Our vaginal microbiome is integral to our health – here’s everything you need to know about this genius intimate ecosystem and how to take care of it.
In fact, microbiome – communities of micro-organisms, including fungi, bacteria and viruses that exist in particular areas of the body – has become a new buzzword as we start to look at our bodies and how they work more holistically.
Guides about how important the microbiomes across our bodies are for our health have flooded our feeds in recent years, with TikTok videos on #GutMicrobiome and #MicrobiomeSkincare racking up millions of views.
But, while we may have a vague understanding of how important our gut microbiome is for our health and how our skin’s microbiome can impact us, another integral microbiome is little discussed: the vaginal microbiome.
More and more research is revealing just how important a role the delicate environment of our vaginal microbiome plays in protecting us from nasty vaginal diseases and infections that can impact everything from how we deal with STIs to our likelihood of conceiving and developing certain types of cancers.
Here’s everything you need to know about the vaginal microbiome, including how to look after it and whether probiotic products marketed at women to improve their vaginal microbiome are actually worth it.
What is the vaginal microbiome?
The vaginal microbiome is an ecosystem of millions of healthy bacteria, viruses and fungi that colonise our vagina and help create the correct environment for it to produce mucus. It’s very carefully balanced and plays an essential role in our vaginal health.
The vagina’s pH should be between 3.5 and 4.5 – the same as a tomato – and it’s the microbiome that helps keep the vagina at this slightly acidic level. The primary species of bacteria that lives in our vagina and keeps it at this important pH is lactobacillus. As postdoctoral medical scientist and AfN-accredited nutritionist Dr Federica Amati tells Stylist: “Lactobacillus is considered the ‘hallmark’ of a healthy vagina because of its role in producing lactic acid, which maintains a protective acidic environment.”
The vaginal microbiome is completely different to the one in our gut. There are trillions of different microbes in the gut, whereas the vagina contains a much smaller variety. The exact make-up of this microbiome is dependent on a whole slew of factors including our age and ethnicity.
Each woman’s vaginal microbiome is unique and individual and it will undergo changes and fluctuations during different stages of our menstrual cycle and throughout our lives.
Why is our vaginal microbiome so important?
Our vaginal microbiome is the first line of defence when it comes to protecting us from vaginal health problems and disease.
“Lactobacillus has a very important role in protecting women from an overgrowth of other types of bacteria and organisms that can cause unpleasant symptoms, for example, smelly discharge caused by thrush and bacterial vaginosis,” Dr Zahra Ameen, consultant gynaecologist and obstetrician at the Cadogan Clinic, tells Stylist.
“A healthy vaginal microbiome will enable healthy lactobacilli to thrive, which helps protect against infections and can also affect the likelihood of conceiving, miscarrying and even developing certain types of cancers.”
Research has found that neglecting our vaginal microbiome can cause a whole slew of health problems. Thrush, an inflammation of the vagina and/or vulva, is caused by a superficial fungal infection.
Bacterial vaginosis (BV) can also develop through a disruption of the vaginal microbiome. It’s mainly caused by disruption of vaginal flora, reduction in numbers of lactobacilli and overgrowth of another bacteria called gardnerella vaginalis and can occur in up to 50% of women.
“BV can also have other adverse effects on women’s health,” explains Dr Ameen, “such as the increased risk of miscarriage, pre-term birth, infection in labour, pelvic inflammatory disease and also the acquisition of certain types of sexually transmitted infections such as gonorrhoea, chlamydia and herpes.”
How can we protect our vaginal microbiome?
Just like any other natural ecosystem, the vaginal microbiome is extremely fragile, which is why it’s important to treat it with care.
“Your vaginal microbiome can be very easily unsettled for a variety of reasons, some of which are and aren’t in your control,” Giulia Guerrini, the lead pharmacist from digital pharmacy medino, tells Stylist. “These can include antibiotics, dietary changes, hormone fluctuation, oral or penetrative sex, sex toys and stress.”
To protect your vaginal microbiome and maintain a good level of hygiene, Guerrini suggests:
- Washing the outside of the vagina (between the folds of the vulva and around the clitoris) with unscented soap at least once a day to prevent smegma build-up.
- Always peeing after sex to flush out any germs that might have come into contact with your urinary tract, which can upset your microbiome and lead to UTIs.
- Avoiding douching. The vagina is a self-cleaning organ, and douching can upset your microbiome.
- Avoiding scented soaps, gels and lubes that can upset your vaginal microbiome.
- Wearing loose-fitting, cotton underwear and changing it each day, particularly in hot weather.
“Keep in mind that it’s totally normal to experience vaginal discharge,” says Guerrini. “However, if it’s a greyish colour or has a strong smell similar to fish, then you might be dealing with BV.”
It’s also important to be sceptical about pills and suppositories that promise to balance the vaginal microbiome.
While there has been a proliferation of these products in recent years, “the vagina is a self-cleaning system and the less you do the better it will be,” explains Dr Marie Drago. “For the part you can see, the vulva, it makes sense to use very gentle products to care for this very specific area.”
So should we use probiotics often touted as a way to maintain our vaginal microbiome? While Dr Ameen doesn’t rule out using these products she warns us to be cautious. “Probiotics may help improve vaginal health,” she says. “However evidence for this scant, if you are going to choose a probiotic, pick one containing lactobacillus rhamnosus.”
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