The Vaginal Wellness Boom Is Here

The wellness crusade has come for the vagina.

While the market isn’t new (Lysol was advertised as a douche in the 1920s, and who can forget Goop’s jade egg?), the conversations around vaginal health have gotten louder on social media.

It’s happening on podcasts, too: Meghan Trainor has discussed pelvic pain, saying she had to “ice myself” after having sex. Last month, Ilana Glazer shared her own 20-year pelvic pain struggle. And companies have responded. According to some estimates, the vaginal health market is projected to double, or even triple, in the next decade.

Some products come across as novelty items, like Kourtney Kardashian’s Lemme Play Gummies and Hygiene Hero’s Vipstick Serum. But many others target vaginal pain, purporting to address what has long been a misunderstood and understudied aspect of women’s health. In some cases, experts say, the products can help treat certain symptoms and provide some relief. In others, they can have no effect at all, target the wrong issue or even complicate existing conditions.

“The wellness industry booms around the gaps in women’s health knowledge,” said Dr. Jocelyn Fitzgerald, an assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh. “So where there’s a lack of research and options, a lot of pseudoscience fills its place, and women are left to their own devices to figure things out.”

‘Oh my goodness, what is wrong with me?’

For two years, Maya Roy, now 19 and a student at the University of Connecticut, had constant, searing pain in her vagina that she said felt like “a swarm of bees attacking.”

It wasn’t a bacterial or yeast infection — she’d been swabbed for each at least 10 times. She was told by one gynecologist that her symptoms, including severe menstrual cramps, were from panic attacks and was prescribed an antidepressant.

“I would go to class and I would try my best, but sitting in those chairs just was terrible,” Ms. Roy said. She added, “Every day I would drive home crying, thinking, ‘Oh my goodness, what is wrong with me?’”

Ms. Roy said she had already been to more than a dozen different gynecologists — not an uncommon experience, experts say — when the vaginal wellness ads started appearing in her browser windows and on Reddit: boric acid suppositories, maca root, omega-3s, vaginal probiotics.

“I basically bought out the whole pharmacy,” Ms. Roy said, estimating that she spent about $450 on various products.

Social media has sparked a major increase in direct-to-consumer products propelled by vague biomedical language — phrases like “OB-GYN backed,” or “evidence-based,” said Cecilia Martínez-Plaza, a Ph.D. candidate at New York University who studies patient-led health movements. For women who are uncomfortable seeking vaginal health care, targeted posts may be their only source for medical information.

A personal recommendation from someone on social media can be easier to trust than a pharmaceutical ad, Ms. Martínez-Plaza said. And the claims are hard to disprove. “Just because we don’t have the data doesn’t mean it doesn’t work,” she said.

To make it even murkier, vaginal wellness products are often regulated as cosmetics, and the Food and Drug Administration generally does not approve them before they go on the market.

Sometimes, the claims cross a line and make the products sound more like drugs or medical devices. Over the past couple of years, the F.D.A. has issued warning letters to manufacturers selling vaginal gels and moisturizers advertised to treat infections, a douche claiming to relieve symptoms of bacterial vaginosis, CBD tampons purporting to treat menstrual pain and vaginal microbiome testing kits intended to diagnose conditions.

A Perfect Storm

At some point in their lifetime, anywhere from 10 to 30 percent of women will experience vulvovaginal pain. In Reddit threads and private Facebook groups, women commiserate about feeling hopeless and how, in some cases, they have been dismissed by doctors.

A study published in JAMA Network Open last year found that more than half of all patients with vulvovaginal disorders considered stopping care because of negative experiences with practitioners. Even worse, said Elizabeth Hintz, an assistant professor of health communication at the University of Connecticut, nearly half of all people who have these symptoms never seek help in the first place.

Part of the issue is the historical lack of data. The National Institutes of Health estimates that it spends just 10 percent of its budget on women’s health research, with the majority of this funding going toward cancer, H.I.V. and AIDS, and pregnancy.

What’s more, the path to better vaginal health care may be narrowing further. As a result of the Trump administration’s crackdown on diversity, equity and inclusion initiatives and policies, Dr. Hintz said she and other researchers are hesitant to use certain language in federal grant applications — words and phrases like “women,” “health disparity” and “sex” — which she worries could only exacerbate the problem.

It’s a perfect storm, Dr. Hintz said, “where people can innovate and sell solutions to problems that the country, the health care system, the federal government and the N.I.H. refuse to study.”

In an email to The Times, N.I.H. press secretary Emily G. Hilliard said that the “N.I.H. is deeply committed to advancing women’s health and improving health outcomes for women across the country. N.I.H. supports research focused on sex-specific health questions, including areas unique to women such as maternal health, gynecologic health and diseases that disproportionately affect women.”

Dr. Danielle Luciano, a professor and chair of the department of obstetrics and gynecology at the University of Connecticut, said she constantly has patients trying different supplements or asking about things they find online. “It’s because we don’t have cures for any of this stuff,” she said. When a doctor doesn’t have a straightforward answer like “giving you amoxicillin to cure your ear infection,” she continued, then patients are going to look elsewhere.

Even with limited treatments, seeking a diagnosis is essential for treating chronic vulvovaginal pain, Dr. Fitzgerald said. “It’s still important to make sure that what you’re treating is correct.” Putting on a vulva balm might relieve some discomfort, she explained, “but you want to make sure that you don’t have a more insidious condition.”

After being referred to a vulvar specialist last year, Ms. Roy was finally diagnosed with neuroproliferative vestibulodynia, an excess of nerve endings in the vaginal opening.

Though the diagnosis was a relief, the pain still kept her awake at night. She was prescribed two antidepressants that can be used off label for nerve-related pain and a muscle relaxation cream, but none helped, she said. Her doctor recommended surgery to remove tissue and the excess of nerves from the vaginal opening, which she had just last week.