A divorced friend of mine who recently started dating was shocked to find that the complete absence of female pubic hair seemed to be an expectation among her potential partners. I’m not surprised, when I was in the dating pool a couple of years back there were men who actually listed full clamscaping required among the personal attributes they were seeking in a girlfriend (and here I was looking for heady conversation and heated debates!).

Wanting more information on the subject she, of course, turned to her gynecologist friend who specializes in vulvovaginal disorders. This is what I told her.

Pubic hair is normal and, like every other body part/appendage/function, serves a biological purpose.  For example, when sweat evaporates it cools our body, eyebrows keep sweat out of our eyes, and orgasms make us want to have more sex so we perpetuate the species. We are a grand work of evolution and genetic code that doesn’t contribute to survival of the species gets dropped along the way. Pubic hair has stood the test of time.

What pubic hair does is protect the delicate skin of the vulva and the vestibule (the opening of the vagina, just outside of the hymen). Pubic hair is a mechanical barrier to the irritants and friction in everyday life. It is the first line of physical defense, the labia being the second (I’ll save labial reduction for another post).

There does seem to be a trend towards removing all pubic hair. Approximately 10% of women report being typically pubic hair-free and another 26% report removing all of their pubic hair some of the time.

Removing pubic hair is purely a cosmetic act and, like all cosmetic procedure, carries both short and long-term risks. Lichen simplex chronicus, an eczema-like condition that can affect the vulva, is more common when women remove pubic hair. Irritation from products or razors also plays a role, but without hair the delicate vulvar skin is intimately exposed to a multitude of irritants (FYI, the symptoms of lichen simplex chronicus, chronic itching and irritation, are frequently misdiagnosed as chronic yeast infections). Other health consequences of shaving pubic hair include molluscum contagiosum, a common virus that may be spread by using a razor and infections from the trauma of shaving and waxing. I also see my fair share of inflamed and infected hair follicles as well as more serious infections.

And finally there are potential cosmetic consequences. When the pubic hair is removed long-term (either laser hair removal or simply chronic waxing or shaving) the labia can thicken over time and take on a leathery appearance. This is called lichenification and is simply a normal response to chronic exposure to daily irritation. Keep in mind that many of the things we do for cosmetics have consequences. Over plucked eyebrows don’t always grow back and breast implants can scar and often need to be replaced. Hey, coloring your hair has risks. I color my hair (shocker, I know) and I understand there is a risk of scalp irritation and even allergy. For me, the benefit of not having grey hair outweighs those risks. Everyone views risks and benefits differently.

In addition to risks I think it is important to really understand why you want to do something cosmetic. I pluck my eyebrows because I prefer a nice arch. I color my hair because I don’t want grey hair. However, I once chemically straightened my hair because my ex kept dropping hints I’d look better that way. Sigh. Straight hair was his beauty ideal. Of course, once done there were other faults. Hey, it was a great lesson that cosmetic enhancements should never be about someone else.

My friend, the one who’s dating, went back to her her prospective partner about the risks and was still met with a skeptical look. “He was unconvinced. He seems really great, but I don’t think I’m into getting a Brazilian. What should I say?” she asked.

My answer, which was probably more relationship advice than medical advice:

“If the concept that you could be at higher risk for chronic skin irritation and other issues doesn’t sway him (because he should really care about your genital health, especially if you’re going to sleep with him), tell him that he should be so lucky to pick one of your pubic hairs out of his teeth and move on to someone who is more invested in you.”

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.