Healthy vagina:13 tips for a balanced microbiome
Updated: Jul 18
The Blackflies have hatched and while i'm not terribly glad to see them - their arrival does mean summer is on the way. Hooray!
During the summer I get more emails about UTIs, Thrush and vaginal infections than I do at other times of year.
Being in a very seasonal part of the world I chalk this up to a few things: during the summer people are more likely to be on holidays and have more sex.
What I've also learned is that when it comes to supporting our bodies through vaginal infections, one element that is often overlooked is vaginal ecology.
Your vagina has a microbiome.
Your vagina has a microbiome just like your gut (gastro-intestinal system) !.
I know - pretty wild right?
Lactobacilli are the predominant bacterial species in your vagina and they thrive in a moderately acidic environment.
Healthy vaginas may also contain a number of pathogenic bacteria and yeast like e.coli and candida - the drivers behind UTIs and Thrush.
And a changing pH.
Your vagina's pH is usually around 4.5 - which is great for the healthy Lactobacillus bacteria.
Pathogenic bacteria tend to thrive when your pH is higher and therefore more neutral.
The thing is...
Your vaginal pH rises twice in your cycle (becoming more neutral) during both ovulation and menstruation.
Cervical mucus secreted at ovulation neutralises your pH in order to assist potential sperm to reach their destination.
Have you ever thought you were 'over' Thrush only to find that it came back a couple of weeks later?
If you have recurrent symptoms, chart your cycles and pay close attention at menstruation and ovulation.
A healthy microbiome is about balance.
When you are healthy and well the “bad bacteria” are kept in check by your “good bacteria”.
But what happens when you get run-down, stressed, or sick?
What happens when you have a new sexual partner, go on holidays and spend lots of time at the beach in wet swimwear?
These are the kinds of scenarios that can stack up and tip the balance - creating an environment for harmful bacteria to thrive in.
13 TIPS FOR SUPPORTING YOUR VAGINAL MICROBIOME
Menstrual cups & sex toys between uses with boiled water and be sure not to leave soapy residues on anything you insert into your vagina.
2. Avoid scents.
Synthetic fragrances used on pads and tampons contain chemicals which may affect your vaginal flora. Opt for organic cotton and reusable menstrual products when possible.
3. Don't douche.
Your vagina will clean itself, douching can alter your vaginal ecology. (The caveat here is if you're working on a specific therapeutic outcome with a practitioner - always ask questions about any treatments and be fully aware of the outcomes.)
4. Use water only.
If you wish to clean your vulva (the external lips of your genitalia) use clean hands and warm water, don't use soap.
5. Wipe from front to back aka wipe from urethra to anus.
It may feel awkward, but this trick helps minimize e.coli bacteria from making contact with your vulva and vaginal opening.
6. Use condoms.
They prevent STIs. Be mindful that scented/flavoured condoms with spermicides may impact your vaginal flora.
7. Pee after sex!
Peeing after sex helps to flush harmful bacteria from your urethra, preventing UTIs from occurring.
Breathable fabrics like cotton, hemp, merino and linen, avoid synthetic underwear and tight-fitting gym clothes. Pool side? Opt for loose-fitting swim / board shorts that dry quickly and allow your vagina to breathe.
Always change your underwear and gym clothes after a work-out and (and pee!).
9. Eat for your microbiome
A wholesome organic diet that includes fresh fruit and vegetables, legumes, whole grains and is rich in pre and pro biotic foods will promote a healthy vaginal microbiome.
Pre-biotic foods are non-digestible components of food that can improve intestinal health by stimulating the growth and activity of beneficial bacteria in the colon.
They include; onion, leeks, garlic, dandelion greens, Jerusalem artichokes, mushrooms, asparagus, barley, oats, green tea.
Pro-biotic foods are associated with various beneficial effects involving intestinal health. These foods include: Miso, kefir, yoghurt, saurkraut, tempeh.
Sugar, refined carbohydrates, cigarette smoking, processed meat and dairy products.
Use antibiotics only when necessary, the problem is that anti-biotics are non-specific, meaning they impact both your good and bad flora so ensure you take a simultaneous pro-biotic regime.
10. Stay hydrated
This is especially important in UTI prevention.
Water and lots of it.
Herbal infusions, green tea (research suggests green tea supports healthy lactobacilli populations, acting as pre-biotic for vaginal flora).
AVOID: Caffeine and alcohol.
11. Get strain specific.
While all probiotics might be “good for your microbiome” in a general sense, getting strain specific has been shown to be more effective when working with particular health conditions.
So what strains support vaginal health?
Lactobacillus rhamnosus GR-1 & Lactobacillus fermentum RC-14.
These two well-researched strains are effective at supporting healthy lactobacillus populations in the vagina.
A couple of nerdy faq's about these bacterial strains:
Lactobacillus GR-1 also inhibits candida albicans and gram-negative pathogens like e.coli.
Lactobacillus RC-14 inhibits candida and gram positive organisms like staphylococci and both strains will show up in the vagina when taken orally.
These bacterial strains are found in these supplements:
Jarrow Formulas Femdophilus and Blackmores Womens Bio-balance.
Suggested dosage: 1 tablet twice daily.
Echinacea flowers by Heather Daniels Pusey.
12. Herbal tonics
Vaginal and urinary tract infections often co-incide with a lowered immune system, increased stress and other factors.
Herbal support is most effective when your unique symptoms, health history and constitution are considered - working with a herbalist will help you find the support your body needs.
These are a few key herbal allies that may be helpful in supporting your urinary and reproductive systems.
Corn silk - Zea mays - Demulcent to the urinary system.
Cranberry juice – anti-adhesive to e.coli bacteria, “flushes” them from urethral wall.
Juniper – Juniperus communis. Urinary anti-septic.
Echinacea – Echinacea angustifolia – Acute immune and lymphatic support.
Raspberry leaf - Rubus ideaus - engages the energy - brings tone and strength to reproductive organs.
Oregano - Origanum vulgare - warming, anti-microbial.
13. Chart your cervical mucus.
Know your normal (so you can tell what’s not normal).
Healthy cervical mucus shifts during your menstrual cycle from a dry, damp or moist sensation to a wet, fluid, egg white consistency and then back to dry/damp/moist following ovulation.
In response to ovulation, cervical mucus can be seen and felt at your vulva.
Healthy cervical mucus is creamy, clear, white, or pale yellow, it arrives 2-7 days before ovulation, dries up and returns the following ovulation.
Unhealthy vaginal discharge might be bright yellow, brown, red, orange, purplish or black and is usually accompanied by uncomfortable sensations – itching, redness, swelling or unusual odor. It may be more persistent or have an erratic pattern.
If you notice unhealthy discharge, see your health-care provider.
Charting your cervical mucus helps you understand when something's not right.
----- ! ! Red Flags ! ! -----
If you experience bloody vaginal discharge (that is not your period), blood in your urine, acute, sudden or persistent lower back, abdominal, flank or side pain that is sharp, stabbing or consistent in nature, contact your primary care physician.
The information in this post is to help support your overall health and well-being and is not intended as medical advice.
Whole body health is vaginal health
Your vaginal microbiome is linked to your overall health.
If you're experiencing recurrent vaginal infections remember to consider your sexual hygiene, diet and lifestyle choices, overall stress and well-being.
Chart your cycles, seek support and stay well!
Gabrielle is a Holistic Reproductive Health practitioner outta Rockland, Maine.
Helping you navigate your vaginal and period health is her game.
Say hello: email@example.com
References for your vaginal ecology nerd out:
Cadieux, P, et al. (2002). Lactobacillus strains and vaginal ecology. JAMA, 287, 1940P1. PMID 11960535.
Evensen, N.A. and P. C. Braun (2009).”The effects of tea polyphenols on Candida albicans: inhibition of biofilm formation and proteasome inactivation.” Canadian Journal of Microbiology 55(9):1033P1039.
Gardiner, G, Heinemann, C et al (2002) Persistence of Lactobacillus fermentum RC-14 and Lactobacillus rhamnosus GR-1 but Not L. rhamnosus GG in the Human Vagina as Demonstrated by Randomly Amplified Polymorphic DNA. Clinical and diagnostic laboratory immunology, 9(10), 92096. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC119863/
McMillan A, et al. (2011). Disruption of urogenital biofilms by Lactobacilli. Colloids and Surfaces B: Biointerfaces, 86:1;58P64.
Reid, G., Charbonneau, D., Erb, J., Kochanowski, B., Beuerman, D., Poehner, R. & Bruce, A.W. (2003). Oral use of Lactobacillus rhamnosus GRP1 and L. fermentum RCP14 significantly alters vaginal flora: randomized, placebo P controlled trial in 64 healthy women. FEMS Immunol Med Microbiol, 35,131P4. PMID 12628548.
CDC - https://www.cdc.gov/std/tg2015/candidiasis.htm