Vaginal Microbiome 101
Much like the gut, the vagina has a microbiome of its own. This unique microbiome has the ability to influence the risk of infection, fertility & sexual health, and is comprised of bacteria, fungi and other microorganisms. However, unlike the gut, which thrives on a diverse microbiome, when it comes to the vagina less is more. We want the vaginal microbiome to be dominated by one species – the lactobacillus species. This beneficial bacteria exert a protective effect on the vaginal microbiome through producing lactic acid and hydrogen peroxide, which are responsible for regulating the pH of the vagina and protecting it against pathogenic bacteria.
A lactobacillus dominant microbiome is important for:
Protection against infections – a harmonious vaginal microbiome can prevent against overgrowth of pathogenic bacteria that are implicated in vaginal infections such as recurrent thrush, bacterial vaginosis (BV), UTIs and STIs
Reducing transmission of STIs – a dysbiotic vaginal microbiome (ie. an imbalance in good & bad bacteria) can make an individual more susceptible to sexually transmitted infections such as HPV and recurrent herpes flare ups
Supporting fertility & pregnancy outcomes – studies have shown that a non-lactobacillus dominated vaginal microbiome is associated with a decrease in implantation and pregnancy, and an increase in adverse pregnancy outcomes. Research also shows that presence of pathogenic bacteria in the vaginal microbiome can impact the ability to conceive and have further adverse pregnancy outcomes
General wellbeing – the vaginal microbiome has the ability to interact with, and influence the health of the gut microbiome, the oral microbiome & the reproductive microbiome
Factors that affect the vaginal microbiome include:
Antibiotics – antibiotics have the ability to wipe out all of our bacteria (including our good bacteria) therefore have a negative impact on the protective Lactobacillus species. Individuals who experience recurrent vaginal infections are often stuck in a cycle of taking antibiotics to clear infections, which reduces lactobacillus levels, therefore making the individual more susceptible to infection
Contraception (such as the oral contraceptive pill, Mirena IUD & copper IUD) – the synthetic hormones contained in the oral contraceptive pill can have an impact on specific microbes in the vaginal microbiome, while clinical reports suggest that IUD’s may increase the risk of BV and alter the delicate balance of beneficial bacteria in the vagina
Diet & lifestyle – nutrition plays a significant role in supporting a healthy vaginal microbiome. Factors such as high sugar intake, a low nutrient diet, high alcohol consumption and regular intake of processed foods have a negative impact on the vaginal microbiome as they drive inflammation and can be incredibly disruptive for both the gut & vaginal microbiomes
Stress – stress has a negative impact on the vaginal microbiome due to its ability to increase inflammation, disrupt hormonal balance and affect the gut microbiome which can contribute to poor vaginal health
Smoking + vaping – studies show that smoking & vaping have a negative impact on the vaginal microbiome, and have a particular association with recurrent BV.
Gut health – dysbiosis (ie an imbalance in our good & bad gut bacteria) can have an impact on vaginal microbiome health due to the ability of pathogens to translocate from one microbiome to another
Hormone health – hormonal fluctuations throughout the menstrual cycle can impact specific microbes implicated in vaginal infections. It is common for vaginal symptoms to flare at certain points of the menstrual cycle, during pregnancy and post-menopause due to fluctuating levels of oestrogen
Unprotected intercourse + multiple sexual partners – sexual practices have the ability to influence vaginal microbiome health as they can disrupt both the pH of the vagina, as well as the state of the microbiome itself
Immune function – compromised immunity and low vitamin D are both factors that can increase presence of certain microbes in the vagina, resulting in candida and aerobic vaginitis
Unusual symptoms such as changes in discharge, odour or discomfort, or presence of recurrent infection are suggestive of sub-optimal vaginal microbiome health.
