Vaginal Health: Separating TikTok Fact from TikTok Fiction

Hi, I’m Doctor Rich, board-certified urogynecologist and passionate women’s healthcare advocate. Today we’re checking out popular vagina TikToks.

Don’t have time to read this post? Watch the video here instead!

[Video of a woman styling her hair and pointing to a caption reading “Things all v@gina owners should have been taught in school”]

[Video begins showing a series of statements:

1. “Discharge is normal.”]

Doctor Rich:

Absolutely correct!

So the vaginal epithelium is a type of skin. If skin flakes off of your scalp, it’s called dandruff. You can have dry skin occurring anywhere else on your body. In the vagina, it’s a mucus environment — and it’s moist. And when the skin flakes out and comes out, it’s going to appear as a discharge — and this is a completely normal process! If there is excessive odor or if there is itching, this might represent a pathologic (or an abnormal) discharge, which you can check out in this video here.

[2. “Sp3rm can live up to 5 days in the v@gina.”]

Doctor Rich:

So yes — sperm can live inside the female urogenital tract (the vagina, cervix, uterus, tubes…) for up to five days. Now, most of the sperm won’t survive (95% will actually be dead by that time). But at 400 million sperm per ejaculate — it only takes one! So just be aware that conception can occur days after the actual sexual encounter.

[3. “All v@ginas have an odor.”]

[4. “Having an STI doesn’t make you dirty.”]

[5. “Kegels are your friend.”]

Doctor Rich:

Right. So discharge is normal — there’s always going to be some odor. 

There are foul odors that can indicate that there’s a sexually transmitted infection. Having a sexually transmitted infection is part of being sexually active. There are many sexually transmitted infections that can be treated easily with antibiotics. You need to protect yourself — use condoms. Many sexually transmitted infections can have long-term consequences, such as infertility with gonorrhea and chlamydia — or neurologic symptoms with syphilis, and can even be lethal in the case of HIV. So you need to advocate for yourself. You need to protect yourself in every sexual encounter, make sure you’re wearing a condom. And no — getting an STI doesn’t make you dirty. 

[6. “V@ginal acne is common”]

[7. Vaginas “come in all shapes, sizes, and colors.”]

Doctor Rich:

Yeah, Kegels are definitely your friend. 

You can start that at any age. It’s a muscular contraction that activates the urogenital diaphragm and pelvic floor muscles — which helps strengthen and prevent unwanted things like prolapse and incontinence.

[8. “V@ginas are self-cleaning.”]

Doctor Rich:


And that’s actually a really important one! The vagina cleans itself and doesn’t need any input from you. Certainly, there is an entire hundred million dollar industry of vaginal cleansing products. And the reality is, by using these products, you just wash out the normal protective bacteria and allow for infections like yeast, like bacterial vaginosis, to set up and cause symptoms. So it is a self-cleaning organ and doesn’t need any additional help. The one caveat for women who are predisposed to getting these types of vaginosis and yeast infections would be to take a probiotic. 

All right, let’s check out the next TikTok. 

[Video of a woman sitting up in bed slowly to dramatic music. The caption reads, “Thinking I’ve had yeast infections for the past 4 years and my gynecologist tells me…” Woman says, “I’m sorry — what’d you say? I just hallucinated!” Caption reads, “It’s actually bacterial vaginosis?!”]

Doctor Rich [laughing]:

Well, you know, these are the two most common vaginal infections there are. There’s yeast, and there’s bacterial vaginosis. Now yeast (almost exclusively) is a kind of a curd-white discharge and is accompanied by significant itching. The bacterial vaginosis, on the other hand, is more of a gray discharge — and it is accompanied by an odor (not typically as much itching). 

And these things can occur at the same time, or they can occur one after the other. It seems like this patient has maybe misdiagnosed (or self-diagnosed) for quite a long time — and found out she had some other infection. 

Keep in mind that there are many different types of discharge and reasons for discharge. There can be sexual infections like gonorrhea and chlamydia or herpes. All of these infections are going to have different symptoms, but it’s almost impossible to know without having an actual diagnostic test. And if it’s a recurrent type of condition, you really need to go each time you have the discharge or the symptoms so that we can collect points of data to determine if it in fact is the same type of infection occurring over and over again — and we can develop a treatment strategy around that.