Fuelling The Vaginal Microbiome Blog

What is the vaginal microbiome?

Much like the gut, the vagina has a microbiome of its own which has the ability to influence the risk of infection, fertility & sexual health. 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. A lactobacillus dominant microbiome is important for:

– protection against UTIs

– reducing transmission of STIs

– reducing incidence of bacterial vaginosis + thrush

– supporting fertility 

Factors that affect the vaginal microbiome include:

• Antibiotics 
• Medication (such as the oral contraceptive pill)
• Diet
• Alcohol
• Stress
• Smoking + vaping
• Genetics
• Gut health
• Hormones
• Unprotected sex + multiple sexual partners
• Chemical Exposure
• Immune function

Unusual symptoms such as changes in discharge, odour or discomfort, or presence of recurrent infection is suggestive of sub-optimal vaginal microbiome health.

The role of the vaginal microbiome in recurrent infections

Elevated pH – We want the vagina to be an acidic environment as this creates a barrier that protects against unwanted bacteria and infection. A vaginal pH above 4.5 provides an environment that encourages overgrowth of opportunistic bacteria and subsequent vaginal symptoms.

Low levels of lactobacillus: lactobacillus species are integral for maintaining the balance in the vaginal microbiome. Lactobacillus are protective, and produce anti-fungal and anti-bacterial substances that keep opportunistic bacteria at bay and help to maintain a healthy pH

Common recurrent infections that are driven by sub-optimal vaginal microbiome health include:

RVVC

• Chronic or recurrent vaginal thrush caused by an overgrowth of the yeast Candida. This can be due to shifts in the vaginal environment that are unable to be brought back into balance without intervention. In RVVC, it is common to experience a flare-up of symptoms in relation to intercourse and certain points in the menstrual cycle (eg. In the lead up to your bleed or at ovulation)
• Common symptoms include a thick discharge, itching, burning, irritation, painful intercourse urination, yeasty odour

Bacterial Vaginosis

• Vaginal dysbiosis caused by anaerobic bacteria resulting in a rise in pH (above 4.6) and depleted levels of protective lactobacillus species
• Common symptoms include:  grey or clear discharge, fishy or foul odour, vaginal dryness, itching, a burning sensation worse for sex or urination
• Microbes involved: Ureaplasma, & Gardnerella are the most common

Aerobic Vaginitis

• Vaginal dysbiosis that is driven by aerobic + intestinal bacteria, resulting in a high level of vaginal inflammation
• Common symptoms include: thick, smooth discharge that could be white or yellow in nature, itching, irritation & pain
• Microbes involves: Strep B, E.coli, Enterococcus faecalis

Ways to support the vaginal microbiome through specific foods

As always, utilising food as medicine can help to foster a healthy vaginal microbiome and reduce the risk of infection. Foods to include for vaginal health:

• Foods rich in essential fatty acids such as salmon, sardines + flaxseeds to support tissue repair
• Prebiotic rich foods to support the health of beneficial bacteria in the vagina such as garlic, onion, asparagus, Jerusalem artichoke & green bananas
• Fermented foods: using food as medicine through incorporating probiotic rich foods (such as yoghurt, kefir, kimchi & sauerkraut) can support beneficial levels of lactobacillus in the vagina
• Green tea: a potent source of antioxidants, green tea helps to neutralise free radicals, reduce inflammation + support a healthy vaginal pH
• Garlic: a broad-spectrum antimicrobial, garlic also has potent anti-fungal & anti-inflammatory properties making it a good food to incorporate to utilise food as medicine when treating specific microbial overgrowths
• Sugar: sugar can be incredibly inflammatory for vaginal conditions, and many microbes implicated in recurrent infection feed off sugar. Opting for a low to no sugar diet is beneficial, finding sugar-free alternatives for your favourite sugar containing foods

Supportive lifestyle practices for the vaginal microbiome

• Avoid using soap, body wash or “femfresh” products in the vaginal area – the vagina is self-cleaning and these products affect the pH of the vagina, making you more susceptible to infection
• Wear organic cotton / bamboo underwear to allow the area to breathe
• Change out of sweaty clothes post workout to allow the area to breathe
• Opt for organic sanitary products
• Find a pH friendly lubricant + condoms 
• Ensure adequate personal + sexual hygiene: wipe front to back, urinate or shower post intercourse and wash any sex toys thoroughly in between uses

Herbal interventions to support vaginal microbiome health

Testing

Given the overlap of symptoms when it comes to vaginal health conditions, testing is crucial in order to identify the specific microbes at play, to inform specific treatment.
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Different microbes require different modes of treatment to eradicate, however all vaginal microbiome conditions require restoration of the protective Lactobacillus species (which should dominate this environment) through supplementing with lactobacillus specific probiotic strains.

Herbal Interventions:

• Pomegranate: is a herb we use frequently in vaginal infections (specifically BV) as it has anti-microbial properties and is effective against 2 common microbes – Ureaplasma + Gardnerella. Pomegranate also supports lactobacillus levels

• Turmeric: turmeric is a herb often used when addressing specific microbial overgrowths due to its potent anti-inflammatory properties and ability to address vaginal & vulval inflammation. Turmeric when applied topically in a cream, can assist with tissue repair which is often compromised in aerobic vaginitis.

• Garlic: a broad-spectrum antimicrobial, garlic is effective against candida as well as e.coli

• Sea buckthorn: when applied to vulval tissues, sea buckthorn is effective at improving the mucosal integrity of the tissue, reducing sensitivity and discomfort, improves elasticity and reduces inflammation

• Probiotics: strain specific probiotics (lactobacillus species) help to maintain healthy pH, increase beneficial bacteria + crowd out opportunistic bacteria

• Lactulose: a prebiotic sugar, lactulose serves as food for beneficial vaginal bacteria, encouraging their growth and activity

• Fennel: increases lactobacillus levels in the vagina + repairs vaginal tissue

Want to learn more?

To learn more about the vaginal microbiome and testing options book at base chat with Alice here