HEALTH SERIES | The Vaginal Microbiome and Bacterial Vaginosis
Let’s chat about the vaginal microbiome. Yes, that’s right, your vagina has its own eco-system dominated by various species of Lactobacillus bacteria. Lactobacillus pumps out lactic acid, which keeps pH low, and also promotes mucus production to keep the vaginal wall healthy. Interestingly, researchers hypothesize that Lactobacillus was introduced to human vaginas approximately 10,000 to 12,000 years ago when humans began eating fermented dairy like yogurt and cheese. Crazy!
So what happens when this eco-system is disrupted? Enter bacterial vaginosis or BV for the cool kids. BV affects 1/3 of women and is characterized by an unpleasant odor, dryness, and itching. Not a pretty picture. Even more troubling, BV can lead to chronic pelvic pain, chronic urinary tract infections, chronic yeast infections, and a higher risk of contracting HIV and STIs. (For pregnant women, it can also lead to pre-term labor and an overgrowth of Group B Streptococcus, which requires antibiotics during delivery that can impact the baby’s microbiome, the mother’s breast milk, and lead to yeast infections post-delivery.)
The most common treatment for BV is antibiotics, which definitely does the trick. But here’s the thing, for most women, BV keeps coming back! What gives? Let’s take a look at some of the underlying factors or root causes of bacterial vaginosis:
o Disruption of gut flora
o Use of medications/products that disrupt the vaginal ecology, including antibiotics and birth control pills
o Certain condoms and vaginal lubricants (even coconut oil can disrupt the balance of bacteria!)
o Certain sanitary products, particularly those containing residues of pesticides and perfumes, which act as irritants
o IUDs (for some people)
o High sugar/high carb diets, which feed bad bacteria
o Nutritional deficiencies, particularly deficiencies in Vitamin A, Vitamin E, Vitamin C, and zinc, which impact the health of the vagina
o Frequent sex and numerous sexual partners (men can introduce unwanted bacteria into the vagina and be asymptomatic themselves)
o Oral sex (Did you know that your mouth has its own microbiome? Well it does and it naturally has a different pH than that of the vagina, which can alter vaginal pH during oral sex.)
o Menstruation, pregnancy, menopause - hormonal fluctuations during these times can disrupt pH which can allow for overgrowth of yeast and unwanted bacteria
You might be a little freaked out, but keep in mind that plenty of women with these underlying factors never develop BV. But let’s say that you do. Is there anything that can be done to prevent it? Of course! Let’s take a look at some preventative measures:
o Avoid unnecessary antibiotic use and if you must take an antibiotic, take a probiotic along with it and continue taking your probiotic for three months after
o Choose natural condoms and lubricants
o Choose organic pads and tampons or use a menstrual cup (I love Lola, but there are plenty of brands out there now!)
o Avoid perfumed products, including toilet paper and bubble baths
o Don’t douche, EVER!
Keep in mind that the above steps are beneficial for all women, regardless of whether you are prone to bacterial vaginosis or not. Additionally, all women can benefit from the following steps to help restore your vaginal ecology:
o Balance your gut flora by including 6 to 8 servings of fruits and veggies in your diet daily, especially leafy greens, and embrace fermented foods!
o Eat a blood sugar balancing diet (remember that a high sugar/high carb diet can lead to more vaginal infections like BV and yeast infections)
o Address your nutritional deficiencies by eating a highly nutrient-dense diet and/or take a multivitamin for extra insurance
o Take a probiotic during your period and during pregnancy to help keep bad bacteria at bay
Research into bacterial vaginosis is really in its infancy and it’s incredibly interesting. Researchers have yet to pinpoint the exact species of Lactobacillus that is beneficial because it seems to vary among women. Additionally, bacterial vaginosis appears to disproportionately affect African American, Hispanic, and Mexican American women, as well as poor and uneducated women. Luckily, researchers are working on a vaginal probiotic that seems promising. Let’s face it, the fact that researchers are finally addressing vaginal health alone is promising!