You’ve probably heard of the gut microbiome, which has been a hot topic in wellness for years now. But did you know that other parts of your body contain their own unique microbiome too? Bacteria and other microbes can be found along the epithelial surfaces of the body, of the tissues covering internal and external bodily surfaces. Microbes reside in and around the skin, urinary tract, nose, mouth, gut, and vagina.
The vaginal microbiome is an ecosystem containing a delicate balance of bacteria and yeast. Balance of these microbes is important for maintaining reproductive and sexual health. The goal is to keep these microbes balanced at healthy levels.
The vaginal microbiome is bio-individual, meaning no two biomes will be exactly alike. Diversity in microbes may be beneficial, as is the case of diversity in the gut microbiome.
This environment is especially important for transferring healthy bacteria to babies born vaginally. This process is called vaginal seeding, in which the mother’s vaginal flora become some of the first and perhaps most pivotal bacteria to grow in the baby’s gut.
Research shows correlations between vaginal health and changes in the vaginal microbiome. So the key is to maintain a healthy biome.
When vaginal flora balance is disrupted, there are several areas that can be impacted. Healthy pregnancy is correlated with a stable low diversity Lactobacillus dominant vaginal microbiome. This initial study shows potential association with vaginal microbiome changes and pregnancy complications. Additional research is needed to understand the potential relationship between vaginal microbiomes and healthy pregnancy.
Numerous factors can throw off the balance of vaginal bacteria. Dietary changes, especially excess sugar and refined carbohydrates, can throw off vaginal bacterial balance.
Physical changes in the vaginal environment can also impact your vaginal health. These include excess moisture from undergarments from sweating from heat and exercise, sexual activities, menstruation, and douching.
In fact, doctors recommend that you do not douche, since this practice can lead to bacterial imbalances and possibly other serious conditions.
Spermicides, diaphragms, and cervical caps can also alter the vaginal microbiome and lead to increased risk of vaginal dysbiosis.
Imbalances in the gut microbiome can also impact the vaginal microbiome through “crosstalk.” Researchers are still unsure exactly how the transfer of bacteria from the gut to the vagina can occur, but the process has been identified in lab studies.
Medications like antibiotics and hormonal contraceptives can alter vaginal flora. Antibiotics can be used to address microbe levels in various areas of the body. However, oral antibiotics can alter levels of bacteria not only in the gut but also in the vaginal microbiome, sometimes resulting in an imbalance.
Hormonal contraceptives can also cause disruptions in the vaginal microbiome through their alteration of reproductive hormone levels.
Hormonal changes can alter the vaginal microbiome. Levels of bacteria naturally change during different hormonal stages, like during puberty or pregnancy.
Research implies that hormones such as estrogen may also play a role in maintaining the pH of the vagina, a key to vaginal bacterial balance.
Aging naturally brings hormonal changes. Decreased estrogen during menopause, for example, can alter vaginal bacteria levels.
Probiotics are popular for gut health, but can probiotics support vaginal health?
The consensus is clear that probiotics can promote healthy vaginal flora and even provide immunity.
A randomized double-blind placebo-controlled trial showed positive changes in the vaginal microbiome with the oral intake of specific strains of Lactobacillus, including L. rhamnosus GR-1, the most researched strain for urogenital health. Of those who took the probiotics, 96% had significant increases in Lactobacillus bacteria in their vaginal microbiome. These beneficial probiotics were also shown to augment the effectiveness of antibiotics when used together for addressing vaginal imbalances.
Research shows positive changes in the vaginal microbiome with the use of probiotics. However, more research needs to be done to see if the changes are maintained over extended periods of time.
Lactobacillus is predominant good bacteria present in the microbiome. This key bacterial bacterial species can help lower the pH of the vaginal environment through its production of lactic acid, making it more acidic. This increase in acidity provides protection to the vaginal microbiome against overgrowth of unfavorable bacteria.
The optimal pH of the vaginal environment is 3.8-4.5.
Lactobacillus in the vagina has been shown to significantly increase during pregnancy, likely as a protective mechanism for the health of the mother and baby. On the other hand, some studies show that this beneficial bacteria decreases with the use of progestin-only hormonal contraceptives. However, more research is needed.
Lactobacillus can be subdivided into different community state types (CSTs), the main ones including L. crispatus, L. gasseri, L. iners and L. jensenii. These can all produce lactic acid and hydrogen peroxide which both help to acidify the vaginal environment to a healthy pH less than 4.5.
Talk to your gynecologist about your options before starting supplementation, especially if you have a specific condition. Additional lifestyle changes to promote vaginal health include:
There are thousands of probiotic species. Many provide benefits that support women’s health.
Since the vaginal microbiome is diverse, many probiotic strains may support vaginal health. While there is no definitive answer on which strains are best, some strains may be more effective than others.
Lactobacillus species overall have demonstrated their effectiveness in restoring vaginal flora. Lactobacillus crispatus is a major determinant of vaginal health. Lactobacillus rhamnosus as well as Lactobacillus acidophilus, a healthy strain common in yogurt, are widely regarded as effectives strains in promoting vaginal bacterial balance.
Care/of’s Probiotic Blend, which is one of three capsules in the Women’s Essential Pack, contains both Lactobacillus rhamnosus and acidophilus as well as Bifidobacteria, another beneficial category of probiotics.
The key to best outcomes with probiotics (and most supplements) is to take them consistently.
Be sure to read the instructions, as some probiotics are oral whereas others may be inserted locally into the vagina for localized support. Also follow instructions on label in regards to proper storage, since some formulations may require refrigeration while others do not.
Also consider incorporating probiotic-rich food regularly into your diet for additional support. These include yogurt, kefir, raw sauerkraut, and kimchi, amongst others.
Suggested dosage varies depending on the product. The numerous studies that have been done have used various strains of probiotic bacteria at varying doses. So while no clear standards have yet been set for doses and strains, both oral and vaginally inserted probiotics hold great promise. H2: Potential side effects and risks associated with probiotics Sometimes oral probiotics may stimulate some initial changes in bowel movements. This effect is often normal while the balance of the microbiome adjusts at first.
Other temporary digestive changes such as bloating may also happen initially and then subside.
If the symptoms persist you may want to try a probiotic with a smaller amount of strains or try a different one altogether.
If you experience any changes in vaginal odor, discharge, bleeding, pelvic pain or discomfort, seek the care of a doctor. It is also good practice to see your gynecologist regularly and update them on any changes in your health or symptoms.
A healthy vaginal environment is important for sexual and reproductive health. Diversity of bacteria that keep an acidic pH is beneficial to vaginal health. Different strains of the key bacteria Lactobacillus are known for their ability to protect the health and immunity of the vagina and balance its flora. Doses vary amongst products, but overall, taking probiotics can support vaginal health.