Feminine Hygiene: Avoiding Infections

Introduction

In 2020, I worked as a backpacking guide for teens and young adults. During our dusty, summer expeditions through the Utah desert, many female clients, both new and experienced in backcountry travel, came to me for help regarding vaginal irritation and infection. Despite this being a common issue, sufferers always felt embarrassed and alone in their predicament. Additionally, girls who experienced discomfort related to feminine hygiene often expressed an aversion to backpacking by the end of the trip, stating that they never wanted to do it again.

The additional hygiene requirements associated with vaginal health can be a serious deterrent for women, girls, and genderqueer folks looking to participate in backcountry sports. In this article, I aim to provide strategies for preventing vaginal infection in the backcountry and to dispel the stigma around the discussion of intimate hygiene in backpacking and thru-hiking.

Vaginal Infections and the Microbiome

People with vaginas are at a higher risk of contracting infections including urinary tract infections (UTIs), yeast infections, and bacterial vaginosis (BV). This risk increases in the backcountry due to a disruption in hygiene habits.

Contracting one of these infections at home is usually easy to deal with, but what happens if you’re in the backcountry with limited access to medical care? At best, a vaginal infection could mean a premature end to your outdoor adventure. At worst, an untreated UTI could result in a kidney infection. A kidney infection can lead to a life-threatening case of sepsis in as little as twelve hours (Dumain, 2023). In the long term, a chronic, untreated kidney infection can cause permanent kidney damage in a matter of months (NIH, 2017). When it comes to preventing complications, treating UTIs promptly is imperative. (University of Pennsylvania, 2022; Porat et al., 2023; National Kidney Foundation; Doganis et al., 2007).

UTIs, Yeast Infections, and BV all result from an upset in the delicate balance of the vaginal microbiome.

Lots of factors can upset the balance of the vaginal microbiome and many of them are associated with hiking and backpacking. Changes to hygiene patterns, increased moisture, and dietary changes can all lead to changes in the composition of the vaginal microbiome (Noormohammadi et al., 2022).

Hormonal changes associated with menstruation and aging can also cause an upset to the balance of this delicate system. After menopause, decreased estrogen and progesterone levels result in a decrease in the presence of Lactobacillus. Fewer Lactobacilli create a more basic vaginal climate, which promotes colonization by harmful microorganisms that cause infections (Kim & Park, 2017). Estrogen levels rise and fall throughout the menstrual cycle. These monthly hormone fluctuations have also led to yeast infections, UTIs, and BV in some people (Reed & Carr, 2018).

So, what does all of this mean for women and genderqueer folks in the backcountry? If you struggle with vaginal infections while backpacking and thru-hiking, you’re not alone. If vaginal infections in the backcountry have suddenly become a problem for you due to the onset of menstruation or menopause, this is also perfectly normal. Now that we understand the cause of these conditions, let’s discuss ways to prevent them.