Hygiene and care

As a sex worker, it is important to take good care of your body. After all, this is what you work with. How do you keep your body healthy, clean and cared for? And how do you do that without extra risk of complaints? How can you continue working when you are menstruating?

Hygiene and care of the vagina

A sexually transmitted disease (STI) can be the cause of vaginal complaints. However, the most common causes of problems of the vagina are not STIs but of poor hygiene, for example, the fungal infections of candida and bacterial vaginosis. You can sometimes suffer from these when there is reduced natural barriers which might happen due to hormonal changes, after medication (especially antibiotics) or due to sex.

The wall of the vagina is elastic, thick and ruffled (able to naturally stretch to accommodate the penis). The wall is naturally lined with a thin mucous membrane which offers you protection against viruses and bacteria. Therefore, it is important that you keep your vagina healthy.

Good vaginal hygiene helps to keep your vagina in its best shape:

  • wash your vulva and vagina only with lukewarm water
  • do not rinse your vagina from the inside (with a shower hose) (also referred to a douche)
  • do not use soap products that claim to be specially for the vagina. These often disrupt the pH balance. They may even worsen your complaints. If you insist on using something like Lactacyd, keep it to once a week only.
  • do not dry yourself roughly, dabbing is best. Ensure of course, that your towel is clean and changed often.
  • change tampons, pads, sponges or cups regularly (preferably after 4 hours).
  • do not use panty liners or tampons when not menstruating.
  • cotton underwear is best, as synthetic fabrics do not breathe as well.
  • use a condom when having sex.
  • get comfortable with your body: check yourself from time to time by feeling or looking at yourself with a mirror. That way you notice changes faster.

Working during menstruation

It is up to you to decide if you should continue working during your menstruation. Some women feel less able to work through their period. This is a good reason to take a short break, especially from Day 2 as the flow normally increases and cramps are worst.

Menstruation can be delayed by continually skipping the contraceptive-free week, if on the Pill, the contraceptive ring or patch.

You can also continue working while menstruating. Special sponges are available for this purpose to catch the blood. There are dry and wet sponges. However, bear in mind these when using menstruation sponges:

Advise for the use of sponges:

  • Do not use them more than once (do not rinse and reinsert). These are one-time use only.
  • Never keep them in for more than four hours.
  • Do not use natural or household sponges. The chemist/drugstore sells menstruation sponges.
  • Always use a condom in addition to the sponge. The sponge does not offer full protection against pregnancy neither does it protect against STIs.
  • Always moisten a dry sponge with a few drops of warm water. (Read the instructions on the box).
  • If you are having trouble pulling out the sponge due to being up your vaginal canal too far, you can point a shower head towards your vagina to allow the water to soak the sponge. The weight and bulk of the soaked sponge will help to ease the sponge down.
  • If it still doesn’t work: call an ACS nurse and we will help you. If the ACS is closed, please call the after-hours GP service (huisarts).

Hygiene and care of the neo-vagina

A neo-vagina is a new vagina. Transsexual sex workers who have had gender reassignment (gender change) have neo-vaginas (vaginaplasty). In most cases, neo-vaginas are formed from the skin of the penis and testicle. Hence, it differs in texture from a biological woman’s vagina — it will not be naturally moist and has no pH levels to aid in self-cleaning, forming a natural bacterial barrier. Because it is made from normal skin, it sweats and has many sebaceous glands that produce sebum/oil.

This means care for a neo-vagina is important to manage sebum build-up which can cause problems. These include:

Tips:

  • Rinse your vagina internally once a week (increasing frequency if there is a strong odour).
  • Only rinse with water!
  • Use a vaginal douche with a cannula which you can insert.
  • After rinsing, apply some oil or calendula cream to the vagina. This will prevent softening and the skin from sticking together. However, it is then important to use condoms that can withstand this.
  • Use a hormone cream that promotes blood flow to the vagina.

Hygiene and care
of the anus

Encountering stool stains when engaging in anal sex is to be expected. While having a daily bowel movement and normal stools can clean out impurities, if you want to ensure a clean canal and anus, you can anal rinse. It will ensure that there will not be any particles of faeces or a bad smell.

Adult stores catering to the sex industry will sell anal rinsing enemas. There are various enemas, either a Microlax or a water enema using a water tube.
It is important to note that anal rinsing also has disadvantages. It can disrupt the bacterial balance that are necessary for the healthy functioning of your bowels. In addition, rinsing can cause small wounds. This increases your risk of contracting HIV or an STI.

When you do not have to rinse
  • When you don’t feel like you need to defecate. The end of your bowel is then usually empty.
  • When the penis of the person you are having sex with is average-sized. In that case, it usually does not reach where your stool sits.
  • If you usually defecate at the same time and already have done it before sex.
How do you clean the inside of the anus?
  • With a rinsing rod. You attach it to your shower hose with the head twisted off.
  • With a hand pump.

Use only water, never anything else. Your intestines can’t handle anything else. It can lead to abdominal pain and increases the chance of an STI.

Do not share the items you use to rinse the inside of your anus with others. If you need to, always ensure they are disinfected and cleaned before and after allowing someone else to use it

Rinse your anus with a rinsing rod, shower hose or pump:

  1. Rinse 1 hour before you have sex. This gives time for all unclean water to leave the anus.
  2. Ensure you have already done a bowel movement (poop) – avoid straining as it can create small tears (fissures) in your anus.
  3. Apply a little lubricant in your anus and on the end of the flushing rod or pump. This will make flushing easier. Lubricants made from silicone are better.
  4. Ensure that the water pressure is not high as it can damage your intestines and bowels. The water should be lukewarm.
  5. Try to relax so that your anus is not too tight. Carefully insert the flushing rod or pump into your anus. Exhale as you do this.
  6. Let the water flow in slowly, until it feels like your bottom is full of water. If you are new to this, start with short session.
  7. Then sit on the toilet and relax your anus. Let the water run out with the.
  8. It can be helpful to flush a few times in a row so you can tell when the water running out is cleaner than when you started.
  9. Don’t start having sex right away. Sit on the toilet again half an hour later. Is there still water in your bowel? Let this come out slowly. Does no more water come out? Then you are ready and can have sex.
How do you clean your rinsing gear?
Always disinfect and thoroughly clean all your rinsing equipment. This is important because bacteria or viruses that may be left on the equipment can make you sick.

  1. Place your rinsing rod or hand pump in a large bowl of water with a splash of bleach. You can buy bleach in the supermarket.
  2. Let it soak for 5 minutes..
  3. Remove the items from the container – bleach is a cleaning agent, so it is helpful to either use tongs or gloves.
  4. Rinse everything well with clean running water. (Do a good job as bleach is not meant to be in your body.).

If the items are fully metal, you can also clean them by boiling them for 5 minutes.

Disadvantages of anal flushing
Unfortunately, flushing does not prevent STIs. In fact, you are slightly more likely to get an STI.

  • If the pressure of the running water is too hard/fast, or you squeezed your pump too hard, you may cause wounds in your bowels and more easily get an STI.
  • When you flush your bowels, good bacteria are also flushed and these keep your intestines healthy. If you flush too often, you may cause lingering intestinal problems and have a higher risk of contracting an STI.
  • If you flush too deeply, you may overstimulate your intestines and often have to defecate instead.
  • Did someone cum inside you? Then don’t rinse again. You will flush the semen further inside and increase the risk of STIs.

So do NOTflush:

  • With too much water pressure
  • Too often (we advise no more than twice a week)
  • Too deep
  • Straight after sex
Care tips
  • Use a stool (squatty potty) under your feet when sitting on the toilet when defecating to avoid straining your sphincter muscle.
  • Don’t push too hard. This will prevent wounds and or haemorrhoids.
  • Eat high-fibre food so your poo is not too hard.
  • Pat your anus clean with toilet paper and try not to wipe too hard.
  • Check yourself from time to time by feeling and looking with a mirror.

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