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Women's Health

4 min read

Meet Your Vaginal Microbiome

It's the Most Important of Your Body, But You've Probably Never Heard of It

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There’s a lot of things women aren’t taught about their sexual health, ranging from how to protect ourselves from STIs, to coping with PMS symptoms.

A lot of things that can go awry *down there* (many of which are super common), but we’re brought up with little to no knowledge of our genitals and their functions—chief among them is the vaginal microbiome.

Just like your gut, your vaginal microbiome is a carefully calibrated ecosystem full of good bacteria, and it plays a key role in keeping us healthy. It’s responsible for keeping you—and your vagina—in top form, and protect you from harmful bacteria, infections and viruses. But while the practice of consuming good bacteria for your gut is well established in the wellness world, very few of us are well-versed on how to look after our vaginal flora. No surprise here, given society’s cultural aversion to vaginas.

“The vaginal microbiome is the natural flora that exists within you vagina,” explains Dr. Hannah Allen. As with your gut, having bacteria living in your body is actually good, even though it might sound counterproductive. “In everybody’s body—on their skin, in their gut, around their digestive tract, in the vagina—you have lots of different organisms that live there naturally and protect you from disease and other problems, so it’s really important to preserve that,” says Dr. Allen.

But when something throws that balance off whack, whether it’s environmental factors, medications, or genetic predispositions, your vaginal microbiome gets disrupted. “And that can predispose you to developing disease states like STIs, or your likelihood of falling pregnant,” adds Dr. Allen. Your vaginal microbiome is also responsible for protecting you from two common infections, bacterial vaginosis (BV) and thrush (something we wouldn’t wish on our worst enemies).

Anything, from jet-lag to sex, periods and over-washing, can throw your vaginal microbiome off balance. “In theory anything that you insert or introduce in the vagina can alter your microbiome,” says Dr. Allen, which is why it’s super important to use body-safe lubes and sex toys, and avoid douching or using feminine hygiene soaps. “It’s so sensitive to so many environmental changes that often it’s hard to pinpoint one thing that caused it, beside obvious things like drugs or antibiotics.”

Anything that you insert or introduce in the vagina can alter your microbiome.

— Dr. Hannah Allen

But interestingly enough, even your period can alter your vaginal microbiome. If you’re one of the many women who routinely get yeast infections after their period, you can thank your vaginal flora for that. “During your period you’re shedding your uterine lining, which also sheds some of your flora, often stripping it back,” explains Dr. Allen, but even in that case your likelihood of a post-menstrual yeast infection is highly contingent on your overall health.

“It depends on what your natural flora state was, and what your predisposing factors were. Have you been well in the run up to your period? Have you been poorly? Have you been taking antibiotics? Have you done anything else that might affect your flora?” she adds.

Because vaginal infections are so (annoyingly) common, many companies sell probiotics specifically designed to maintain your vaginal microbiome healthy, and purport to replenish good bacteria while keeping infections at bay and preventing diseases. But chances are that you’ve gone about living your life without knowing what your vaginal microbiome is, let alone whether or not you should be shelling out on vaginal probiotics to keep it healthy. So are these supplements necessary?

Every woman’s vaginal microbiome is completely unique, making the need for probiotics subjective. “It’s not one-size-fits-all,” says Dr. Allen. “Generally speaking probiotics are pretty good for you, they replenish your normal flora and try to get you disease-free.” But for certain people or conditions, probiotics are actually recommended. “If you are immunosuppressed, have been taking lots of antibiotics or things that disrupt your normal flora, then they are very good,” explains Dr. Allen. “For the general healthy public who is looking after their health, eating healthy, living well, and doesn’t have any symptoms, they don’t necessarily need to go and spend a lot of money on—pretty expensive—probiotics. But they’re not harmful in any way.”

So the worst case scenario is that they’re a waste of money, but Dr. Allen highlights that there’s still not enough evidence on how probiotics affect your vaginal health. “There are so many environmental, psychological, physical factors that influence your vaginal microbiome, but because of the lack of research into this area it’s all anecdotal. We can speculate, but we don’t know for sure.”

Whether or not to take vaginal probiotics, however, is not necessarily the key to a healthy vaginal microbiome. Dr. Allen points out that vaginal health is directly linked to overall wellness, and vice-versa. “Everyone needs to be thinking about this, about their general health. Clinically it’s not about focusing just on one area, [your vaginal microbiome] is a representation of your overall health, and we have to look at it holistically rather than “this is your vagina, then this is you”. We need to be thinking “Am I making healthy lifestyle choices? Am I looking after myself? Am I getting enough sleep? Am I practising safe, good sex? Am I psychologically well?” All of these things will impact on your vaginal microbiome. Your wellness as a whole package is going to be represented by a healthy or unhealthy vaginal microbiome.”

Vaginal health is directly linked to overall wellness, and vice-versa.

The lack of R&D means there is still a lot we don’t know about the vaginal microbiome, but what we do know is that we need to start taking care of our sexual health in a more holistic way. As women we’re not really encouraged to take charge of our sexual health, and you can thank cultural taboos for that, so for most of us, life consists of genital-related “aha” moments—little bits of information that make up the Puzzle Of Sexual Health.

A healthy vaginal microbiome doesn’t depend on how “clean” you are or how much kombucha you drink, and it’s more like a continuum of health. The bottom line is: treat your body right, and be kind to your vagina.

Illustrations by Erin Rommel. Erin is the founder of @second.marriage, a Brooklyn-based brand, illustration, and design studio.

Written by Liv Cassano. Liv is the Editor of Vitals, follow her at @liv_css.

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