Updated: Sep 21
Bacterial vaginosis (BV) is a common vaginal infection that affects lots of women, yet isn’t often talked about due to the nature of the symptoms. With some women asymptomatic, others experience unusual discharge, itching and a fishy odour, so it’s no surprise it’s something we don’t like to discuss. But, BV can have other implications such as increased risk of contracting STI’s such as HIV, of pre-term babies or miscarriage and pelvic infections so it is important that it isn’t left untreated.
Whilst antibiotics work for some, the relief is often short-lived and the infection returns, here are some useful tips to naturally support a healthy vagina!
1. Look after your Lactobacillus!
There is lots of talk about gut microbiomes at the minute, but are you aware your vagina cultivates its own microbiome too?
Lactobacillus is a species of bacteria that have been shown to largely populate a healthy vagina (Shivakoti et al., 2020). Having low levels of lactobacillus has been linked to Bacterial Vaginosis(Ravel et al., 2011), but why?
The lovely Lactobacillus species protect your lady parts in several ways:
- They produce lactic acid which keeps the pH of the vagina more acidic thereby warding off any growth of unwanted or non-beneficial bacteria.
- They produce hydrogen peroxide, which also helps to keep the pH more acidic and the ‘bad’ bugs at bay.
- Its colonisation on the vaginal epithelial cells basically stops other harmful bacteria attaching and procreating (Martin, 2012).
What can you do?
Eat fermented foods
Kefir, kimchi, sauerkraut, natural ‘live’ yoghurt, all contain varying amounts of lactobacillus, by regularly eating these foods we can support a healthy amount of lactobacillus both in out gut and vaginal microbiome.
Always check the label to make sure these products haven’t been pasteurised, as this will have killed off the lovely bugs we need.
Be mindful if you have had a course of antibiotics, your levels of beneficial bacteria may need to be replenished as antibiotics can wipe out the beneficial bacteria along with the non-beneficial bacteria, so be sure to include these foods to help boost you levels.
If you have had several courses of antibiotics, it may be worth talking to a Registered Nutritional Therapist for ways to support a healthy microbiome, both for your gut and your vagina!
Eat the rainbow
So, the fermented food helps to get the beneficial bacteria where they need to be to help ward off bacteria we don’t want to get comfortable, now they need something to eat. Beneficial bacteria love to feed on fibre from a variety of fruits and vegetables – a recent study demonstrated that the more fibre women consumed from fruits and vegetables the less likely they were to get BV.
In fact, increasing fibre intake from fruits and vegetables is also associated with reduced risk of cardiovascular disease, diabetes, obesity and more (Jebb, 2014; McKenzie et al., 2016). So, get eating that veg! Ensuring we eat differently coloured fruits and vegetables (Eating the Rainbow) helps provide this fibre along with many other micronutrients.
2. How are your hormones?
Oestrogen & progesterone support the growth of protective Lactobacillus in the vaginal microbiome, so it stands to reason that when oestrogen is low, there is opportunity for the non-beneficial bacteria to proliferate and increases the chance of BV.
We are complicated creatures, and there are times in a ladies’ life when oestrogen levels naturally fall, for example, throughout the monthly cycle and also when they begin to gradually decrease during perimenopause and the menopause (Shen et al., 2016).
The diagram below displays such times when our hormones fluctuate – take a note of the blue line as this demonstrates the change in diversity (away from a lactobacillus dominant microbiome) and times when BV maybe more likely to rear its ugly head.
(Kaur et al., 2020)
There may be other times, such as a period of prolonged stress, drinking alcohol, eating sugary and processed foods that can all affect our hormones (further posts to follow on how you can address these and support your body!).
If you are experiencing peri or postmenopausal symptoms along with BV, and dietary changes like those suggested are not working for you, speak to your GP, as you may benefit from hormone replacement therapy (HRT) to support your microbiome.
3. Don’t Douche!
Various vaginal douche products contain known endocrine disrupting chemicals, such as phthalates. Endocrine disruptors are chemicals that can mimic or interfere with our hormones, like oestrogen – which, as we now know, will not help our lovely Lactobacillus. (Geller et al., 2018)
So where possible stay away from the chemicals. All you need to wash with is water, don’t use wipes and watch your lube – look out for lots of chemicals on the label, such as, phthalates that can be contained in these products, as these can act as endocrine disruptors.
Want to know more about your vaginal microbiome?
The Female EcologiX by Invivo, is a test which can be done at home and provides an insight into both the pH of your vagina along with the presence of beneficial and non-beneficial bacteria and yeasts, including those associated with BV.
This is a great place to start if you have had recurrent episodes of BV.
Would like further support? Book in for a complimentary call to see how you could work us for optimum health
Geller, R. J. et al. (2018) ‘Phthalate exposure and odds of bacterial vaginosis among U.S. reproductive-aged women, NHANES 2001–2004’, Reproductive Toxicology. Elsevier Inc., 82, pp. 1–9. doi: 10.1016/j.reprotox.2018.09.001.
Jebb, S. A. (2014) ‘Carbohydrates and obesity: from evidence to policy in the UK’. doi: 10.1017/S0029665114001645.
Kaur, H. et al. (2020) ‘Crosstalk Between Female Gonadal Hormones and Vaginal Microbiota Across Various Phases of Women’s Gynecological Lifecycle’, Frontiers in Microbiology. Frontiers Media S.A., 11, p. 551. doi: 10.3389/fmicb.2020.00551.
Martin, D. H. (2012) ‘The microbiota of the vagina and its influence on women’s health and disease’, in American Journal of the Medical Sciences. Lippincott Williams and Wilkins, pp. 2–9. doi: 10.1097/MAJ.0b013e31823ea228.
McKenzie, Y. A. et al. (2016) ‘British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)’, Journal of Human Nutrition and Dietetics, 29(5), pp. 549–575. doi: 10.1111/jhn.12385.
Ravel, J. et al. (2011) ‘Vaginal microbiome of reproductive-age women’, Proceedings of the National Academy of Sciences of the United States of America. National Academy of Sciences, 108(SUPPL. 1), pp. 4680–4687. doi: 10.1073/pnas.1002611107.
Shen, J. et al. (2016) ‘Effects of low dose estrogen therapy on the vaginal microbiomes of women with atrophic vaginitis’, Scientific Reports. Nature Publishing Group, 6(1), pp. 1–11. doi: 10.1038/srep24380.
Shivakoti, R. et al. (2020) ‘Dietary macronutrient intake and molecular-bacterial vaginosis: Role of fiber’, Clinical Nutrition. Churchill Livingstone. doi: 10.1016/j.clnu.2020.01.011.