Otitis

Women's hygiene tips. Intimate hygiene

The importance of a woman's personal hygiene cannot be overestimated. Similar procedures allow you to maintain cleanliness in intimate areas, which greatly contributes to maintaining health. Manufacturers of cosmetics produce numerous types of products that are specifically designed to care for intimate areas. Improper care or lack thereof can lead to the proliferation of opportunistic microflora, leading to various diseases and as a consequence to disruptions in work reproductive system women.

Feminine hygiene for every day

One of key points when caring for the intimate area, it can be called washing. This procedure should become a mandatory, daily event in the life of every woman. During washing, traces are eliminated physiological secretions, which in small quantities acceptable even in normal conditions. At the same time, they are cleared skin, and is eliminated bad smell, which is caused by microorganisms that multiply quickly in a favorable environment. To wash, you can use different cleansers, not forgetting that they should be “soft” and not aggressive. However, it is better to stock up on special cosmetics, the composition of which is designed taking into account the scope of application. Such cosmetics will cope with their tasks more effectively and will not harm the delicate skin in the intimate area.

Which means are better to choose?

Separately, we note ready-made cosmetic preparations (gels, soaps, sprays), which are offered by almost every famous brand. From the widest range the right product should be chosen based on your own preferences and the manufacturer’s recommendations. Carefully study the composition of the product to avoid the risk of allergic reactions. Main task any of the preparations intended for intimate hygiene – maintenance acid-base balance at the required level (3.8-4.5 pH). With the help of various additional components, the properties of the product are adjusted and significantly expanded (protection from irritation, from the development of pathogenic microflora, from unpleasant odors).

Among special means, which should be used while washing, can be distinguished:

Gel for intimate hygiene.

A soft emulsion that does not contain soap, very gently cleanses the skin. As a rule, such a product necessarily contains lactic acid, which normalizes the microflora of the mucous membranes. Some manufacturers add natural herbal ingredients that give the product special properties– moisturizing, disinfecting effect, pleasant smell. A convenient bottle equipped with a dispenser allows you to economically consume liquid and preserve it hygienic properties. It is better to avoid using intimate hygiene gel, which contains dyes, chemical flavors and other substances that can negatively affect “living” tissues intimate area.

Soap for intimate hygiene.

The product usually contains lactic acid, as well as other components plant origin with anti-inflammatory effect. Soap for intimate hygiene may be liquid or solid in consistency. When choosing a suitable sample, rely on ease of use. Regular soap is cheaper. However liquid product you can take it with you on a trip. It is consumed much more slowly due to the fact that only a small dose of the drug is needed each time.

Foam, mousse

Designed for very sensitive skin, which does not want to accept the coarser consistency of the product. Typically, such products are chosen by women who are prone to irritation and specific diseases associated with imbalance of microflora in the intimate area. Among the most common pathologies are thrush and colpitis of various etiologies.

Deodorizing spray for intimate hygiene.

Dysbacteriosis can cause not only unpleasant sensations, but also a persistent, irritating odor, which a special deodorant will help combat. Under no circumstances use regular deodorant for these purposes. This will only make the negative situation worse and harm your skin even more.

Cream

Intended for external use after hygiene procedures. It is used to enhance therapeutic effect gel or soap, relieves irritation, “calms” the skin, and reliably protects it from the development of pathogenic microflora. The product is recommended to be applied as a protective agent before swimming in water bodies and public swimming pools. Some samples represent a reliable barrier to the spread of infections, so they can be used during sex.

Don't forget about the so-called folk remedies. For example, chamomile for intimate hygiene has been used since time immemorial. Decoction medicinal plant used for washing and for compresses, which help cope with unpleasant sensations and get rid of irritation. The flower has a pronounced anti-inflammatory effect. It is no coincidence that it is often a component of special mass production means. Chamomile for intimate hygiene- not the only one plant matter, which is added to drugs of this order. Common regulars: calendula, sage, aloe vera. Panthenol and vitamins are also often found among the ingredients used.

Selection of linen

The type of underwear plays a decisive role in preventing irritation and diseases in the intimate area. Doctors unanimously speak about the dangers of thongs, which with their narrow elements rub delicate skin, which inevitably leads to inflammatory processes. It is not recommended to frequently wear underwear made from synthetic fabrics. If you cannot refuse lace, fishnet panties, pay attention to the processing of the product. The gusset made of cotton fabric reduces the risk of negative consequences. The best option The underwear is a natural, moisture-absorbing fabric with a comfortable cut, thanks to which the panties protect the intimate area without irritating the skin in this area.

Hygiene on critical days

What a woman needs most is hygiene procedures V critical days. During this period, the intimate area is most susceptible to the occurrence and development of infections.

In addition to special preparations for washing, the following are used:

Pads or tampons

Among gynecologists, pads are considered a safer option. Not every woman follows the instructions and changes the tampon every 2-3 hours, as expected. That's why menstrual blood stagnates in the vagina and forms a favorable environment for development pathogenic microorganisms. However, tampons have their advantages - they are invisible under clothing, allow the skin of the perineum to “breathe”, and do not cause a feeling of excess moisture in the intimate area. Tampons should absolutely not be used if a woman has been diagnosed with bacterial infection. In all other cases, the right to choose remains with the fair sex.

Intimate hygiene wipes

This an indispensable tool very useful when you have your period and you need to change your pad/tampon at work or in any other place where you happen to be. The wipes are impregnated with special substances that gently cleanse the skin and have bactericidal properties.

Hygiene during pregnancy

During this period, women complain about profuse sweating, more frequent urination, increased secretion from the vagina. All these factors negatively affect the microflora of the intimate area, so more attention should be paid to cleansing the skin in this area. To avoid discomfort You can wash yourself several times a day using special products. Use intimate hygiene cream and deodorant only if your doctor has approved it. These products may contain substances that are harmful to the unborn baby.

Sex life and hygiene

Maintaining good hygiene is essential if you are active. sex life. Sexual contacts, even with a regular, trusted partner, can provoke various negative manifestations. During sex, microscopic wounds and scratches often form on the skin in the intimate area, which can become inflamed when pathogenic microorganisms enter.

The need for daily intimate procedures is directly related to the preservation reproductive health women. After all, if you stick to proper hygiene, you can avoid many gynecological diseases.

Intimate hygiene is such a sensitive topic that people usually try not to touch on it. However, such silence can lead to big troubles.

To wash, you should not use soap, but only warm water or special compositions for intimate hygiene that contain substances that do not disturb the acidity of the vaginal environment and create conditions for the growth of lactobacilli. You need to wash yourself with clean hands, at least twice a day.
The direction of the water jet when washing and hand movements should be directed from front to back so as not to introduce infection into the vagina from the area anus(by the way, after performing natural necessities, movement toilet paper should be directed the same way). After washing, moisture is not wiped off, but blotted so as not to accidentally scratch the delicate surfaces.
Area around anus need to be washed with regular toilet soap, because intimate hygiene gels do not provide the necessary disinfection for this area.
The towel should be clean, soft, and should only be used by its owner.
During menstruation, you should not take a bath or swim in a pool or body of water. It is better to avoid sexual intercourse. During menstruation, sanitary pads should be changed at least four to five times a day.
If you use vaginal tampons, remember that you need to change your tampon every two hours. In most developed countries, doctors do not recommend using tampons regularly.
It is advisable not to constantly use sanitary pads unless this is necessary special reasons. Women's daily discharge is normally so insignificant that they do not require the use of pads. If you are concerned about increased vaginal discharge between periods, it is better to consult a gynecologist.
Douching (rinsing the inside of the vagina with various solutions) should only be done if prescribed by a gynecologist. They are not only unnecessary for regular hygiene, but can also seriously damage the vaginal microflora.

Why is it necessary to pay so much attention to such seemingly simple things?

The fact is that the “center” of the female reproductive system - the uterine cavity - should normally be sterile so that the developing embryo is not damaged by bacteria or viruses.

The vaginal opening is anatomically located near the anus, so it is necessary to pay increased attention to the peculiarities of feminine hygiene in order to avoid infection in the woman’s internal genital organs. You should also avoid creating favorable conditions for the proliferation of pathogenic microorganisms in the perineal area.

The uterus becomes especially vulnerable to infections during periods such as menstruation, since during menstruation there is no protective plug of mucus in the cervix.

In addition to the mucus barrier in the cervix, the path to microorganisms is blocked by bacteria that inhabit the vagina. Normal microflora This organ is 90% composed of lactobacilli that secrete lactic acid. Acidic environment vagina inhibits most pathogenic bacteria. If for some reason the environment in the vagina becomes alkaline rather than acidic, the number of lactobacilli is greatly reduced, and other microbes can occupy the vacated space. This condition is called dysbiosis, and if the anaerobic flora predominates - bacterial vaginosis.

The simplest and most common cause of a violation of the acid-base balance in the vagina is the entry of alkaline soap suds into it while washing. It's okay if this happens once. But constant alkaline “blows” lead to serious violations microflora, the proliferation of pathogenic bacteria, and, accordingly, inflammatory disease of the female genital area.

The protective capabilities of the genital organs depend on the woman’s age. Until the age of 17-18, that is, before the onset of puberty, the microflora of a girl’s vagina is easily disrupted by any adverse effects. Its stability also decreases in women who have reached menopause. During these periods of life, the rules of intimate hygiene must be observed especially carefully.

Correct balance of intimate microflora

Intimate care is important part women's health, but, unfortunately, many women are not sufficiently aware of the rules for its implementation. Violation of the rules of intimate care can lead to disastrous consequences - dysbiosis (dysbacteriosis) of the vagina, which, in turn, can be the cause of many inflammatory processes in the female genital organs.

Every woman should know how to properly care for herself in the intimate area, how to recognize disturbances in the vaginal microflora, and how to restore and maintain the correct balance intimate microflora.

Taking a shower correctly

Disturbances in the balance of intimate microflora can lead to various reasons. One of the most common is incorrect water procedures. Under no circumstances should you bathe too often - no more than 2 times a day. In addition, there is no need to wash the vaginal opening itself with soap - it is enough to treat only the external genitalia with soap. You need to use delicate soap, or best of all, a special intimate soap, gel or other product designed specifically for these purposes.

It is advisable to use boiled water to cleanse the genitals. It should be warm, but not too hot and certainly not cold. There is no need to use a washcloth, as the skin of the intimate area is very delicate. The direction of movement during this intimate procedure is from front to back. Other movements can cause bacteria to enter the vagina from the anus.

Other causes of vaginal dysbiosis

Very often, dysbiosis is a consequence of taking antibiotics, decreased immunity, and poor hygiene during sexual intercourse. A man should also be very careful about his intimate hygiene, because many bacteria are introduced into a woman’s vagina by her partner. Both participants must wash themselves before sexual intercourse. For men, it is also enough to use warm clean water and mild soap without a washcloth.

If you are using disinfectants for the intimate area, do not resort to their help too often. Ordinary antibacterial soap with triclosan, for example, can completely kill everything beneficial bacteria, getting into the vagina. Adhere to reasonable limits, because very often women, in pursuit of cleanliness, upset the balance of the intimate microflora of the vagina, and, as a result, pathogenic and opportunistic microorganisms colonize there.

One more common reason- abuse of tampons. If you experience discomfort in the vagina, a strange smell and color of discharge, an increase in its quantity, or discomfort during sexual intercourse, then you should avoid using tampons altogether. They should not be used in last days menstruation, and also change less frequently than every 4 hours. In any case, using pads is much safer if we're talking about about maintaining proper balance in the vagina. During menstruation, you should refrain from sexual activity, visiting the pool, sauna and taking baths.

It is very important to wear the right underwear. Panties made from synthetic non-natural fabrics, thongs and tight trousers are reasons that can also lead to disorders in the intimate sphere. Ideal underwear should be made from pure natural fabric, preferably cotton. Panties should not pinch or “cut” into the skin.

How to restore the normal balance of intimate microflora?

The natural environment for the vagina is acidic. Soap is an alkali, so excessive washing with soap only harms our intimate area. Lactic acid, which is secreted by special “friendly” bacteria living in the vagina, is aggressive for various microbes, but at the same time it is gentle on sperm. That is, disturbances of the intimate microflora in some cases even prevent the desired pregnancy from occurring.

Treatment of vaginal dysbiosis involves the use of special suppositories with lactobacilli and ascorbic acid. Be sure to consult with your gynecologist and take a flora smear at the beginning and end of treatment. It is also very important to stimulate the protective properties of the immune system, correct and balanced diet nutrition, consumption of fermented milk products, taking vitamin supplements.

You can also get rid of microflora disorders using folk remedies. Fermented milk products help fight the occurrence of dysbacteriosis not only from the outside, but also directly at the site of its occurrence. An excellent folk remedy that is absolutely safe and time-tested is washing with kefir.

Simply take any kefir, dilute 2 tablespoons of it in a glass of warm boiled water, and wash with this solution for a week. You can also use douching with the addition of kefir or natural whey.

Intimate hygiene is necessary for every person. Proper care for delicate parts of the body provides comfort and convenience. If you follow all the recommendations correctly, there will be no discomfort, odors and various diseases caused by dysbacteriosis.

Following the rules of genital care is extremely important for a woman’s health. Ignoring basic hygiene principles leads to many troubles and diseases, such as inflammation fallopian tubes and ovaries, as well as salpingoophoritis, erosion and even cervical cancer. These diseases begin with the entry of microorganisms into the uterine cavity and various viruses. How to prevent these problems from occurring? In pharmacies you can see a wide range of products for the care of female genital organs, but choosing the right one is not so easy. Let's try to understand this issue.

All women try to take care of their appearance: they take care of their skin, hair, and buy decorative cosmetics. Hygiene of female genital organs also has its own rules.

Hygienic care of female genital organs

*Twice a day, after washing your hands, wash yourself with warm water. At the same time, move from the pubis towards the anus. Direct the water stream from front to back. This will prevent infection from entering the vagina from the anus.

*Regular soap can only be used on the skin around the vagina. If you use it on the intimate area, you risk disturbing its acid-base balance. The normal microflora of this organ consists mainly of lactobacilli that secrete lactic acid, and if the environment becomes alkaline, their number decreases, and the vacated space is populated by other microorganisms. They are the cause of thrush (or candidiasis), gardnerellosis and bacterial vaginosis.

*After the washing procedure, blot, but under no circumstances rub, your genitals with a clean, soft towel. Among other things, it must be individual.

*Wear underwear made from natural fabrics - your body will be able to breathe through it, and the natural microflora of the vagina will be preserved.

*Rub them with sponges and washcloths. This can lead to cracks and scratches through which bacteria can easily enter.

*Pointing a stream of water directly into the vagina will wash away the natural protective lubricant and risk infection.

*On critical days, swim in the pool, have sex, take a bath. At this time, the female genital organs become especially sensitive, and inflammation of the uterus or appendages may occur.

There are many special products that make caring for intimate areas easier. Gels, wet wipes, special soap – what should you choose?

*The gels contain special plant extracts, which help maintain cleanliness despite increased sensitivity woman's genitals. These products are intended for daily hygiene. They do not cause dryness and irritation, have anti-inflammatory and hypoallergenic properties, refresh and eliminate odor.

The absence of alkali in the gels eliminates the disturbance of the acid-base balance of the vagina. Squeeze the product into your palm, gently apply to the mucous membrane and then rinse thoroughly with warm water. The gel relieves inflammation of the genital organs and limits the spread of bacteria.

*IN special soap for intimate hygiene contains various herbal extracts. It also warns inflammatory processes mucous membrane, as well as infectious diseases genitals.

*Try to buy products that contain triclosan. This component is absolutely safe antibacterial cosmetic product, does not irritate delicate skin and mucous membranes, and also does not causing development sustainable flora.

*During travel feminine hygiene genitals must also be supported. Take care of your intimate area with intimate hygiene wipes. They are impregnated with special lotions containing antiseptics, so they keep your skin healthy. Wipes prevent the appearance of unpleasant odors and fight them well. Just do not rinse your skin after using them. Dry the genitals, moving from the pubis to the anus.

*As for panty liners, doctors have different opinions on this matter. Some of them believe that such products are harmful women's health, increasing the risk of thrush. Still, most doctors believe that you can use panty liners if you change them more often. When choosing products, you should pay attention to the presence of a hygienic quality certificate.

*On critical days, alternate the use of tampons and pads.

*According to experts, use tampons in the presence of cervicitis, vaginitis, endometritis and others inflammatory diseases not recommended.

*Be sure to wash your hands thoroughly before using tampons.

*When choosing pads, consider the amount of discharge.

By observing these important tips, you will maintain your health and well-being!

Every woman strives for the ideal appearance both in the eyes of men and women. Only a few do not resort to cosmetics to give greater expressiveness to their facial features. The image of a woman has become a kind of ideal in our hearts; a girl should always be irresistible, clean and smell delicious. But in reality appearance The boundary of the personal hygiene circle does not end. Any girl should pay attention not only to the external component, but also to the intimate area of her body. Surprisingly, not every woman in these places can boast of cleanliness. Even today, seemingly well-groomed ladies do not pay any attention to the hygiene of the intimate area; some do not even know that some care is also required there. Even those ladies who keep their vaginal area clean make a number of mistakes and do it completely wrong. And only a few take proper care of the vagina.

Therefore, the topic of our article will be devoted to female intimate hygiene, rules of vaginal care, mistakes and consequences of incorrect or impaired vaginal hygiene.

What is feminine intimate hygiene and why is it needed?

Caring for the intimate area is not just regular washing of the vagina, which, by the way, many people do fundamentally wrong - it is a whole series actions aimed at maintaining the cleanliness of the intimate area and water procedures, the list is not limited. Parents should instill intimate etiquette in girls from childhood. This will, in particular, help avoid many diseases that develop due to improper hygiene of the intimate area. But bad luck, often even parents have an erroneous idea about these procedures.

So if washing your pussy is not enough, then what else should you do? Hygiene of female genital organs is the whole system, a single cycle of interconnected things that must be observed:

Of course, washing is one of the main actions that must be performed every day. But everyone has their own opinion on how this should be done. Below we will dwell on this point in more detail and tell you everything
Maintaining hygiene during menstruation - as it turns out, some women have no idea what this means. Many people think that you just need to wear pads for everything. But this is far from true
Compliance with the rules of wiping both after urination and defecation
It is necessary to choose correctly underwear. It also plays a significant role in the hygiene of your intimate area.
It is necessary to find a compromise between fashion and comfort when choosing clothes. You also need to follow the rules of wearing clothes
Long hair on women is beautiful only on the head. But in the intimate area they are not only not aesthetically pleasing, but also create a favorable environment for the development of bacteria
Proper sexual hygiene will also reduce the risk of developing a number of unpleasant diseases female genital organs
Physical exercises aimed at maintaining vaginal tone
Nutrition. At least periodically you need to eat foods that help maintain proper microflora inside the vagina

As you can see, intimate hygiene is a whole complex. But this does not mean at all that you need to abandon everything and focus only on the vagina. These procedures do not take much time. Below we will talk in more detail about each of the above points and find out what is included there.

Vagina care rules

Water treatments

Of course, you can’t do without water procedures. But many people do it wrong. The vagina has its own microflora, which is not recommended to be disturbed. There is no need to wash anything inside, just wash the outside of the pussy. If you wash the inside of the vagina, you will disrupt the microflora, making the organ more vulnerable to bacteria, which can contribute to the development of various diseases. If it is necessary to wash the penis from the inside for any reason, then there is no need to use soap, it upsets the natural balance and pH. An imbalance, as we have already said, leads to infections. There may also be irritation and allergic reaction. You can say that you always do this and nothing happens, everything is fine with you, but it doesn’t happen every time.

The water must have an optimal temperature and be running. It is not recommended to wash yourself in a basin, since with this approach bacteria and feces particles can get inside the vagina, causing microflora disturbances. Surely you have seen advertisements on TV for anti-thrush products; this disease appears precisely because of this.

Intimate vaginal hygiene during menstruation

During menstruation, it is recommended to pay more attention to vaginal hygiene. Wash frequently and change pads or tampons promptly. Quite often, the rules for using these products are violated; girls do not comply with the frequency of changing pads and can wear one all day long. If you don't have copious discharge during menstruation - this does not mean that replacement should be made only when it is completely wet. Even if the gasket appears clean, it must be replaced. Replacement must be done every 2-3 hours. Blood in the vagina disrupts the internal balance, you already know the consequences. It also promotes the development of various kinds of microorganisms, and with prolonged contact of your pussy with the pad, they can penetrate inside.

Rules for wiping

After you pee, you need to get rid of any remaining urine. To do this, a girl should always have sanitary napkins with her. Give preference to non-scented products, since chemicals and perfume components entering the female genital organs is extremely undesirable. you need to strictly point towards the anus, this way you will avoid feces getting inside.

What underwear helps maintain intimate hygiene?

The intimate area must be ventilated. There's a lot here sebaceous glands And elevated temperature, together these factors create a favorable environment for bacteria. Therefore, you need to choose underwear made from natural materials - cotton. It is not recommended to wear tight-fitting panties; give preference to more spacious and comfortable underwear. Panties should always be dry; if you are soaked to the skin, then if possible you need to change clothes; wet underwear contributes to the development of fungal infections.

What clothes should you prefer?

As mentioned above, the intimate area needs ventilation. But not all clothing meets the requirements for caring for the intimate area. Try to wear it less often tight clothes, give preference to loose-fitting clothes. Wear skirts more often.

Pay attention to pubic hair

Long hair in the intimate area is not only unsightly, but also unhygienic. Bacteria linger on the hair. Also, excessive vegetation in the genital area creates greenhouse effect and increases the temperature and prevents ventilation. Especially on hot days, due to densely growing hair, active reproduction of microorganisms begins.

It doesn’t have to be bald, you can just shorten them with scissors, which will be good.

Maintaining hygiene before, during and after sex

If this is not possible, then use a condom. Many people think that it is only intended to prevent unwanted pregnancy or reducing the risk of some kind of disease venereal diseases. But in fact, it can also save you from other diseases associated with poor intimate hygiene.

After sex, you also need to take a shower and pee. During sexual intercourse, microorganisms enter the urethra and can provoke inflammatory processes - urine will wash them away.

If you do not use a condom, then it is necessary to wash the sperm from the vagina after the end of sexual intercourse. The fact is that it changes the microflora inside the female genital organs, and we have already talked about the consequences of these violations more than once.

Train your vagina

Vaginal care includes more than just measures to keep the intimate area clean. You also need to pay attention to the physical shape of your genitals. With simple exercises you can strengthen your vaginal muscles. In turn, stronger intimate muscles will make your sex life more vibrant.

To do this, you need to do the following: imagine as if you need to interrupt the process of urination. At this time, exactly the muscles that we need are activated. Try to do daily training by tensing your vagina, first for 3 seconds, then for more for a long time. Over time, you will begin to feel and control these muscles better.

Trained intimate muscles allow you to forget about such a common problem among women as.

Nutrition to maintain vaginal microflora

The majority of diseases occur precisely because of microflora disturbances. Therefore, it is necessary not only to take measures to prevent uninvited guests from entering your cave, but also to strengthen the defense, so to speak. To do this, you need to eat foods that help maintain microflora, and these are yoghurts and other dairy products.

Eating garlic is useful not only in preventing the appearance of worms, but also in preventing the development of fungus in the vagina.

As you can see, the range of vaginal care is very wide, but despite quite large number The procedures necessary to maintain the hygiene of a woman’s intimate area will not take much time. Remember that hygiene of the female genital organs is, in particular, the key to the health of your reproductive function.

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The fair half of humanity should carry out water procedures for the genitals every day. In this case, you should wash them with warm water, directing it from front to back. This rule should also apply to the use of toilet paper. Why is this so important? The thing is that a woman can introduce various infections into the vagina, including coli which causes inflammation of the genital organs.

Due to poor ecology, we have to comply with several more elementary rules when carrying out water procedures:

To saturate the skin cells with oxygen and moisture, you need to use a washcloth;
- in order not to disturb the natural flora of the genital mucosa, you should not allow gel or soap to get into the vagina;
- to tone the skin and activate protective properties body, it is necessary to use folk remedies, such as sea salt, herbal infusions, etc.;
- after a shower, the body should be dried with a hard towel.

On the days when menstruation occurs, you should wash yourself three to four times a day without soap and preferably with boiled water, since at such a moment any infection can enter the genitals.

Don't forget to change your underwear every day.

A few more points about feminine hygiene

The modern girl strives to look attractive and does not care about her health. However, this may lead to sad consequences, especially in the cold season. Hypothermia - no best friend your genitals, so try to dress as warmly as possible.

Deodorants are also an integral part of hygiene female body. And if you have increased sweating, then you simply need this product, since the skin needs protection from harmful microorganisms that multiply in a humid environment.

To be healthy, you just need to follow a few simple rules. One of important points is to use quality tampons and panty liners. Wearing synthetics can also lead to dire consequences. It is very important to keep your skin and genitals clean so that you don’t get “rewarded” later chronic diseases. Improper adherence to personal hygiene rules adversely affects