Abstract

Female genital hygiene needs evolve substantially across the life course, from infancy through older age and are shaped as much by culture, socioeconomic conditions and the physical environment as by physiology. This review summarizes current evidence on genital hygiene across the female life course and examines how cultural beliefs, learned behaviors, regional practices, ethnicity and climate influence hygiene practices and associated health outcomes worldwide. Several consistent themes emerge. Menstruation remains stigmatized or taboo in many societies and hygiene practices are commonly transmitted from mother to daughter, making established behaviors slow to change. Access to affordable menstrual products, clean water, private sanitation facilities and menstrual health education remains highly unequal globally. Certain long-standing practices, particularly vaginal douching, continue to be associated with adverse reproductive health outcomes despite widespread cultural acceptance. Clinical evidence indicates that contemporary menstrual products are generally well tolerated across diverse ethnic groups and climatic conditions, while ethnic differences in susceptibility to skin irritation appear to be modest. Overall, healthy genital hygiene depends less on the products themselves than on equitable access to education, safe hygiene practices, menstrual products, clean water, sanitation and supportive health systems. Recent global initiatives, culminating in the 2024 recognition of menstrual health as a human right, have helped reframe genital and menstrual hygiene from a private concern to an important issue of public health, equity, dignity and sustainable development.

Keywords:Genital hygiene; Menstrual hygiene management; Life course; Culture; Ethnicity; Climate; Sanitary pads; Douching; Vulvar health; Menstrual stigma; Incontinence