Some women in China are relying on alternative products bought online for DIY diagnosis and treatment of gynecological issues due to their fears of being judged if they seek out hospital treatment.

On the e-commerce platform Taobao and short video platform Douyin, pads, special detergents, and plasters are being sold as cheap alternatives to formal gynecology treatment. 

Often, the marketing of these products implies that vaginas are naturally dirty, making it necessary for women to clean their vaginas thoroughly. Although doctors do recommend regularly cleaning the vulva, the outer part of the vagina, usually while showering, overcleaning the vagina may actually lead to diseases arising. 

This deliberate confusion between “real and fake health advice” is typical of sellers of these alternative products, says 29-year-old sex education promoter Qiu Shaoshuai, who has tested hundreds of these alternative products. 

Many of these products market themselves as effective at detecting or treating vaginitis, the common disease where the vagina becomes infected. The disease, which may lead to pain when urinating, can be caused by various reasons, including underwear made of poor-quality materials and sex.

However, many of the ads directly link vaginitis to sex. One company selling vaginitis testing pads on Douyin uses as a marketing tool a comment left by a customer about her boyfriend breaking up with her after seeing her pad come out positive. “My ex-boyfriend bought me this testing pad. When he saw the pad turn purple, he broke up with me,” the comment says. 

The company encourages men to buy the pad for their girlfriends as a “loyalty test.” On Douyin, the vaginitis test pads sell for 27 yuan ($3.70) per box, with more than 1,000 sales made.  

“The products are not reliable at all,” Zou Shi’en, chief physician at the department of gynecologic endocrinology and reproductive medicine at the Obstetrics & Gynecology Hospital of Fudan University, tells Sixth Tone. 

The pads are a type of pH test paper, which is not related to how vaginitis is diagnosed, Zou explains. He primarily uses observations of patients’ symptoms and their own self-reports about these symptoms to diagnose vaginitis. 

One of the most popular alternative products is the controversial feminine care brand Fuyanjie, which sells cleansers for the vagina. These cleansers, which come with pumps to allow users to directly deliver the cleanser into their bodies, are usually priced below 50 yuan per bottle. 

The brand has faced repeated criticism from authorities for being “deceitful” and running afoul of regulations banning antibacterial products from labeling themselves as effective for relieving symptoms and treating diseases. It is famous for the slogan that used to feature in its television ads: “The more you wash, the healthier you become.”

On Taobao, sales of Fuyanjie products consistently reach tens of thousands per month. 

Mandy Chen, a 24-year-old white-collar worker in Shanghai, contracted vaginitis after using Fuyanjie following her mother’s suggestion in 2021. Her doctor told her to stop using the product immediately. 

“We have a special taboo surrounding women’s ‘dirty’ things back in my hometown and my mother always told me to wash my whole body. Who would have thought that one day I would be sent to the hospital for being too clean and washing too much?” says Chen. 

In the two years after her diagnosis, Chen visited the gynecology department at her hospital four times. Her doctors advised her to select the material of her underwear carefully and to pee after sex.

“These were all basic tips,” says Chen. “So basic that I wonder why I wasn’t told and can barely find them having surfed online for over 20 years.”

Keen to prevent her friends from making the same mistakes, Chen shared her hospital experiences with them. However, she found that they were even more hesitant to visit a hospital than before, due to existing fears about the bad attitudes of doctors and the invasiveness of exams, such as the use of vagina expanders. 

Several young women Sixth Tone spoke to expressed similar fears about going to the hospital for gynecological treatment. On the popular discussion platform Douban, a group called “No Fear for Gynecological Exams” has over 30,000 members, with discussions often centering on negative experiences of being “slut-shamed” by hospital staff. 

Sex educator Qiu is one of these women. She says her middle-aged doctor rolled her eyes and told her “only people who’ve been messing around get infected with this disease” when she took her first vaginitis test in her early 20s at a leading hospital in her hometown of Qingdao, Shandong province.

The doctor’s attitude changed when she found Qiu’s hymen intact — a sign of her virginity. 

“Suddenly she became like my sweet auntie, here to check a loved one’s health condition,” says Qiu. 

Sex remains a taboo topic in China. Slogans such as “good girls don’t need HPV vaccines” are popular online, and even trended on Douyin previously. In April, a female stand-up comedian was criticized for talking about her STIs in her sets. 

“When there’s a lack of medical resources and adequate sex education, and people’s expectations of hospitals are that they will be judged there, it’s natural for the public to turn to these alternative products,” says Qiu.

In his career spanning several decades, physician Zou has often seen patients delay seeking hospital treatment because of their fear of gynecological examinations. He cites one example of a patient in her early 50s who was diagnosed with advanced endometrial cancer after a year of symptoms. 

“If she had come for a checkup when she had early symptoms, the treatment would have been much better,” says Zou. 

In recent years, Zou has been active on social media spreading information about common diseases affecting women and encouraging women to take annual physical exams. He has proposed to hospital leadership that they create an official introductory video for patients to better understand what is involved in gynecological exams — something he has already done for his own followers on WeChat.  

“I hope that sex education can be a topic that can be openly discussed in society,” says Zou. “Knowledge of physiological hygiene should not be dumbed down.”

Editor: Vincent Chow. 

(Header image: VCG)