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How To Maintain A Healthy Vaginal Microbiome, According To Experts

Just like the gut, the vagina is full of beneficial bacteria which make up the vaginal microbiome.

The main bacterial comes from the genus Lactobacillus, which has the important job of making lactic acid to stimulate healthy cervical mucus and discourage the growth of unwanted bacteria, yeast, and viruses.

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It's important to maintain a healthy balance of these bacteria for a number of reasons. Here are some of the main benefits of a healthy vaginal microbiome, common causes of imbalance, and five simple tips to support yours.

The benefits of a healthy vaginal microbiome.

A healthy vaginal microbiome1 may reduce the risk of sexually transmitted infections (STIs), bladder infections, and even cervical cancer2.

A healthy vaginal microbiome is also how you avoid the symptoms of yeast infections and bacterial vaginosis (BV), the two most common "ecological disorders" of the vaginal microbiome.

Yeast infections are an overgrowth of what should be a relatively small population of yeast living in your microbiome.

They generally lead to a thick, white vaginal discharge, as well as itchiness, redness, and irritation around the vagina.

BV is an overgrowth of what should be a relatively small population of normal bacteria, such as Gardnerella. Symptoms generally include odorous discharge, itching, and burning while peeing3.

Discharge can vary in odor and color, depending on the time of your menstrual cycle. However, if the changes are out of the ordinary or prolonged, it's a good idea to check with your doctor.

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Common disruptors of the vaginal microbiome.

The vaginal microbiome can be vulnerable to disruption via menstruation, as well as any external intrusions, like penises, fingers, tampons or menstrual cups, IUDs, or sex toys.

Research has shown that unprotected sex and sex with multiple partners may increase the risk of developing BV4.

"Additionally, there is a significant association between bacterial vaginosis and female sex partners5, because women who have sex with women appear to be at increased risk when compared with women who have sex with men only," one study states.

The vaginal microbiome can also be disrupted by factors that damage lactobacilli, like prolonged use of antibiotics6, smoking7, stress, and estrogen deficiencies occurring with amenorrhea, menopause8, or certain forms of birth control.9

Additionally, using scented soaps or douches can disrupt the pH in the vagina and disturb the microbiome.

While it's a common misconception that douching helps clean the vagina, its effect is actually more harmful. In fact, women who douche are five times more likely to develop bacterial vaginosis10 than those who don't.

How to support the vaginal microbiome with five easy steps.

Whether your vaginal microbiome is out of whack, or you just want to continue supporting the health of it, here are five places to start:

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1. Take a vaginal probiotic.

If you're trying to balance the bacteria in the vaginal microbiome, consider talking to an OB/GYN about incorporating a vaginal probiotic into your supplement routine.

These include strains of lactobacilli that have been scientifically proven to restore the vaginal microbiome and treat yeast infections and BV.

The best-studied product is a combination of 11Lactobacillus rhamnosus11 and 11Lactobacillus reuteri11, which can be taken orally.

Probiotics can also be inserted vaginally as pessaries or capsules like the Swiss vaginal tablets12 that combine Lactobacillus acidophilus with the gentle estrogen estriol (because estrogen promotes a healthy vaginal microbiome).

2. Don't douche.

The vagina keeps itself clean with lactic acid and the normal flow of vaginal discharge.

Trying to "help it out" with vaginal washing or douching will only increase the risk of bacterial imbalance. It is important, though, to wash the vulva "gently and carefully with water," board-certified OB/GYN Maria Sophocles, M.D., FACOG, NCMP, previously told mbg.

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3. Avoid smoking.

Research shows that cigarette smoke is associated with bacterial vaginosis and a decrease in 13Lactobacillus13 in the vaginal microbiome.

While the link is unclear, the researchers write "our results suggest that smoking is associated with several important metabolites present in the vagina that may have implications for women’s health."

4. Use condoms.

If you’re struggling with recurrent bacterial vaginosis, consider using condoms during sexual activity—particularly with new partners. (Here: a guide on when to stop using condoms in a relationship.)

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5. Maintain a healthy gut microbiome.

Improving the gut microbiome can positively affect the vaginal microbiome14.

Simple strategies include adding fiber-rich, or fermented foods to the diet, taking a probiotic, incorporating daily movement into the day, practicing stress management, and getting good quality sleep.

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Lara Briden, N.D.
Lara Briden, N.D.
Naturopathic Doctor

Dr. Lara Briden is a naturopathic doctor and women’s health activist currently working in Christchurch, New Zealand. She first worked as a researcher and evolutionary biologist at the University of Calgary. Then she went on to graduate as a naturopathic doctor from the Canadian College of Naturopathic Medicine (CCNM) in Toronto.

Dr. Briden's love of science and the natural world has informed the way she works with patients. She views the body as a logical, regenerative system that knows what to do when it's given the right support. And in her 20 years of practice, she has seen that simple principle in action with thousands of patients. Her book Period Repair Manual is a compilation of lessons from her practice that work for periods and specifically for coming off birth control.