaps, detergents and personal-care products among Black consumers. In his 1969 book on Black consumers he wrote, “Undoubtedly, much of the desire for cleanliness is to overcome the prejudicial old wives’ tale that ‘all Negroes smell bad’.”
Predatory marketing is not a tactic of the distant past, but still exposes Black communities to toxic chemicals. Johnson & Johnson recently announced the end of its commercial talcum baby powder sales, after thousands of lawsuits linked use of the product to ovarian cancer. The National Council of Negro Women claimed the company marketed its baby powder to Black women for decades without communicating its potential dangers.
“Generations of Black women believed [Johnson & Johnson], and made it our daily practice to use their products in ways that put us at risk of cancer – and we taught our daughters to do the same,” Janice Mathis, executive director of the National Council of Negro Women, told NPR.
So much of what I learned about personal hygiene was passed down from elders and women in my family. While none of them advised me to use vaginal cleansers, the opposite could just as easily have been true. “It really goes back to cultural norms. I remember seeing my aunts using powders for ‘freshness’ and to control moisture, but now we know those products are underregulated,” says Williams, from Black Women for Wellness.
The Food, Drug and Cosmetic Act – which regulates menstrual products as “medical devices” but unmedicated vaginal products as “cosmetics” – hasn’t been substantially updated since 1938.
Federal bills, like those introduced by the Illinois Representative Janice Schakowsky and the California senator Dianne Feinstein, aim to strengthen the Food and Drug Administration’s ability to require pre-market testing on personal care products, and reduce public exposure to toxic product chemicals.
In the meantime, consumers shouldn’t have to muddle through the confusing cultural messages that I did. Vaginal cleansers and endocrine disruption maybe aren’t what you’d call polite dinner table conversation, but I make it a point to have open conversations with family and friends about the personal care products they use. You never know; it might save someone a lifetime of illness.
