Vaginal microbiota: what is it and how does it affect our health?

Until a few years ago, hearing about vaginal microbite was something strange. To this day, scientific evidence has advanced so much that it makes it impossible to deny the importance of taking care of our microbiota to maintain good health. In the following interview, Dr. Radharani will talk about the vaginal microbiota : What is it and how does it affect our health.

How would you define the vaginal microbiota? And what is its importance for women’s health?

The vaginal microbiota is the set of beneficial bacteria that live in our vagina and that must be in balance with us to guarantee that we have a microenvironment capable of protecting ourselves. In this way, the bacteria and fungi that cause discomfort or pathologies cannot grow, since the healthy microbiota prevents it.

Our vaginal microbiota is an important part of our natural protection against vaginal and urinary infections, so it is important to know how we can keep it healthy and balanced through our lifestyle.

What are the main microorganisms that make up the vaginal microbiota and what functions do they perform?

The microorganisms that predominate in our vaginal microbiota are lactobacilli. Among them, Lactobacillus crispatus, L. jensenii and L. gasseri predominate. These bacteria have a fundamental function for vaginal health since they are capable of forming lactic acid from the glucose present in normal vaginal secretions. Lactic acid is very important for intimate health since it maintains the environment of the vagina with an acidic pH between 4 and 4.5. This is essential because it prevents other bacteria and fungi from growing.

What is the relationship between the vaginal microbiota and common vaginal infections? And with cystitis?

When we have a situation that takes us away from equilibrium, such as:

  • Taking antibiotics.
  • Hormonal changes such as menopause, postpartum or lactation.
  • Douching or excessive washing with harsh soaps.
  • Frequent use of underwear made of synthetic materials.
  • Excessive humidity or heat, vacations, frequent beach and pool.
  • Stress.
  • Emotional situations that can affect us.
  • Intense sexual activity

All this can result in a change in the vaginal microbiota because the amount of beneficial lactobacilli decreases. This decreases the acidity of the vagina, which allows other bacteria or fungi to grow and makes us more prone to the dreaded candidiasis or bacterial vaginosis.

In the case of cystitis, which unfortunately is also quite frequent, it occurs because this change in our microbiota allows bacteria such as E. coli to ascend to the bladder and colonize it, since there is no defense barrier to prevent it.

What factors can negatively affect the balance of the vaginal microbiota and how do they influence gynecological health?

The delicate and perfect balance of our vaginal microbiota works fantastic if we are healthy in body, mind and spirit, as I always like to say. This means that the vagina is self-cleaning and has its own mechanisms to eliminate the “bugs” that can make us sick, and residues, for example, from menstruation or after sexual activity.

Although there are situations where this balance can be broken. For example, when we take an antibiotic, when we go through periods of psychological stress, intense sexual activity, hormonal changes such as menopause, postpartum, lactation or with some contraceptives. What happens in these cases is that the amount of lactobacilli in the vagina decreases, which favors the growth of fungi or bacteria that cause infections, because the pH of the vagina increases and the defense barrier provided by our “good” bacteria decreases.

What are the symptoms of a vaginal microbiota imbalance and when to seek medical attention?

All women of childbearing age have vaginal discharge. This flow changes throughout the cycle, it can be more or less abundant depending on the day of the menstrual cycle. The most important thing is always to know that it should not produce a bad smell or itching. The normal color ranges from white, yellowish white or crystalline on the days of ovulation. If you notice that your vaginal discharge changes color, becomes greenish, brown, tinged with blood, with a fetid odor like rotten fish or you feel irritated, itchy, swollen in your genitals, then you should see your gynecologist as soon as possible.
You should also ask for help from a professional if you have discomfort when urinating such as pain or burning, you feel like urinating as soon as you finish doing it, you feel like going to the toilet very frequently and you only urinate a small amount, if your urine has blood, it is cloudy or it changes its smell, since this should make you suspect that you are suffering from cystitis. The sooner you go for help, the sooner we can treat you, thus preventing the discomfort from getting worse.

I recommend above all that you avoid self-medicating. It is always preferable to be able to examine yourself before receiving treatment, do the necessary tests and indicate the appropriate treatment, as well as give you lifestyle recommendations or supplements appropriate to your case to prevent you from having another episode.

Are there measures that can be taken to maintain the healthy balance of the vaginal microbiota?

Our microbiota is the reflection of our entire lifestyle, we are a whole. It is essential to take care of our healthy habits to favor the balance of our bacteria and maintain intimate health:

  • Take care of your diet, carry anti-inflammatory Mediterranean nutrition based on natural foods, seasonal fruits and vegetables to guarantee the vitamins, antioxidants, and minerals that help us have an optimal immune system. Seeds, nuts, spices, aromatic herbs, proteins of high biological value together with whole grains and plenty of water.
  • Minimize sugar and refined flours, especially if you are prone to candidiasis to help maintain a healthy intestinal microbiota, avoiding colonization by candida. Reduce alcohol and ultra-processed foods, also toxic like tobacco.
  • Maintain adequate hygiene without falling into excessive washing or strong soaps. Once a day wiping from front to back is enough.
  • If you have vaginal or vulvar dryness due to menopause or other special hormonal situations such as being lactating or taking contraceptives that cause you this discomfort, then try to have a vulvovaginal hydration routine to help promote the care of the mucous membranes and protect you from discomfort and infections.
  • Sleep 7 to 8 hours a day to take care of the immune system.
  • Meditate, do yoga or deep breaths, therapy or any tool that allows you to manage stress since this makes us more prone to repeated infections because it depresses the immune system affecting our microbiota.
  • Always urinate before and after sexual activity, and if you have vaginal lubrication problems, always use an aqueous lubricant.
  • Drink plenty of fluids and empty your bladder every two hours, avoid holding the urge to urinate.

Check with your doctor about the use of supplements to prevent and care for your vaginal microbiota. There are preparations based on natural substances such as blueberry, rosemary, pomegranate and grape that can help us prevent bacteria from sticking to the bladder and we can eliminate them more easily. If you are prone to repeated cystitis or candidiasis, it is very important that you know that these annoying episodes have a solution and must be treated holistically, going to the root and making improvements in your habits and lifestyle.

What is the role of prebiotics in maintaining the health of the vaginal microbiota and how can they be used effectively?

Prebiotics are foods that act like indigestible fiber. They are nutrients for our healthy microbiota. In this way they help us maintain the balance of the vagina.
They will help us feed our good bacteria so that they protect us from fungi and pathogenic bacteria, helping to prevent infections.

We can use prebiotics rich in antioxidants such as cranberry, pomegranate, grape and rosemary extracts to complement the treatment of a vaginal infection such as vaginosis or candidiasis, for example. In this case, they will help us recover more quickly the microbiota that protects us, restoring vaginal balance.
We can receive them orally or locally. Orally they will go to the intestine to feed our intestinal bacteria and in this way they come to colonize the vagina. Vaginally they can be used in creams or ovules, acting on the bacteria population in the area.

A prebiotic can also be an excellent preventive measure in case you suffer from recurrent infections or are going through a period of great stress that can make you more prone to vaginal infections, always in conjunction with a healthy lifestyle.

Thank you very much for this magnificent interview and for helping us to make visible the importance of taking care of our vaginal microbiota!

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