Learning objectives

After studying this module, assistants will: 

• Understand the different issues affecting women’s intimate health 
• Be able to share self-care tips for treatment and prevention
• Feel confident suggesting various treatment paths
• Know when to refer to the pharmacist.

The vagina is a tube of smooth muscle that runs from the vaginal opening to the cervix (the lower part of the uterus). It is self-cleaning, and natural secretions (discharge), produced by the cervix, keep it moist and protected from infection.

The colour and consistency of these secretions can vary, partly as a result of hormonal changes that occur during the menstrual cycle, pregnancy and the menopause. However, sometimes changes in these secretions can signify the presence of an infection.   

A healthy vagina is home to a wide variety of bacteria, including lactobacilli. These help to maintain an ideal pH of around 3.8-4.5 and protect the vagina from potentially harmful bacteria. If the balance of bacteria is disturbed or there is a change in pH, it can result in infection.

These changes may be caused by the menopause, menstruation, antibiotics, intrauterine contraceptives or washing the area with strongly perfumed or harsh soaps.   

The hormone oestrogen, which is mainly produced by the ovaries, plays a role in vaginal lubrication. During the menopause, oestrogen levels fall, as do the secretions that act as a natural lubricant, and this can result in vaginal dryness.

However, it is not just women going through the menopause who can be affected by vaginal dryness – it is also associated with certain medicines (e.g. contraceptives, chemotherapy and antidepressants), diabetes, tampon use, vaginal douching and breastfeeding.