THE VAGINAL MICROBIOME and the gut/vagina connection:
Have you experienced the struggles of vaginal dysbiosis, in the form of infections such as Bacterial Vaginosis or Candida overgrowth/Thrush? Believe me, if the answer is yes, you are certainly not alone!
These conditions are actually more common than anyone would believe, though because of the sensitive nature of the topic, and the shame shrouding any sort of vagina-related ailment, not many women are too keen on talking openly about it. Fancy that! With attitudes and connotations surrounding even a healthy vagina often straying into the territory of ‘gross’, ‘unclean’, ‘smelly’, and ‘shameful’, it is no wonder we women are reluctant to let on when things aren’t quite right down there.
I, myself, had a long battle with vaginal dysbiosis, manifesting in alternating thrush and BV infections for years!
It’s hell, and severely affects your self confidence, sexual expression and drive, and your relationship with your body suffers heavily.
So I get it. Oh, boy, do I get it!
And this experience, this ongoing struggle with my own vagina, led me on a path of research and healing that has resulted in me having quite a bit of information on the topic that I’d like to share with you.
Now it’s not the be-all and end-all, and there are MANY things you can do to ensure a happy little vag-emite (only the Aussies will get that one, and I seriously won’t blame you if you don’t approve!).
I’ve written a big old checklist of these ‘Yoni Care’ measures in another post that you can read here.
But the main thing I’d like to discuss in this post is the importance of the gut in vaginal health. The gut microbiome is extremely important to all manner of things when it comes to general health and balance in the body, and it also has an effect on the vagina’s microbiome too.
Yes, your vagina has it’s own little microbiota, or vaginal community of bacteria, that prefers to exist in harmony with just the right balance of each of the many bacterial strains that coexist in there.
It’s inhabited by a range of microbes from a pool of over 50 species.
Lactobacilli are the most common, particularly in healthy women.
Vaginal microbiota form a mutually beneficial relationship with their host and have major impact on health and disease.
When this bacterial balance is tipped in favour of some of the more nasty players, Bacterial Vaginosis (BV) can result. And when other members of the vaginal village - such as yeasts - that are perfectly normal, happy little guys in the right amounts, are allowed to flourish a bit too much, they overthrow the protective bacteria and turn into a real problem - as in the case of candida overgrowth resulting in vaginal thrush.
When the vaginal microbiota is a touch too diverse, the friendly and essential hoard of lactobacillus are edged out of their homes and unable to hold down the fort like they normally do to maintain a nice acidic pH and keep yeast at harmless levels. This tip of the balance in the wrong direction is often what has happened in the case of BV, which is the most common urogenital infection among women of reproductive age. In half the cases of BV, the infection is asymptomatic, so you may not know you even have it.
This is a little scary because having BV can increase the risk of preterm labor and low birth weight, pelvic inflammatory disease, UTI, and increased susceptibility to sexually transmitted disease, including HIV.
The reason I mention this is because it’s all about having the right balance of bacteria to maintain a healthy environment within the body. And the gut microbiome can affect the vaginal one through bacteria from the GI tract ‘trans-locating’ (ie. migrating) to an area where it is not supposed to be! In other words, any pathogenic strains of bacteria that are present in the gut, can therefore infect the vaginal tract and disrupt the delicate balance of flora there and this could lead to BV or Thrush.
So looking after the gut is of the utmost importance, not only for the health of the rest of the body, mind, and soul (I mean, heck, the gut manufactures 90% of the body’s serotonin - If that’s not reason enough to take better care of it, I don’t know what is!) but for creating and maintaining vaginal health and balance.
Which brings me to my next point.
The most common treatment for BV typically includes antibiotics such as metronidazole. This is very effective at the time of treatment but the recurrence rates of BV are really high, and often once women have gotten rid of the infection for the first time, they will continue to suffer and struggle with re-appearing symptoms intermittently on an ongoing basis for years. Not to mention the effects of the antibiotics on the gut AND vaginal microbial balance, wiping out much of the good bacteria, along with the bad, in one foul swoop.
Therefore it is common for the BV to go away for the moment, but for candida to make itself a problem almost immediately, with women then see-sawing between the two versions of vaginal dysbiosis indefinitely.
Over-the-counter treatments for thrush are similarly short-lived in their effectiveness, with a huge recurrence rate, and an increasing resistance to the drugs in these medications as a result of such frequent use.
Clearly the available medical treatment of these infections needs some work!
So, if you absolutely have to use antibiotics - and by all means, do your darndest to avoid this if at all possible! - clever use of probiotics is essential to repopulate the vagina (and gut) with the helpful, protective kind of bacteria that belongs there in abundance.
Several scientific studies have shown that the use of antibiotics to get rid of the bad bacteria coupled with pro-biotics to populate the vaginal tract with the right sort of organisms is the most effective - uch more effective than just antibiotics alon.
To get a tad nerdy on you for a second…(as if I hadn’t already!)
When looking into probiotics, the two most beneficial strains of lactobacillus for the vagina specifically are . rhamnos GR-1 and . reuter RC-14 which have been shown to have the best success at adhering to the epithelium as well as colonising the area and lasting the distance well after treatment has ceased.
Studies have tested both direct vaginal and oral methods of administering probiotics. Interestingly, the oral method seems to be just as, if not more, effective than vaginal suppositories.
A lesser known treatment that many doctors swear by, and that studies have begun to support, is Boric Acid suppositories.
Boric acid is a natural antifungal and antiseptic, and studies have shown that it inhibits the growth of Candida albicans, the strain of yeast behind most cases of the vaginal thrush, as well as other kinds, such as Candida glabrata, an increasingly common cause of infection that tends to be more resistant to other treatments.
The powder, an irritant, should never be applied directly; suppositories are designed for this reason and can be directly inserted inside the vaginal tract for 5 to 7 days.
Another possible treatment that is supported by some interesting new research is the use of Saccharomyces boulardii. This little guy has been shown to be helpful in the treatment and prevention of vaginal thrush as it inhibits the adhesive and biofilm forming abilities of Candida Albicans (the main culprit of thrush infections).
S. Boulardii is interesting as it is actually a tropical species of yeast, but it functions in the body like a pro-biotic!
This is pretty cool stuff, and a great start, however there is not enough research data in this field to make a definitive conclusion about whether it is an effective treatment for thrush, and pro-biotics and dietary factors are still the leading approach for any vaginal dysbiosis. But watch this space!
So, there you go! The low down on your down low!
I hope this information was helpful, and if you’re left wanting more you can read this article on additional Yoni Care tips, or get in touch with me to ask a question.
You can holla at me or book a private session here or my instagram @ freya_graf_ymt