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How to mind your female flora

Understand the importance of vaginal microbiome with expert inputs on how to maintain it optimally

Vaginal microbiome is essential for the reproductive and sexual health of a woman.
Vaginal microbiome is essential for the reproductive and sexual health of a woman. (Unsplash/Wren Meinberg)

It is believed that around 30% of women globally experience symptoms of severe vaginal microbiome imbalance during their reproductive age. The symptoms include a burning sensation while urinating, itching around the outside of the vagina and a strong odour from within. If this has you concerned, here are some easy-to-follow practices you can follow to keep these infections and diseases at bay and have your vagina in the pink of health.  

Dr. Kalpana Erande, a sexologist who has a community called ‘Care for Couples’ on coto, a social community platform only for women, addresses the Whys, Whats, and How-tos about female flora with expertise and clarity.

What is vaginal microbiome?
Vaginal microbiome is a community of tiny organisms like bacteria and yeasts within the vagina. Lactobacilli, a specific bacteria found in the vagina, is the cornerstone of the vagina, producing lactic acid that lowers the vaginal pH to 4-4.5. This low pH and high lactic acid level keep the pathogens at bay, preventing harmful bacteria, creating natural antibiotics, reducing inflammation, and aiding in self-cleaning.

This balance of good microorganisms acts as a protective shield, lowering the risk of infections. Like gut microbiome, the vaginal microbiome’s imbalance affects immune function, reproduction, and increases one’s vulnerability to certain health issues.

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Why is vaginal microbiome important?
The vaginal microbiome plays a crucial role in a woman’s health. It is essential for the reproductive and sexual health of a woman. Dr Kalpana lists out why these bacteria are so crucial. 

  1. Lower risk of STIs
    Having higher levels of lactobacilli in the vaginal microbiome has been associated with a decreased risk of sexually transmitted infections (STIs) and pelvic inflammatory disease (PID). 
  2. Vaginal health maintenance
    Vaginal microbiome helps maintain vaginal health by regulating the balance of microorganisms, preventing the overgrowth of harmful bacteria, yeast, and infections. 
  3. Fertility support
    The condition of the vagina, including its pH and secretions, is essential for fertility. A healthy vaginal microbiome contributes to optimal conditions for conception, successful pregnancy, delivery, and postpartum recovery. 
  4. Avoid pregnancy complications
    An imbalanced vaginal microbiome can lead to pregnancy complications such as miscarriages and preterm labour, proving its role in ensuring a smooth pregnancy journey. 
  5. Cancer prevention
    Unhealthy sexual practices, poor hygiene, and irritation can disrupt the vaginal microbiome and potentially contribute to gynaecological cancers.

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What causes unbalanced vaginal microbiomes?
The density of vaginal microbiomes often reduces, which can cause mild to severe infection. So, what causes this fluctuation?  Dr. Kalpana Erande explains: 

  1. Medication impact: The use of medications, particularly antibiotics, can disturb the natural balance of both gut and vaginal flora. Thus, it is crucial to use antibiotics judiciously and only when a medical professional prescribes them, in order to prevent imbalances and potential resistance.
  2. Hormonal fluctuations: Variations in hormonal levels during menstruation, pregnancy, or menopause, can influence the stability and function of the vaginal microbiome. These hormonal shifts and imbalances due to menopause and PCOS-like conditions can also affect vaginal secretions and overall microbial equilibrium. 
  3. Unprotected sexual activity: Engaging in unprotected sexual activities with multiple partners exposes the body to potential pathogens and sexually transmitted infections (STIs). This risk extends to not only penetrative sex but also oral and anal activities. Proper use of barrier methods is essential for protection. 
  4. Hygiene practices: Extremes in hygiene practices can disrupt the delicate vaginal microbiome. Excessive hygiene measures such as douching, can strip away the protective layers, while inadequate hygiene can lead to infections due to stagnation of secretions. 
    Dr. Erande adds, “By being mindful of medication use, managing hormonal changes, practicing safe sex, and maintaining balanced hygiene practices, women can maintain a healthy vaginal microbiome and overall well-being.”

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What are some of the complications that can arise from imbalanced female flora?
Depending on the intensity and frequency of vaginal microbiome fluctuations, you can experience mild to severe infections, and if not treated in time, it can lead to life-threatening diseases.

  1. Vaginal infections: A reduction in lactobacilli can create an environment in which harmful pathogens can thrive, resulting in a condition known as vaginal dysbiosis. This can pave the way for various infections, including bacterial vaginosis, yeast infections, and urinary tract infections (UTIs).
  2. Itching, burning and pain: Vaginal dysbiosis is characterized by a higher diversity of bacteria, allowing disruptive microbes like Gardnerella, E. coli, or Mycoplasma to flourish. The overgrowth of these disruptive microbes can cause uncomfortable symptoms such as itching, burning, irritation, and pain.
  3. Bacterial vaginosis (BV): The most common result of vaginal microbiome disruption is bacterial vaginosis (BV), characterized by elevated bacterial diversity and an abundance of disruptive bacteria. Dr. Erande elaborates, “Studies show that the composition of the vaginal microbiome is linked to risks such as STIs (Chlamydia, Gonorrhea, Trichomoniasis, Herpes, HPV, HIV), pelvic inflammatory disease, fertility issues, pregnancy complications (miscarriage, preterm labour), gynaecological cancers (ovarian, cervical, endometrial), and cervicitis.”

Tips to maintain vaginal microbiome at optimal level
Maintaining a balanced vaginal microbiome is crucial for the overall reproductive and gynaecological health. It can lead to severe complications, but adopting simple practices can go a long way in keeping these problems at bay. Dr. Erande recommends: 

  1. Gentle cleansing: Avoid using harsh soaps and douches that can disrupt the natural balance of vaginal secretions. Opt for washing with warm water and ensure proper cleaning from front to back to prevent anal infections.
  2. Wear breathable underwear: Wear breathable underwear and change them regularly to prevent moisture buildup, which can create a favourable environment for infections. 
  3. Avoid douching: Refrain from douching or using scented products as these can alter the pH balance of the vagina and lead to imbalances.
  4. Practice safe sex: Engage in protected sexual activity to prevent exposure to alkaline semen, which can affect the vaginal microbiome. Consistently use condoms during intercourse to maintain a healthy environment. 
  5. Lifestyle and diet: Incorporate probiotics into your diet to support the growth of beneficial bacteria. Maintain a balanced diet and stay hydrated to promote overall vaginal health. 

Most importantly, if you notice any imbalances or experience symptoms like itching, odour, or unusual discharge over a long period, seek guidance from a healthcare professional. Timely medical advice can help ensure the maintenance of a healthy vaginal environment.

Shweta Dravid is a self confessed explorer who writes on travel, health, wellness, mindfulness and life truths.

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