Published February 6, 2024 What’s a microbiome, anyways? Researchers at Harvard explain it as a bustling morning in New York City, full of people running to and from work or appointments. That’s essentially what’s going on inside your body, at all times. Trillions of teeny tiny microorganisms (also called microbes or microbiota) including bacteria, fungi, viruses, parasites and yeast coexist throughout your body, with the largest concentrations found in your gut. Your microbiome is sometimes referred to as an organ since it plays such a critical role in all of your body systems and overall health. Every one of us has a unique composition of microorganisms that was originally dictated by our genetic makeup, then influenced by our birth experience (c-section vs vaginal birth), if we were breastfed, where we live(d), our diet, any antibiotics we took, etc. While you’ll often hear the term microbiome used as an umbrella term to include all the microbes in your body, each body system, and even organ has its own microbiome. Just as your gut has particular species of bacteria and yeast, so does your vagina and urinary tract. We recently dove DEEP into the vaginal microbiome and how to keep it in check. Signs and symptoms your vaginal microbiome is off: Itching Redness Swelling Pain during sex Abnormal discharge (thin + gray, or thick and white) A foul, fishy odor Burning or pain when you pee Recurring infections What causes a vaginal microbiome imbalance? Gut issues – Simply put, what happens in the gut doesn’t always stay in the gut. When your gut microbiome gets imbalanced (from any number of the factors we listed earlier), pathogenic bacteria like E. coli can overflow and colonize your vagina. A study performed in 2022 showed that women with less diverse gut microbiomes struggled with recurrent UTIs. In particular, women who lack bacterial strains that produce butyrate (a short-chain fatty acid with anti-inflammatory properties) tend to get chronic UTIs (1). Pregnancy – As your pregnancy progresses, your vaginal tract undergoes a multitude of changes that can impact your vaginal microbiome including: hormonal fluctuations and altered vaginal mucous production. Additionally, studies show that pregnant women have significantly less diverse vaginal microbiomes with primarily Lactobacillus species (2). This is because Lactobacilli are protective against vaginal and urinary tract infections, which can be dangerous during pregnancy and can even cause preterm births (3). You might be thinking, wait, isn’t this a good thing? Don’t I want these beneficial Lactobacillus species? Yes! But once you deliver, your postpartum vaginal microbiome transitions back to a more diverse population of microbes. This change can cause vaginal infections as your body readjusts back to equilibrium. Antibiotics – Taking oral antibiotics can completely shift your vaginal microbiome as soon as ONE day after starting treatment (4). Wild. The standing scientific theory here is that antibiotics aren’t able to differentiate between “good” and “bad” bugs, so they end up wiping out both. This leaves your vaginal microbiome more susceptible to overgrowths of unwanted microbes like Candida (a type of yeast), especially if you’re not proactive about getting in your probiotics! Is there anything worse than taking antibiotics for one vaginal infection and winding up with a yeast infection?! Improper hygiene – We’ve said it before but we will say it again for the people in the back: Wear. Cotton. Underwear. Unlike synthetic fabrics, cotton is super absorbent so it’s able to mitigate excess moisture down there. The same goes for workout clothes – sweaty, synthetic yoga pants are breeding grounds for pathogenic bacteria. More importantly, many women fall into a harmful cycle of thoroughly washing their vaginas with a scented soap due to vaginal symptoms (often an embarrassing odor) only to develop more/worsened symptoms due to overwashing and a subsequent microbiome imbalance. If you want to freshen up, stick to warm water or pH balanced feminine washes and never (I repeat, never) wash inside your vagina! Sex – Be aware that unprotected sex with a new partner may throw your vaginal microbiome off big time, particularly by increasing the abundance of BV-causing bacteria like Gardnerella vaginalis (5). Another factor? Semen. Since it has a higher pH (7.2-8.0) than your vagina (3.8-4.5), semen can create an ideal environment for pathogenic microbes to flourish. It also contains its own bacteria that can get introduced to your vagina during unprotected sex. Some ways to have a microbiome-friendly sex life are: 1) practice safe sex 2) pee after sex 3) choose your lube and condoms wisely (more on this in a moment!) 4) treat any bacterial or fungal infections you or your partner might have, STAT! What are vaginal microbiome tests? You may have noticed the myriad of at-home vaginal microbiome test kits on the market these days – it really seems like they’re having a moment. These user-friendly kits help determine if you have any infections (like yeast infections and BV) or vaginal conditions that need to be addressed. While they’re certainly handy, there is currently no clinical evidence to support the use of at-home test kits’. Our suggestion? Until we test these systems out for ourselves or find research articles that demonstrate their accuracy, we think that leaving vaginal microbiome testing to doctors is your best bet. It’s also worth mentioning that you don’t have to wait until you have an infection to test! Many women find it fascinating and empowering to learn more about their vaginal microbiome so that they’re able to better support it. How to balance your vaginal flora Prevention is the best medicine! Avoid vaginal infections and UTIs with our top diet and lifestyle tips. Take a targeted vaginal probiotic – Most of us weren’t taught that our vaginas actually need specific probiotic species in order to maintain the correct pH level and, therefore, prevent infections. Taking a probiotic for gut health is a wonderful practice, but it’s probably not doing anything for your vaginal health. To combat invaders and keep your vaginal microbiome balanced, you’ll want to use a probiotic supplement that contains predominantly Lactobacillus species. Look for: L. rhamnosus, L. gasseri, L. reuteri, L. helveticus, L. crispatus and L. acidophilus. Add a vaginal health supplement into your routine – We combined vaginal-specific probiotic strains like L. gasseri, L. rhamnosus and L. reuteri with concentrated whole food cranberry in our unique vaginal formula, Flora V. This jack-of-all-trade supplement supports urinary tract health, maintains optimal pH levels, targets odor and keeps yeast in check. Be the first to snag a bottle! Keep an eye on your sugar intake – The pathogenic yeast and bacteria that cause UTIs, BV and yeast infections LOVE sugar. Additionally, sugar raises the pH of your urine, creating a more alkaline environment for bacteria to grow and infection to spread. So if you’re someone that tends to get vaginal infections easily (shout out to all our sensitive girlies), be aware of your refined sugar (and alcohol!) consumption. Choose your lube wisely – Women use lube for vaginal dryness during menopause, sex, and even gyno visits. Yet most lubes contain chemicals that are either bacteriostatic (they prevent bacterial growth) or bactericidal (they kill bacteria). This means that beneficial bacteria like our beloved Lactobacilli get caught in the crossfire. In particular, lubes containing chlorohexidine guloconate have been shown through in vitro research studies to reduce growth and recolonization of Lactobacillus species (6). In general, steer clear of parabens, chlorhexidine gluconate and nonoxynol-9 and opt for lubes with a pH of 3.8-4.5. We like Maude. Only wash with gentle soap or warm water – You may or may not know that your vagina is a self-cleaning organ that needs minimal intervention. Water really is the best cleanser, but if you want something a little extra just make sure it’s vagina-friendly so as to not disrupt your pH. Similarly, try to avoid scent in any product that comes remotely close to your vagina! Fragrances are often added to things like soaps, pads, tampons, lubes and vaginal sprays.