 One area that has gained significant attention in recent years is the vaginal microbiome—a complex and dynamic community of microorganisms that play a vital role in women’s health. Much like the gut microbiome, a healthy vaginal microbiome is essential for maintaining health and preventing disease.
Did you know? A healthy vaginal microbiome plays a key role in reproductive health, reducing the risk of sexually transmitted infections (STIs), supporting fertility, and contributing to overall wellbeing.
This article will provide an overview of the vaginal microbiome, why it’s important, and how lifestyle and nutrition can support its balance and health.
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What is the Vaginal Microbiome?
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The vaginal microbiome refers to the collection of bacteria, fungi and viruses that inhabit the vaginal environment.
In contrast to the gut, we don’t want to see a large variety of bacteria. In healthy women, the vaginal microbiome is predominantly composed of Lactobacillus species, which are beneficial bacteria that help maintain an acidic environment (an optimal vaginal pH level is between 3.5 and 4.5).
Yes, we want the vagina to be an acidic environment!
This acidity is crucial in preventing the overgrowth of harmful microorganisms, including pathogens that cause infections such as bacterial vaginosis (BV) and yeast infections, like candida.
The composition of the vaginal microbiome can vary significantly between individuals and can be influenced by various factors such as age, hormonal changes, sexual activity, hygiene practices, and diet.
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Why is the Vaginal Microbiome Important?
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The vaginal microbiome is an essential aspect of women’s health because it serves as the body’s first line of defence against infections and other health issues. Here are a few reasons why maintaining a balanced vaginal microbiome is so important:
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1. Prevention of Infections:
The Lactobacillus species produce lactic acid, which keeps the vaginal environment acidic. This discourages the growth of harmful bacteria and yeast that can lead to infections such as BV, Candida, and urinary tract infections (UTIs).
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2. Immune System Support:
The vaginal microbiome communicates with the immune system, helping to regulate inflammatory responses and keeping harmful microbes in check. When this balance is disrupted, the risk of inflammation and infection increases.
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3. Reproductive Health:
An imbalanced vaginal microbiome can lead to complications such as infertility, preterm birth, and other reproductive issues. Maintaining a healthy microbiome is critical for women who are pregnant or planning to conceive.
Your vaginal microbiome is important for men’s fertility too. Certain strains of bacteria can be passed between partners. Some, like Ureaplasma, can affect sperm quality, but men are usually asymptomatic, so this is often only picked up when a woman’s vaginal microbiome is tested.
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4. Sexual Health:
A balanced vaginal microbiome can reduce the risk of sexually transmitted infections (STIs), including chlamydia, gonorrhoea, and HIV, by creating an environment that is hostile to harmful pathogens.
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Signs of Vaginal Microbiome Imbalance
Many women with vaginal microbiome imbalance often don’t have any symptoms, but the issues are picked up during fertility investigations. However, many women with a dysregulated vaginal microbiome may notice some of the following symptoms:
Unusual vaginal discharge – thin greyish/white or ‘cottage cheese’-like discharge.
Vaginal itching, burning or irritation inside the vulva or on the skin around your vagina.
Odour – a noticeable, often unpleasant odour, especially after intercourse or menstruation, but can be there at any time.
Frequent or recurrent yeast infections, BV, or urinary tract infections (UTIs) may signal a chronic imbalance in the vaginal microbiome.
Inflammation of the vaginal or vulvar area, including redness or swelling.
Unexplained infertility or frequent miscarriage.
Endometriosis – studies have shown that women with endometriosis have higher levels of dysbiotic, inflammatory microbes in their vagina.
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What Disrupts the Vaginal Microbiome?
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A number of factors can disrupt the balance of the vaginal microbiome, leading to an overgrowth of harmful bacteria or yeast. Some common contributors include:
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Antibiotic Use: Antibiotics can wipe out both harmful and beneficial bacteria, leading to an imbalance that may result in infections like BV or yeast infections.
Hormonal Changes: Fluctuations in oestrogen levels, such as those during menstruation, pregnancy, perimenopause or menopause, can alter the composition of the vaginal microbiome. For example, lower oestrogen levels can lead to a less acidic vaginal environment, which promotes the growth of harmful bacteria, while higher levels of oestrogen seen in puberty and perimenopause can also cause symptoms of vaginal health imbalance.
Diet: A diet high in sugar and refined carbohydrates can encourage the growth of yeast, while a diet low in probiotics and fibre may reduce beneficial bacteria.
Hygiene Practices: Over-washing, using harsh soaps, or douching can disrupt the natural balance of the vaginal microbiome by removing beneficial bacteria.
Sexual Activity: Unprotected sex, frequent changes in sexual partners, or semen (which is alkaline) can alter vaginal pH and disrupt the microbial balance.
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How Can I Improve My Vaginal Health?
Recurrent thrush, BV or UTIs are inconvenient, but also distressing. Topical creams are available at many pharmacies, but they don’t address the root cause of the problem.
I also find that many women assume that that they have candida (yeast infection), but they are actually dealing with BV, cytolytic vaginosis or aerobic vaginitis which is why topical creams don’t work!
If symptoms are recurrent and difficult to shift, I do recommend a vaginal microbiome test to understand exactly what you are dealing with and work with a nutritional therapist who understands women’s health. Â
If you just need to keep your vaginal and reproductive health balanced, here are my top tips for achieving a healthy vaginal microbiome:
Avoid using soap to wash your intimate areas. Wash with water only or a pH neutral soap.
Avoid any scented products around your vagina. This includes scented sanitary products, perfumed sprays or wipes. If there’s an odour, then you need to get to the root cause, not mask it with synthetic endocrine disruptors.
Stop smoking or vaping. Nicotine from smoking or vaping secretes into the vagina and disrupts the vaginal microbiome.
Limit alcohol, sugary, sweet foods and refined white carbohydrates as these may contribute to vaginal dysbiosis and yeast infections.
Eat an unprocessed & varied diet rich in brightly coloured vegetables and fruits (for polyphenols), prebiotics and probiotics (unless histamine is an issue for you).
Balance your hormones. Not always simple, but totally achievable with the right diet and lifestyle. Notice if taking the Pill or HRT has improved or worsened your symptoms. If you are 40+ (or thereabouts), look at my Perimenopause Support Programme.
Be vigilant about cleaning anything that comes into contact with your vagina – period cups, sex toys, reusable period underwear etc.
Reduce the use of G-strings and choose natural cotton underwear.
Consider stress levels and previous sexual trauma, which may be a triggering factor in vaginal infections.
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In Conclusion
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The vaginal microbiome is a key player in women’s overall health and wellbeing. A balanced microbiome helps protect against infections, supports immune function, and promotes reproductive health. Through functional medicine principles such as addressing root causes, eating a nutrient-rich diet, managing stress, and practicing gentle hygiene, women can optimise their vaginal microbiome and maintain long-term health.
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