Au natural: For those women who opt out of hair removal, that certainly makes sense from an evolutionary perspective. Pubic hair may have evolved to help keep dirt out of the vagina, warm the genitals, or for pheromones. There is no shame in this management as it is the natural look. The only time it would be an issue is if it reaches a length to braid since it can catch in the speculum (ouch!), or after a vaginal delivery and laceration repair (long hair can get tangled in the suture, and if you ob/gyn has to trim it in order to finish the repair, we are definitely NOT your local spa, so there may be some uneven edges). We also do some trimming with clippers prior to cesarean deliveries.
Waxing: A very common management for women. Generally neither particularly beneficial or harmful from a health standpoint; however, the microtrauma from frequent hair removal may predispose to folliculitis or occasionally cellulitis requiring antibiotics as well as susceptibility to herpes infection. If this is your preference, and you aren’t having problems, then go for it! If you are requiring frequent trips to your doctors office for symptoms and still want some control over your pubic hair, then clipping may decrease your symptoms in comparison to waxing or shaving.
Vajazzling: In case you’ve missed it, the trend of applying Swarovski crystals to freshly waxed skin has become something of a phenomenon. While this can help your mons be all matchy-matchy with your favorite 90s jean jacket, the application of adhesive glue to freshly waxed skin does provide an increased risk of trapping bacteria in the follicles, which in turn predisposes to infection. Also, it seems like it would be little uncomfortable for your significant other.
Labial and Clitoral Piercing: According to some women, these piercings can enhance their sexual experience and orgasms, and others feel a bit more naughty or adventurous after having these piercings placed. For clitoral piercing, it is often preferable to pierce the clitoral hood rather than the clitoris itself to decrease (NOT eliminate) the risk of nerve damage. If you’re interested in heavier bling, the labia can accommodate larger jewelry, although this may predispose to stretching. However, even for women adventurous enough to give this process a try, there may not be enough skin available to provide a safe piercing. As far as safety goes, allow adequate healing time after the procedure, be sure to use a reputable piercing store (to minimize, although not eliminate, risk of infection), and make sure to pick a low-allergen material. Obviously, it has baseline risks of bleeding, infection, nerve damage (among others) as well as possibility for traumatic removal if caught on clothing or during intercourse. Also, the piercing would need to be removed during delivery of a baby or surgery. Lastly, be aware that depending on location of the piercing, condom perforation may be an issue predisposing to unwanted pregnancy or transmission of STDs.
Douching: The practice of using various chemicals to “clean” the vagina. Per the American Congress of Obstetricians and Gynecologists, this practice should be avoided in favor of mild soap and warm water for vaginal cleaning. Health risks of douching show increased rates of bacterial vaginosis, pelvic inflammatory disease, difficulty conceiving, ectopic (tubal) pregnancy and even cervical cancer. Also to be avoided is placing anything you may eat in the vagina. Regardless of what Dr Oz may say, a tampon soaked in yogurt doesn’t necessarily help with yeast infections, particularly if you don’t know how to take it out (and wait a few weeks to have it removed because you’re embarrassed). I was tempted to mail that one to him and suggest a part 2 episode on how to remove tampons.
Thus concludes your friendly ob/gyn’s perspective on some common genital modification techniques. So, please don’t stress before your next pelvic exam, it’s all good!