When we talk about the microbiomes in our bodies, we tend to think about the activity in our guts, but this is not the only place where a microbiome exists. In fact, the vaginal microbiome is an important system which is both dynamic and detailed and subject to a lot of fluctuations, due in no small part to the way we treat our bodies as well as our hormonal changes.
The vaginal microbiome plays a significant role in both vaginal health and the overall health of a woman's body, so it is vital to pay attention to it. There are many factors that can impact on the health and balance of the vaginal microbiome, so in this article we thought we would take a more detailed look at what it is, how it works, and the best ways in which you can look after it.
What is the vaginal microbiome?
In order to picture the vaginal microbiome, it helps to imagine a thriving ecosystem containing bacteria, fungi and viruses[i]. The bacteria found here is healthy ‘good’ bacteria known as Lactobacilli, and in a healthy woman, they outnumbers the ‘bad’ bacteria which also exists in the vaginal microbiome, helping to create a balanced environment[ii]. Lactobacilli act as a first line of defence against infections, as well as helping to keep the pH of the vagina in its normal range: between 3.8 and 4.5[iii]. In addition to this, Lactobacilli are also capable of taking up space on the vagina wall in order to perform a blockade against harmful bacteria. They produce the body's own natural antibiotic to help stop any disruptive bacteria from growing and reduce inflammation in the genital area[iv]. Lactobacilli are therefore incredibly important and when the balance of good and bad bacteria is upset in the vaginal microbiome, the disruptive bacteria can start to cause problems.
A vaginal microbiome which is out of balance can lead to a number of issues, including infections such as bacterial vaginosis or yeast infections like thrush[v]. An imbalance can also play a part in a number of fertility issues and can be associated with infertility, pregnancy complications and sexually transmitted infections[vi].
If you are wondering whether this is something you need to be concerned about, then it is worth remembering that as many as 1 in 3 women will get bacterial vaginosis each year (whilst the same number will be dealing with urinary tract infections by the time they are 24) and 75% of women will experience a yeast infection at least once[vii]. Which goes to show that the health and balance of the vagina microbiome is something which can impact on every woman at some point in their lives.
What are the signs of an unhealthy vaginal microbiome?
If you didn't know that your vagina microbiome existed until now, then you might be wondering how to recognise whether it is healthy or not. One of the indicators to pay attention to is any discharge that you experience and more importantly, the changes to it. A thin, clear or white discharge is considered to be perfectly normal, but if it starts to change in colour, consistency or smell then it could be an indication that something is wrong[viii].
Other symptoms to be aware of include burning, itching or pain in the vagina area which may indicate some form of infection[ix].
Bacterial vaginosis (BV) is one of the most common vaginal conditions a woman can suffer from, and is recognisable by an unusual discharge with a strong fishy smell as well as a change in the colour or consistency of the discharge. It is not usually a serious issue and can sometimes occur without any symptoms at all. However, having BV can increase the risk of contracting an STI as it upsets the normal pH of your vagina, making it less acidic and therefore reducing your natural defences against infection[x].
It is important to understand what is normal for you so that it is easier to spot any changes that could be the start of an problem. This allows you to act much more quickly and deal with the issue in its earliest stages. If you notice any changes or anything of concern, then it is essential that you speak to a doctor as soon as possible.
How to improve the vaginal microbiome
Now that you know about the importance of the vagina microbiome as well as how to spot an unhealthy vagina microbiome, you might be wondering what you can do to keep it in the best possible condition. It is worth remembering that the vaginal microbiome is generally fairly low maintenance. Of course, cleanliness is essential, but the use of fragranced soaps and harsh detergents can be responsible for upsetting the balance[xi]. It is therefore important to stick to water and a gentle, unperfumed soap when showering to help avoid any problems.
Your diet can also play an important part in the health of your vaginal microbiome. Foods such as yogurt, kefir, kimchi, pickles and sauerkraut all contain probiotics which can help support Lactobacilli whilst prebiotics such as leeks, onions, asparagus, whole wheat food and bananas can stabilise the vaginal pH[xii].
Sexual health is another important factor in the balance and health of the vaginal microbiome. Sex can disrupt the balance of the vaginal microbiome[xiii] and having unprotected sex without a condom can expose you to the bacteria of other people's microbiomes[xiv]. It also leaves you at risk of developing sexually transmitted infections (STIs), which can all then have their own impact on the vaginal microbiome.
There are also some suggestions that intense exercise, use of a locally released progestin contraceptive and a vegetarian diet can impact on the stability of the vaginal microbiome and loss of Lactobacillus species.[xv]
Sources
- https://eveappeal.org.uk/our-research/our-research-programmes/forecee/forcee-vaginal-microbiome-as-a-risk-indicator-for-ovarian-cancer/what-is-the-vaginal-biome-and-why-is-it-important-qa/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6743080/
- https://www.theguardian.com/society/2023/sep/11/the-vaginal-microbiome-how-to-look-after-it-and-what-to-avoid
- https://www.evvy.com/blog/vaginal-microbiome
- https://pelvicare.uk/blog/signs-of-an-unhealthy-vagina
- https://www.healthline.com/health/womens-health/vaginal-ph-balance#medical-attention
- https://www.nhs.uk/conditions/bacterial-vaginosis/
- https://www.medicalnewstoday.com/articles/327507#ph-levels
- https://www.newscientist.com/article/2127635-unprotected-sex-may-disrupt-the-microbiome-in-vagina/#:~:text=Having%20sex%20with%20a%20male,by%20one%20type%20of%20bacteria.
- https://journals.asm.org/doi/10.1128/msphere.00593-20#:~:text=Interestingly%2C%20intrasample%20diversity%20was%20greater,health%20remain%20to%20be%20investigated.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10768674/#:~:text=In%20essence%2C%20these%20findings%20advocate,probiotics%20on%20the%20women%20health.&text=The%20composition%20of%20the%20vaginal,unique%20vaginal%20microbiome%20needs%209%20.
