Hygiene in the Field: Keeping the Lady Parts Clean 101

“Women aren’t biologically suited for austere environments…you know…because of…hygiene.”

Actual quote from a concerned man when we were talking about female/male integration in the military for deployments. What did he mean, exactly? We get too smelly? Our hair gets too greasy? To be blunt, I’m pretty sure this particular guy didn’t even know what he meant, but since this has been a common “oh no, the women are integrating” fear tactic, I knew what he was trying to imply—our lady parts aren’t suited for the harsh environment of…drumroll please…the lack of showers and sitting toilets during deployments.

Now I don’t know where this rumor started. Clearly our American ethnocentric way of life has obscured the millions of women who don’t bathe in showers or sit on toilets currently in the world. Those women, by the way, seem totally fine with their lady parts, but I digress. Yes, hygiene in the field is a concern—just like it is with men (looking at you Joe Operator with that fungal infection under your beard). Our concerns are perhaps different, but the solutions are typically the same: maintain good hygiene in the field.

So, in order to help out that future female operator, hiker, or outdoors(wo)man; and to shed some light on the subject for the male leader, friend, father, etc, let’s discuss this in more detail.

Proper hygiene prevents the one thing you can’t fix by improvising in austere environments—infections.  You may be the deadliest tactician in military history; the best water collector this side of the Mississippi; are 10 for 10 on your survival snares; and can build a lean-to that sleeps five people comfortably; but there’s nothing that ruins a trip like a urinary tract or fungal infection.  Yup, folks, infections suck; they do not discriminate based on gender, strength or agility; and without proper treatment they can wreak havoc on your system, even leading to permanent damage.

Bacterial Infections

A urinary tract infection, also known as a UTI, is a bacterial infection in your urethra, bladder or kidneys.  In austere environments, women tend to get UTIs more often than their male counterparts because the opening to their urinary tract, or urethra, is shorter, enabling bacteria to more easily reach the bladder.  Additionally, their urethra is located near their rectum, increasing the likelihood of contamination without proper hygiene. 

Dr. Sean Mulvaney, U.S. Navy SEAL turned Army doctor, explains that untreated UTIs can lead to permanent damage.  “While lower urinary tract infections may resolve spontaneously if you have a strong immune system and stay well hydrated, more often than not, antibiotics are required to hasten the resolution and reduce the pain.  Without intervention, upper tract infections can lead to permanent kidney damage, and in some cases, infertility.” 

The most common causes of UTIs in outdoor environments are dehydration, holding in urine, and wiping incorrectly.

“Women holding in their urine is usually the main culprit of UTIs,” Dr. Mulvaney said.  “The bladder can be a breeding ground for bacteria.  Staying hydrated and urinating regularly flushes the bacteria out of your body.”

So, ladies (and fellas with lady companions), let’s talk about peeing in the woods.  Here’s your scenario: You have your pack on; you and your group are making good time on a moderately strenuous hike or movement.  Your camelback is providing needed hydration as you trek your way up the mountain.  Then you have to pee.  But you don’t want to stop the forward progress by making the group take a 20-minute break; and you certainly don’t want to take your pack off and travel 200 yards into the woods to drop your pants in private.  So you hold it.  Then you stop drinking water because you have to pee so badly.  Next thing you know, there’s a bacteria party in your very full bladder, and your choice to dehydrate prevents you from flushing said bacteria out of your system placing your kidneys in a deficit.

Or worse, you’re so used to holding in your urine, you weaken your bladder muscles which could lead to urinary retention—the inability to fully empty your bladder.  Studies have recently been conducted regarding military women and urinary retention issues, as female pilots and other service members tend to have privacy, safety and security concerns urinating in austere environments. The Journal of Military and Veterans’ Health published a study that found genitourinary infections and urinary incontinence affected up to one-third of serving women.

The good news is with proper planning, life hacks and the right gear, these issues are easily preventable.

Prevent Bladder Issues:

1) Female Urination Device:  Invest in a female urination device that enables you to pee standing up.  These funnel-like devices are held flush against your body for quick evacuation.  There are a few devices on the market to choose from, including a hardened funnel with removable tube, or a softer, flexible silicone device. Some come with their own carrying case.  The best part about them is you simply unzip your pants to use—no dropping your pack; no great exposure to the elements; no 15-min hike to find privacy.   

2) Empty your bladder at night, too.  Now that you have your handy female urination device, leaving the tent to pee in the middle of a cold night is a thing of the past!  Consider dedicating an old water bottle as an in-tent/in-hooch receptacle rather than getting dressed and making the trip to the tree line in the pouring rain.

3) Pee rag: Whether or not you can wrap your head around the female urination device, a pee rag is a discreet, convenient way to hygienically wipe yourself without the trouble of carrying a roll of toilet paper around.  Urine is sterile except in the case of bacterial UTIs.  Keeping a small rag clipped to your bag is a quick hack to rummaging around in your pack.  If you are still hesitant about keeping a rag on your pack, think about this—ultra-violet rays from the sun are nature’s disinfectant.

Fungal infections

The overgrowth of candida, a fungus normally present on the skin, causes what is more commonly known as yeast infections.  This is common in men, too. Because candida thrives in any warm, dark and moist places, uncircumcised men are more likely to develop an infection on the underside of the foreskin.  Other common areas include the mouth, armpit, skinfolds and between the toes.

Aside from keeping yourself clean with proper washing, other tips for prevention include:

1) Keep things dry.  Invest in moisture-wicking, loose clothes.  Ensure you dry completely after you wash to deny fungus the damp condition it needs.

2) Avoid perfumed soaps or detergents that may irritate the skin.

The vagina contains a happy mix of bacteria and yeast.  A vaginal infection occurs when the bacteria and yeast become unbalanced.  An overgrowth of yeast—usually due to the destruction of normal bacteria-- causes vaginal yeast infections.  An overgrowth of vaginal bacteria causes bacterial vaginosis.  If left untreated, bacterial vaginosis can increase the risk of pelvic inflammatory disease which could lead to infertility.  Both infections result in unusual discharge, odor, irritation and/or itching.  Really, just another bad day outside.

Tips to prevent vaginal infections:

1) Promote a dry environment.  Invest in the right pair of underwear.  Buy an antimicrobial pair of underwear that washes and dries easily and prevents chaffing. 

2) Keep panty liners handy: If you cannot wash your underwear daily, you can maintain a dry and hygienic environment by using panty liners.

3) Clean properly.  Look for female-specific wipes that are pH-balanced.  Remember, the key is the normal bacteria/yeast balance.  Anything that is antibacterial will kill the bacteria you need and throw off the balance.  

Lastly, for women (and men who are responsible for daughters), it’s important to stay hygienic while on your periods.  Keeping tampons in longer than advised can lead to vaginal infections and toxic shock syndrome.  It’s important to properly plan how to handle periods in the elements. 

Common options for period management:

1) Tampons and pads.  In hiking and camping situations, you’ll have to pack out what you bring in.  Keeping plastic bags, or buying feminine hygiene-specific bags at your local outdoors store, will assist in this endeavor.  You’ll need to ensure you have enough supplies for the duration of the trip.

2) Menstrual cups.  There are multiple brands of menstrual cups on the market.  They are reusable and can be worn up to 12 hours.  However, they fit differently, so it’s advised to try multiple brands before taking them on the trail.  Also, they should be cleaned with mild soap (not antibacterial) and water after each use.  For those without access to soap and water, wipe with dry or damp tissue to clean the cup and clean completely at the next convenient time.  Just ensure hands are clean before insertion and removal.

3) Period underwear. Companies now make underwear specially designed to hold the equivalent of multiple tampons.  This is a very sustainable solution for period management but may also be inconvenient in austere environments as you need to change them daily (or multiple times a day depending on flow). Wash in cold water after use.

4) Birth control. For the hiker and general outdoors(wo)man, controlling when you get your period has many benefits.  While skipping your period is generally safe to do while on birth control, it’s best to discuss with your doctor first. In fact, talk to your doctor about the associated risks of hormonal birth control and if you’re a good candidate for a prescription. 

In austere environments, preventing infections is much easier than treating them.  While women’s issues tend to be a tad more complex in the wilderness, both genders can suffer from bacterial and fungal infections.  Proper hygiene is essential to the health and success of you and your group. Understanding what you and the women of your group need to prevent these problems from occurring will keep everyone happy and healthy. 

So, next time you hear the argument that women aren’t “suited” for austere environments, kindly explain the amazing technology of female urination devices and menstrual cups. I promise you it’ll end the conversation. But if it doesn’t, do remind him that the yeast infection on his chin healed up nicely. Then, go to the store, grab a few pH-balanced wet wipes and some antimicrobial underwear for your pack and go be the badass I know you will be.