How to Take Care of your Vaginal Microbiome?

While essential for human reproduction and women's overall well-being, vaginal health has frequently been overlooked in public discourse. Only recently have researchers directed their attention toward understanding how to effectively nurture and sustain it, which primarily involves tending to the health of the vaginal microbiome.

What is the vaginal microbiome?

The vaginal microbiome represents an intricate balance of billions of beneficial microbes and potential pathogens, like bacteria and yeast. Within a healthy vagina, the microbiome exists in a harmonious symbiotic relationship with the body, offering defense against harmful bacteria in exchange for nutrients and habitat. Notably, Lactobacillus bacteria, producing lactic acid to maintain an acidic vaginal pH (ideally between 3.8 and 4.5), play a significant protective role. They also take up space on the vaginal wall to prevent other pathogens from lingering and keep inflammation down in the genital tract.

However, disruptions in Lactobacillus levels can lead to a state called vaginal dysbiosis wherein pH are high due to a reduced amount of lactic acid. This elevates the risk of conditions such as bacterial vaginosis (BV), candidiasis (thrush), and sexually transmitted infections (STIs). BV is the most common vaginal condition in women ages 15-44, with a pervasiveness as high as 50% in some communities, although 50% of all patients of BV are asymptomatic.

What are the causes for vaginal imbalance and infections?

The composition of the vaginal microbiome is in a constant state of flux, and both internal and external causes can upset the balance, triggering vaginal infections as a result.

Hormonal shifts

The levels of oestrogen change throughout the reproductive journey (such as menstruation, pregnancy and menopause), and with the usage of hormonal contraceptives. While high oestrogen levels can lead to yeast infections, low levels can lead to a condition called vaginal atrophy. This condition is characterized by thinning vaginal walls and vaginal dryness. It can occur during breastfeeding periods and post-menopause as well.

Antibiotic usage

Broad-spectrum antibiotics like tetracyclines (e.g. doxycycline, tetracycline, etc.) and quinolones (e.g. ciprofloxacin, levofloxacin, etc.) can potentially eliminate the healthy Lactobacillus bacteria, creating a space for harmful organisms to thrive and increasing the risk of vaginal infections.

Sexual activity

Exchange of bodily fluids and direct skin-to-skin contact during intercourse can introduce new microbes into the vaginal environment. Harmful bacteria or pathogens from a partner's genital area can enter the vagina, leading to infections. Additionally, friction and movement during sexual activity can cause minor abrasions or microtears in the vaginal tissue, providing tiny openings as entry points for pathogens.

Use of Irritants

The use of scented soaps, feminine hygiene sprays, vaginal douching, and copper intra-uterine contraceptive devices can cause irritation or allergic reactions, potentially leading to secondary infections. Wearing tight-fitting underclothes can also cause irritation.

Diet

High dietary fat intake and inadequate intake of essential micro-nutrients like vitamins A, C, D, E, β-carotene, folate, and calcium have been associated with an increased risk of infection.

Uncontrolled Diabetes

Women with diabetes have a higher likelihood of developing yeast infections. They are also at an increased risk of contracting sexually transmitted diseases, underscoring the importance of regular screening and appropriate treatment.

Immunocompromised System

A weakened immune system, which can result from corticosteroid therapy or HIV infection, can contribute to the development of vaginal infections, particularly yeast infections.

Smoking

Cigarette smoking has anti-oestrogenic effects that can negatively affect the growth of Lactobacillus bacteria. Additionally, nicotine and its metabolites are found in higher levels in smokers, possibly contributing to foul-smelling vaginal conditions and vulnerability to infections.

How to maintain a healthy vaginal microbiome?

Although each person's vaginal microbiome is distinct with different groups of residing microbes, there are universal practices that can be adopted to promote vaginal health such as:

• The vagina has a self-cleaning system thanks to its mucus secretion. Daily washing with just water is, therefore, sufficient. Douching, or intravaginal washing, and overusing irritants like soap, antiseptics, vinegar, scented toilet paper, or cleaning tissues that contain chemicals harmful to the natural vaginal microbiome should be avoided.

• Unnecessary and unprescribed use of antibiotics can disrupt the balance of protective and disruptive bacteria in the vagina, and hence should be avoided.

• Practicing safe sex, with the use of protection and ample lubrication, is especially important. However, scented condoms should be avoided due to their potential negative impact on the vaginal microbiome.

• Regularly changing tampons, sanitary pads, menstrual cups, or period underwear to maintain hygiene during menstruation is essential to prevent the growth of disruptive bacteria.

• Eating food items that are rich in probiotics, such as yoghurt, can be a good way to maintain a healthy pH value.

• Wiping from front to back after using the toilet helps prevent the spread of harmful bacteria from the anus to the vagina.

• Sweating during exercise can create a conducive environment for disruptive bacteria to grow. Showering after working out can help maintain vaginal hygiene.

• Opting for cotton underwear, which is breathable and controls moisture and temperature, is recommended. Organic cotton, free from pesticides, is an even better choice. New underwear should always be washed before wearing.

• Smoking should be avoided to prevent malodourous vaginal conditions.

Key Takeaways

Prioritizing the often-overlooked vaginal health is vital for women's well-being. The vaginal microbiome, a delicate balance of beneficial and potential harmful microbes, plays a key role.

Factors like hormonal shifts, antibiotic use, sexual activity, irritants, diet, and smoking can disrupt this balance, leading to conditions like bacterial vaginosis and yeast infections. Practicing mindful hygiene, especially during menstruation, avoiding irritants, and practicing safe sex can help maintain equilibrium.

Understanding and nurturing the vaginal microbiome is a proactive step towards sustaining women's health and quality of life.