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  • Gut and vaginal microbiomes differ, with bacteria potentially travelling via the gut-vagina axis, and could cause issues.
  • Vaginal microbiome imbalance may affect pH, general comfort, and sexual health, and may lead to discomfort and infections.
  • Factors like hormones, contraceptives, lifestyle, and diet could significantly influence vaginal microbiome balance.

Adapted for the UK from content originally published on the Metagenics Institute website

Conversations surrounding the microbiome and how it impacts our health have gained significant attention. But what exactly does it mean when we talk about the human “microbiome”? The microbiome is a community of microorganisms, such as bacteria, viruses, and fungi that reside in our skin, gut, and vaginal tract.1 The microbiome aids in digestion, supports vaginal health, improves cognition, and promotes general wellbeing.1

Not all microbiomes in our body’s system are exactly the same. The gut and vaginal microbiomes differ, and understanding this difference helps us find the right solutions to avoid unwanted women’s health issues.2 The gut microbiome is more diverse, while the vaginal microbiome is more selective in bacteria strains that keep the vagina balanced and healthy. In other words, what may be good for the gut may not be for the vagina.2

Some of the bacteria that help keep our gut healthy, or any bacteria that are harmful in general, can cause problems if they find their way to the vagina.3 This can occur when certain bacteria travel through the gut-vagina axis— a collection of intricate pathways connecting the vaginal tract to our gut.3 This can upset the balance in the vaginal and/or urinary tract and lead to women's health problems.3

Effects of imbalance within the vaginal microbiome

Any imbalance in the vaginal microbiome can impact a woman’s gynaecological health, including:

• Overall vaginal health and wellbeing: The vagina is home to specific types of bacteria. When these bacteria are lost, it can upset the balance and lead to physical discomfort.4

• Vaginal pH: A healthy vaginal microbiome is dominated by Lactobacilli bacteria which help to keep a slightly acidic pH. This delicate ecosystem is highly sensitive to imbalances in the microbiome, leading to infections, discomfort, and disruptions in daily life.

• Sexual health: Vaginal imbalance may also affect intimacy and sexual health. Sexual activity may be uncomfortable.6,7

Factors affecting the vaginal microbiome

Throughout a woman’s lifecycle, different factors can upset the balance of bacteria in the vagina, including:

• Menstrual cycle and hormones: Oestrogen helps maintain a healthy environment in the vagina, including keeping a low pH level, which is important for vaginal health. If you have high oestrogen levels, you're more likely to experience an imbalance.8 This can happen to women who are in their reproductive years, those who take strong birth control pills, or those receiving hormone therapies.9

• Contraceptives: Some birth control methods have shown to alter the healthy vaginal microbiome. It’s a good idea to discuss contraceptive methods that are right for you with your doctor.10

• Menopause and aging: When oestrogen levels drop during menopause, it can impact the vaginal microbiome by decreasing vaginal flora, leading to imbalance.5,11

• Lifestyle: Everything from the soap you use, choice of undergarments, and the choice to practice safe sex can impact your vaginal health.7 Also, the stress in our daily lives can affect our body's balance as well. Stress can increase levels of a hormone called cortisol, which in turn can affect our oestrogen levels.5,7

• Diet: Eating processed foods loaded with fats and carbs can compromise your vaginal health. It’s important to eat a balanced diet with plenty of fibre, vitamins, and minerals.12,13 And don't forget about the potential benefits of high-quality probiotics!

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References:
1. Ogunrinola GA et al. Int J Microbial. 2020; 2020:8045646.
2. Amabebe E et al. Front Immunol. 2020;11:2184.
3. Brannon JR et al. Nat Commun. 2020;11:2803.
4. Han Y et al. Front Micriobiol. 2021;12:643422.
5. Lehtoranta L et al. Front Micriobiol. 2022;13:819958.
6. Gholiof M et al. Front Reprod Health. 2022;4:963752.
7. Lewis FMT et al. Obstet Gynecol. 2017;129(4):643–654.
8. Cheng G et al. Eukaryot Cell. 2006;5(1):180–191.
9. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999. Accessed December 5, 2022.
10. Gupta K et al. J Infect Dis. 2000;181(2):595-601.
11. Szymański JK et al. Int J Environ Res Public Health. 2021;18(9):4935.
12. Neggers YH et al. J Nutr. 2007;137(9):2128-2133.
13. Tohill BC et al. Am J Clin Nutr. 2007;85(5):1327-1334.

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