Probotics. Kombucha. Kefir. Dysbiosis. Simprove. By now, if you've ever Googled the words “gut health,” you'll be familiar with these terms. Over the past few years, digestive wellness has been a major topic of conversation in the wellness sector, with countless videos on TikTok promoting the benefits of taking probiotics regularly and consuming the aforementioned paraphernalia. They all help boost the illusory gut microbiome, aka the bacteria and other microbes that support digestion, immunity, heart health, and just about everything else.
Now, however, the conversation has shifted, highlighting a different and somewhat unsuspecting part of the body: the vagina. To some, this may seem strange. But there is something called the vaginal microbiome, and it has become the topic of the day among the health-obsessed. On TikTok, videos with thousands of views pontificate about the benefits of maintaining a healthy vaginal microbiome (a term used interchangeably with “vaginal microflora”), linking it to fertility, STIs, immunity, inflammation, and HPV. Online, you can buy all kinds of products that claim to support it, from shower gels to vaginal probiotics.
But what really is the vaginal microbiome? And why should we keep it? As with gut microbiomes, the term simply refers to the group of microbes that are present in the area. These typically comprise a mixture of bacteria, viruses and fungi. “It is a community of microorganisms that are normally found living together in a specific part or organ of the body,” explains Dr. Shirin Lakhani, an expert in intimate health and hormones. “It is a group of specific microorganisms of the vaginal ecosystem.”
The reason why it is so important to maintain a healthy vaginal microbiome is because any dysregulation can lead to a wide range of diseases and health problems. “These include diseases such as bacterial vaginosis, fungal infections, an increased risk of infections, infertility, miscarriages and pregnancy complications,” says Ina Schuppe Koistinen, a microbiome researcher at the Karolinska Institute in Stockholm. “The vagina and the well-balanced ecosystem of its microflora change only due to external factors, such as hormonal levels, medications, infections, the use of hygiene products or penetrative sex.”
So what does a healthy vaginal microbiome look like? Well, for starters, it has a lot of Lactobacilli, which is the bacteria that prevents infections; It is also found in kefir. “He Lactobacilli “They are considered 'good' bacteria and play a very important role in vaginal health, releasing lactic acid and hydrogen peroxide, which creates an acidic environment that helps maintain a healthy pH balance within the vagina,” she says. Dr. Lakhani. Normally, a healthy vaginal pH is low, usually between 3.8 and 4.5; Maintaining this means that other harmful bacteria (such as those that cause thrush) are less likely to thrive there.
It is normal for vaginal pH to change slightly throughout the month depending on what stage of your menstrual cycle you are at. “Blood has a neutral pH of 7.4, so during menstruation, the presence of blood in the vagina will increase the pH levels of the vagina,” explains Dr. Lakhani. Having unprotected sex can also increase the pH, which subsequently makes you more vulnerable to infections, since semen normally has a pH of around 7.1 to 8. “Using condoms will prevent the semen from altering the pH balance of the vagina,” she adds. Of course, unprotected sex can also cause a transfer of bacteria, potentially exposing you to STIs that will alter the vaginal microbiome.
Avoid 'feminine hygiene' products altogether. There is a large market, but vaginal wipes, douches, or any deodorant-based product often have a high pH level that alters the pH of the vagina and causes irritation.
Dr. Shirin Lakhani
Smoking can also increase vaginal pH, and research has found that female smokers are more likely to have bacterial vaginosis (BV), which is usually not serious but should be treated with antibiotics as it can increase the risk of contracting an STI. Symptoms include unusual vaginal discharge, such as a change in color or odor.
Lactobacilli It is maintained in part by estrogen, which leads to the accumulation of glycogen, which is the main nutrient for bacteria. This means that our vaginal microbiome changes with age. “After menopause, with reduced estrogen production, the glycogen content in the vaginal tissue decreases, resulting in a neutral pH,” explains Koistinen. “The number of Lactobacilli decreases, replaced by a vaginal flora similar to that which existed before puberty. Women after menopause often lack Lactobacilli in the vagina, which contributes to the high frequency of urinary tract infections. Estrogen therapy can help restore a Lactobacillidominated vaginal microbiome.”
As for what women can do to maintain a balanced pH and vaginal microbiome, some companies would have you believe that the key is to purchase their products: vaginal drops and scented vaginal sprays and serums are just a few of the options available online. Good marketing and branding can make you accept the idea that these are essential elements to help you maintain a healthy and, above all, correctly scented vagina. But in most cases, it's probably the opposite. These so-called “feminine hygiene” brands are not only capitalizing on a culture fueled by female shaming, which has fooled women into thinking that their vagina needs to look or smell a certain way to be considered acceptable, but they are actually causing a devastating impact on our vaginal microbiome.
“Avoid 'feminine hygiene' products altogether,” advises Dr. Lakhani. “There is a large market, but vaginal wipes, douches or any deodorant-based products often have a high pH level that alters the pH of the vagina and causes irritation. The vagina cleans itself, so these products aren't really necessary.”
Probiotics could help, depending on the content, although the benefits are controversial given the dearth of research on female sexual health in general. “There is no proven evidence that taking probiotics works to maintain a healthy microbiome in the vagina,” says Dr. Lakhani. Koistinen has previously said that there are very few probiotics available that contain the specific effect lactobacillus which has been found to promote the vaginal microbiome. “But probiotics that contain the right strains of Lactobacilli that are related to good vaginal health can restore a dysbiotic vaginal microbiome,” he adds.
Of course, there are ways to ensure you get the necessary nutrients through your diet. “Maximizing fermented foods rich in prebiotics and probiotics will promote lactobacillus grow and thrive,” says Hannah Alderson, hormone specialist and registered nutritionist. “Think kefir, kimchi and sauerkraut. As for supplements, you can look for a probiotic that contains specific vaginal strains, such as Lactobacillus crispatus. “The bacteria contained in an oral supplement or food will eventually reach your vagina.”
It might also be worth examining the menstrual products you use. “I always recommend opting for organic, unscented tampons and changing them regularly, as this can help prevent bacterial overgrowth,” says Mo Carrier, sexual wellness expert and founder of MyBliss condoms. “Even better, try using a menstrual cup, as this can minimize exposure to any nasty chemicals that can alter our pH.” The clothes you wear can also help. “Breathable cotton underwear and avoiding tight clothing, especially during the warmer months, can also help maintain a healthy environment,” Carrier adds.
Work is underway to learn more about the vaginal microbiome. Research scientist Fatima Aysha Hussain, for example, is leading a vaginal microbiome transplant study to see whether fluid from a healthy vaginal microbiome transferred to someone living with recurrent BV can prevent the infection from returning. So far, initial results have been promising. But more research is needed, particularly when considering the impact the vaginal microbiome has on our overall health and well-being, because it's not just about increasing the risk of STIs and BV.
“If there is an imbalance of vaginal microflora, research suggests important potential implications for health outcomes such as infertility, frequent miscarriages, endometriosis, polycystic ovaries, frequent urinary tract infections, and vagino-vulvar itching,” adds Alderson. “Therefore, the composition of the vaginal flora plays a very important role in vaginal, reproductive and general health. As I see in my private clinic, unfortunately many women are not aware of these connections.”
Perhaps this is partly because all of this is still fairly recent. “The concept that the vaginal tract has a microbiome was classified a little less than a decade ago,” Alderson notes. “And although the research is in its infancy, influencing and manipulating the vaginal microbiome to improve gynecological and reproductive health has great potential. “It’s incredibly exciting for women’s health.”
