Feminine hygiene products are sold as agents to help women stay clean, fresh, and comfortable. From intimate washes and douches to scented pads and tampons, the scope of available products in the market promises to meet every woman's hygiene need. However, concerns have been rising lately about the safety of these products, some studies claiming that rather than promoting health, they can contribute to a heightened risk of vaginal infections.

A new study done by the University of Guelph in Ontario, Canada, has fueled this fear. The study asked more than 1,400 Canadian women about their use of feminine hygiene products, and the results were frightening. The study found that 95% of participants had used some type of over-the-counter hygiene product at least once, and importantly, those who used these products regularly were three times more likely to experience some type of vaginal infection.

While some hygiene products, like tampons and sanitary pads, are necessary and integral parts of the menstrual cycle, other products like vaginal washes, scented pads, and anti-itch creams are advertised to be necessary for feminine health. Do these products, which many women count on to keep themselves clean, cause harm?

The vagina is a self-cleaning organ that possesses a natural cleansing mechanism. The healthy condition of the vaginal environment is maintained by the presence of beneficial bacteria, primarily Lactobacillus, that maintains the pH balance and helps in preventing infections. If the fragile microbial ecosystem is disrupted, it causes many infections, such as BV, yeast infections, and UTIs.

Dr. Deepti Sureka, Urologist, says that vaginal anatomy needs to be grasped before the safety of hygiene products for women can be known. "The vagina is not meant to be over-cleaned or manipulated. Overuse of hygiene products, especially douches or scented products, may cause an imbalance in natural pH and lead to infection," says Dr. Sureka.

Common Feminine Hygiene Products and Their Risks

Vaginal washes and douches

Vaginal wash is one of the most widely used feminine hygiene products used by women in terms of freshness maintenance. These items, however contain chemicals, which can throw the vaginal flora out of its natural balance. Doctors have long since condemned douche as it leads to infections; the idea behind douching is not only to get rid of pathogens but also *Lactobacillus*, those beneficial bacteria of the vagina, making the vagina open to infections.

Fragrant Products

Most women prefer scented pads, tampons, and panty liners because they will not like the smell of the menstrual discharge. Unfortunately, the majority of these products contain synthetic fragrances and chemicals that are irritating to the very sensitive skin of the vaginal mucosa. Such irritation may become a breeding ground for infection, such as yeast and BV. For others, some may suffer from chemical sensitivities, which further complicates the condition.

Tampons

Tampons are a product that most women need to use when they menstruate. Tampons are relatively safe if used properly. However, leaving a tampon in for too long causes the growth of dangerous bacteria that can lead to TSS, a rare but potentially fatal condition. In addition, the synthetic materials used in some tampons may cause irritation in the vaginal area.

Menstrual Cups

Menstrual cups have become popular as an eco-friendly and sustainable alternative to tampons and pads. However, if they are not cleaned properly or used for too long, menstrual cups can increase the risk of vaginal infections. As with tampons, the risk arises when the cups are not sanitized adequately, and bacteria grow.

Panty Liners and Pads

Use panty liners regularly without actually knowing that they encourage an atmosphere with humidity that thrives on bacterial and fungal growth. The constant usage of pads for extended periods especially under humid conditions, puts more possibility of developing skin irritation and infection.

Application of fragrant scents compounds the risk of developing allergic reactions or irritation.

Habits Affecting Vaginal Health

Beyond the products themselves, it is how women use them that is key to preventing infections. Dr. Sureka advises women to be good about hygiene, changing pads and tampons regularly, thereby reducing bacterial buildup. "It's important to change tampons every 4-6 hours and avoid leaving them in for extended periods," she says.

Proper use of menstrual cups entails frequent sterilization, and hands should always be cleaned before insertion or removal. Excessive cleaning of the vagina, such as washing or scrubbing too frequently, can strip the skin of its natural oils and beneficial bacteria, which are necessary to maintain vaginal health.

How to Minimize the Risk of Vaginal Infections

While the risks associated with feminine hygiene products are concerning, there are a number of ways women can minimize the risk of infections:

1. Use Warm Water for Daily Hygiene

For most women, warm water is enough to clean the external genital area. If further cleaning is required, opt for a mild, fragrance-free soap, but do not use it inside the vagina.

2. Opt for Breathable Fabrics

Go for cotton undergarments and avoid wearing tight clothing that can retain moisture. Dry fabrics prevent the vaginal region from getting moist, thus avoiding bacteria or fungal infections.

3. Steer Clear of Fragrant Products

Using fragrance-free pads, tampons, and liners helps to reduce the amount of chemicals one is exposed to. Fragrant products tend to have artificial fragrances, which cause irritation of the vagina and may lead to allergic reactions.

4. Reduce the Use of Female Hygiene Products

Unless prescribed by a healthcare provider, avoid douching or using vaginal washes. The vagina is naturally self-cleaning, and overuse of these products can disrupt its pH balance and microbial environment.

5. Consult a Healthcare Provider

If you experience persistent irritation, unusual discharge, or symptoms of infection, it’s crucial to consult a healthcare provider or urologist promptly. Early intervention can prevent infections from escalating and help maintain vaginal health.

Feminine hygiene products can offer convenience, but when overused or misused, they can contribute to an increased risk of vaginal infections. Women must be informed about the potential risks associated with certain products and adopt healthier hygiene practices. Ultimately, understanding the natural functions of the body and avoiding unnecessary interference with that process is key to preventing infections and maintaining overall vaginal health.

Dr. Deepti Sureka is a Consultant Female Urologist at Asian Institute of Nephrology and Urology Hyderabad, India.

Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey. 2018. BMC Women's Health.

Feminine Hygiene - United States. 2024. Statistica

The United States has signed 24 bilateral health Memoranda of Understanding or MoUs with Latin America and African countries under the Trump administration's America First Global Health Strategy.

The first agreement with Panama is described as “strengthening Western hemisphere health security”, which it added is “a priority”. Thereafter, four Latin American agreements too involve smaller grants and focus on disease surveillance. Other 20 agreements all with African countries who have been previous recipients of health grants via the now disbanded US agency for International Development or USAID and decimated US President's Emergency Funds for AIDS Relief (PEPFAR).

The five-year MoUs aim to quickly shift financial responsibility for key health services to national governments. In several countries, including Kenya, Uganda and the Democratic Republic of Congo (DRC), more than half of HIV programme funding has traditionally come from donors, particularly the United States. In the DRC, for instance, at least half of the antiretroviral medicines used have been financed by the US.

What Do These MoUs Comprise?

The transitional Memorandums of Understanding (MoUs) signed between the United States and several countries come with a major condition. They require strong investment in infectious disease surveillance systems.

The goal is to ensure that pathogen information from outbreaks is shared with the US within a week. Officials say this helps detect global threats early and protect public health.

At the same time, it gives US pharmaceutical companies early access to pathogen data, allowing them to develop vaccines, medicines and diagnostics more quickly.

The US–DRC Health Agreement

The United States and the Democratic Republic of Congo (DRC) signed their health MoU on 26 February. According to the US State Department, the agreement focuses on strengthening the country’s ability to detect and contain infectious disease outbreaks before they spread internationally.

• The focus reflects the country’s recent health challenges.
• The DRC has experienced several Ebola outbreaks in recent years.
• It is also dealing with the world’s largest mpox outbreak.

Funding Commitments

Under the agreement:

• The US will invest up to $900 million over five years
• The DRC will increase its health spending by $300 million

Most of the funding will support a national integrated surveillance and outbreak response system.

This includes:

• A laboratory network capable of detecting outbreaks within seven days
• Faster outbreak investigations and response systems
• Coordination between the US and other global health partners

The MoU also aims to modernize health data systems through electronic medical records, interoperable platforms, better trained community health workers and expanded services for HIV, tuberculosis, malaria, polio and maternal and child health.

Minerals Before Health

In several cases, health agreements were preceded by deals related to natural resources.

The United States and the DRC first signed a strategic partnership on critical minerals. The deal aims to secure supplies of minerals needed for commercial and defense industries.

The DRC is one of the world’s largest sources of rare earth minerals, including cobalt and copper. China has historically dominated the purchasing and processing of these resources.

Recently, the DRC has begun opening its mineral sector to US investors. According to Reuters, the government sent Washington a shortlist of state owned assets involving:

• manganese
• copper
• cobalt
• gold
• lithium

Guinea followed a similar path. It signed a minerals MoU with the US on 5 February, followed by a health MoU on 27 February. The health agreement prioritizes strengthening laboratory networks and improving biosafety standards by 2027.

Legal Pushback and Rejected Deals

Not all countries are comfortable linking health support to access to resources or data.

In the DRC, a group of lawyers has challenged the minerals agreement in the Constitutional Court. They argue that the deal violates the constitution and undermines national sovereignty over natural resources.

Zimbabwe also withdrew from negotiations with the US over a similar agreement.

Officials said the country was asked to share biological resources and outbreak data for years without any guarantee that vaccines, treatments or diagnostics developed from that data would be available to Zimbabwe if a future crisis occurred. They also said the US did not offer reciprocal sharing of its own epidemiological data.

Concerns in Kenya and Zambia

Kenya’s agreement with the United States has also faced legal hurdles. The country’s High Court halted the MoU after two court challenges questioned provisions that could allow the US access to patient data and pathogen information.

Zambia has also expressed reservations about its proposed health deal with Washington. The agreement stalled after the US linked the billion dollar package to cooperation in the country’s mining sector, particularly copper and cobalt.

Zambia has since asked for revisions, saying parts of the deal do not align with its national interests.

Critics Call the Policy “Extractive”

Some experts argue that these agreements reflect a broader shift in US global health policy.

Sophie Harman, professor of international politics at Queen Mary University of London, wrote in the BMJ that extraction appears to be central to the approach.

According to her analysis, the policy focuses less on improving global health outcomes and more on strengthening US economic and geopolitical interests, including competition with China.

She warns that countries entering such agreements could risk giving up resources or scientific data while gaining relatively limited health benefits.

Rare diseases may be individually uncommon, but together they represent a large and persistent care gap. More than 300 million people globally live with a rare condition, and when families and caregivers are counted, the impact touches over one billion lives. The economic burden is estimated to exceed $7 trillion each year.

In India, the challenge is compounded by geography, uneven specialist availability and the lifelong nature of many rare conditions. The question is no longer whether the system recognises the need, but whether it can deliver continuous care at scale.

Why Patients Still Struggle To Reach Care

For most rare disease patients, the hardest part is not always the science but the pathway to care. Diagnosis is often delayed, sometimes by years. Patients move between providers carrying incomplete records. Specialist centres are concentrated in a few large cities, forcing families to travel repeatedly for consultations that may last only minutes. This is both financially draining and clinically inefficient.

Telemedicine is beginning to ease some of this pressure. Virtual consultations allow specialists to extend their reach beyond metropolitan clusters. For families in tier two and tier three locations, this can mean earlier clinical input and fewer avoidable journeys.

Remote monitoring tools are also shifting care from episodic hospital visits to continuous oversight, which is particularly valuable for conditions that require close tracking over time.

Why Data Matters More Than Ever

If access is the visible challenge, data fragmentation is the structural one. Rare disease information remains scattered across hospitals, laboratories and individual case files. This weak visibility affects everything from prevalence estimates to therapy development. Policymakers struggle to size the problem accurately. Clinicians miss longitudinal patterns. Industry investment becomes harder to justify.

Digital health systems can address this by creating longitudinal patient records that follow individuals across providers. Even relatively modest steps such as strengthening diagnostic reporting or building disease registries can significantly improve coordination. For rare diseases, where patient numbers are small and widely dispersed, structured data is not a luxury. It is the backbone of effective care.

India’s Digital Opportunity

India has begun building the rails needed for this transition. The Ayushman Bharat Digital Mission is creating a national health data architecture anchored in unique health IDs and interoperable records. If applied rigorously to rare diseases, this infrastructure can support lifelong patient tracking, improve referral accuracy and give policymakers clearer visibility into disease burden.

Interoperability will determine how far this effort goes. The growing adoption of FHIR standards and API led systems is slowly allowing previously disconnected hospital platforms to exchange clinical information. For rare disease patients, whose care often spans multiple providers and years of follow up, this continuity is not technical detail. It is essential to safe treatment.

AI Moves From Promise To Practice

Artificial intelligence is also starting to show practical value. Globally, AI based clinical decision support tools are being used to flag potential rare disease cases hidden within routine health records. This matters because many rare conditions present with non specific symptoms and are frequently missed in early stages.

Collaborations between technology firms and pharmaceutical companies are demonstrating how electronic health record analysis, suspect patient lists and longitudinal data can help clinicians triage cases earlier for confirmatory testing. As these tools mature and integrate into routine workflows, they could significantly shorten the diagnostic odyssey that rare disease families currently endure.

Engaging Patients Beyond The Clinic

At the patient level, the shift is becoming more practical and visible. Tools that let people log symptoms, get medication reminders and share updates in real time are helping them stay more consistent with treatment, while giving clinicians better insight between visits. For lifelong conditions, this kind of day to day support brings care into the flow of everyday life, where most disease management actually happens.

Federated data models add an important layer of trust. By enabling analysis across multiple small patient populations without moving sensitive personal data, they address both privacy concerns and the sample size limitations that have historically slowed rare disease research.

From Pilots to Systems

Progress is visible across both public and private sectors. Regulated digital health platforms are already supporting rare disease programmes in several countries. Industry collaborations are using AI to detect conditions that often go undiagnosed for years. Public genomic databases are generating new diagnoses by enabling experts to build on shared evidence.

India’s immediate task is to move beyond isolated pilots. Telemedicine networks must be tied to referral protocols and reimbursement pathways. Digital registries must be built with strong governance and patient trust. AI tools need to be embedded into everyday clinical workflows rather than remaining demonstration projects.

Why Investment Makes Fiscal Sense

Poorly managed rare diseases create avoidable hospitalisations, lost productivity and long term care costs. Evidence increasingly shows that targeted investments in data systems, screening and coordinated care can reduce downstream expenditure. For low- and middle-income countries working within tight health budgets, these are not marginal gains.

India already has many of the building blocks needed to improve rare disease care, from expanding digital health infrastructure to growing AI capabilities and increasing policy focus. The real test now is disciplined execution.

Telemedicine networks must deepen their reach, patient registries need to become reliable and usable, data must move securely across systems, and clinicians should have decision support tools that fit into everyday practice. Taken together, these steps can meaningfully narrow today’s access gaps.

Digital health will not make rare diseases any less complex. But if implemented thoughtfully, it can reduce distance, shorten delays and bring much needed continuity to care journeys that are currently fragmented. For families managing lifelong conditions, that would be a tangible and much overdue shift.

In India, it is not uncommon for families to travel across cities, sometimes across states, seeking answers for symptoms that simply don’t make sense. A child who is not meeting developmental milestones. A young adult with unexplained muscle weakness. Recurrent hospital visits with no clear diagnosis.

For many, this long and frustrating search for clarity is what medicine calls the diagnostic odyssey.

Rare diseases are individually uncommon, but collectively they affect millions of people worldwide. Rare diseases affect an estimated 263–446 million people worldwide, spanning every geography, healthcare system, and socioeconomic context. India alone is estimated to have 70 million people living with rare diseases.

Importantly, although 70%–80% of rare diseases are genetic in origin, routine medical practices often consider genetic testing only after years of inconclusive evaluations.

In India, this challenge is amplified by several factors, including limited awareness of rare conditions, uneven access to specialized testing across regions, and a tendency to treat symptoms individually rather than look for a unifying cause.

A child may see a neurologist for seizures, a gastroenterologist for feeding issues, and a developmental pediatrician for delays, without anyone connecting the dots.

Studies have shown that patients and their families frequently wait years before receiving a confirmed diagnosis. Globally, rare disease diagnosis can take anywhere between 5–30 years.

In a country like India, where healthcare expenses are often paid out-of-pocket, this prolonged uncertainty can be devastating. Beyond cost, there is the psychological toll; parents wondering if they missed something and adult patients often questioning whether their symptoms are “all in their head”. During this period, families undergo repeated tests, face conflicting opinions, and bear significant emotional and financial strains.

Research shows that families experience profound emotional burden during the diagnostic odyssey, including stress, anxiety, and feelings of isolation.

Why Do These Conditions Stay Undetected For Years?

In many cases, the explanation is written into a person’s DNA. Genetic disorders rarely announce themselves clearly; instead, they often mimic common illnesses. Fatigue may look like anemia, developmental delay may resemble a learning difficulty, and repeated infections might be treated as isolated events rather than part of a larger pattern. Because the symptoms overlap with more familiar conditions, doctors naturally begin by treating what appears most likely.

Most healthcare systems also follow a step-by-step diagnostic approach; rule out the common causes first, then move to less common ones if symptoms persist. While this method works well for typical illnesses, it can significantly delay answers for rare genetic conditions. Without looking directly at the genetic blueprint, the underlying cause may remain hidden, even as the visible symptoms are managed one at a time.

Today, advances in genomic technologies such as whole-exome sequencing (WES) and whole-genome sequencing (WGS) allow us to examine thousands of genes simultaneously. Rather than guessing which gene might be responsible, we can comprehensively analyze a patient’s DNA to search for answers.

Evidence increasingly supports the use of genomic sequencing earlier in the diagnosis and care of rare diseases. Similarly, studies highlight how genomic testing not only provides diagnoses but also directly influences treatment decisions and long-term care planning.

In the Indian context, integrating genetic testing earlier could transform care. Instead of years of fragmented consultations, patients could receive a precise diagnosis sooner. This clarity can:

• Prevent unnecessary or repeated investigations
• Guide appropriate treatment strategies
• Inform family members about potential risks
• Enable informed decisions about future pregnancies
• Equally important, it replaces uncertainty with understanding.

Encouragingly, awareness around rare diseases is growing in India, and conversations around early genomic testing are becoming more mainstream. As technology becomes more affordable and accessible, we have an opportunity to fundamentally change the patient journey.

No family should spend years searching for answers when science has the tools to help. By embracing genomic medicine earlier in the diagnostic pathway, we can shorten the odyssey, reduce suffering, and empower families with clarity.

Because when symptoms don’t add up, sometimes the answer lies written in our genes.