Attention ladies out there, it’s time to talk about the world that is living within the bounds of your underwear lines. You might be thinking ‘oh, this is an uncomfortable subject’, and yes – it can totally be, but it is also extremely important when thinking about fertility, pregnancy and just our health in general!
What is the Vaginal Microbiome?
First of all, what on earth does “microbiome” mean? The word microbiome refers to a community of microbes which may include bacteria, viruses and fungi, that exists within and on our bodies, from your gut, to your skin, to breastmilk and yes, the vagina!
Now, moving on to the vaginal microbiome. Perhaps, you have read my blog on the gut microbiome, or have heard this term thrown around a fair bit. Essentially, our vaginal microbiome is the same thing and is COMPLETELY normal, where a community of microbes live from the cervix to the external anatomy of the vulva. The link between our microbiome and wellbeing is becoming more and more understood through research, and the vaginal microbiome is no exception.
The vaginal microbiome is a complex little ecosystem made up of more than 200 bacterial species. These species are unique, like a fingerprint, to each and every one of us, and may be influenced by:
- Fluctuates over your menstrual cycle
- Certain hygiene practices like using powders, deodorants or douching
- Sexual habits.
Several species of bacteria, one of which is Lactobacillus (yep, you probably heard about this one on the back of the yoghurt container), dominates the vagina and thrives in an acidic environment. This species of bacteria supports our ability to fight off infections, dysbiosis (some kind of imbalance of the microbiome), prevent sexually transmitted infections (STIs), maintain mucus production and help care for a healthy pregnancy and vaginal delivery (Mendling et al., 2016).
Does the Vaginal Microbiome Impact my Fertility?
Can this world down under affect your chances of successful conception?
Well perhaps, according to a recent pilot study which identified differences in the vaginal microbiome of women experiencing fertility and infertility – how fascinating! The study examined the microbiome in women with a history of infertility, undergoing IVF and those with a history of uncomplicated conception. The researchers found that women with infertility, more often had the bacteria Ureaplasma in the vagina, whereas fertile women did not (Wee et al., 2017).
The researchers would like to ultimately establish what is the best combination of microbes in the reproductive system, that would make fertility and pregnancy more likely to occur – watch this space!
Interestingly, the condition bacterial vaginosis (or BV) has also been shown to be higher in women experiencing tubal infertility, and we are not sure why or how it is impacting their chances of IVF success and avoiding an early pregnancy loss, but it is something to be mindful of (van Oostrum, et al., 2013).
BV refers to any imbalance in the vaginal microbiome creating symptoms which may include a foul-smelling “fishy” odour downstairs, vaginal itching, burning during urination (easily mistaken for a urinary tract infection, and sometimes you could be completely asymptomatic. If you think this may apply to you, don’t be embarrassed, go and get swabbed with your GP to screen for BV and ensure appropriate treatment so it isn’t affecting your chances of conception success.
Does the Vaginal Microbiome Impact my Pregnancy?
Of course, the vagina is the first external surface a vaginally-delivered baby comes into contact with when entering the world, so it seems obvious that it is pretty important in getting your baby’s personal microbiome off to the best start! This includes their gut microbes which we continue to see play a large role in our long-term health including mental health too. Of course, unavoidable, or potentially life-saving C-section deliveries, babies are in fact exposed to skin microbes rather than the vagina.
Women are now considering something called “Vaginal Seeding”, which includes applying vaginal fluids to the baby, especially their lips, after C-section delivery, to introduce these bacteria to them (Dunn et al., 2018). Chat to your doctor first to discuss whether this is right for you, as it is currently not common practice here in Australia and you need be screened for STIs and Group B Streptococcus to avoid causing more harm than good for your bub with vaginal seeding.
What About Vaginal Thrush (Candida)?
How could I possibly write a blog post on the vaginal microbiome without mentioning the dreaded thrush, right?
For those ladies who have experienced this condition know that it is a seriously uncomfortable condition, characterised by vaginal itching and cottage cheese-like discharge. This caused by the overgrowth of the otherwise normal fungus, Candida, when it multiplies, then we have a problem!
Well lucky for us (not!), pregnancy is a time where we are more susceptible to thrush, increasing from 20% when not pregnant to 30% when pregnant!
Risk factors for thrush include:
- Pregnancy – because of the reduced immune response during this time.
- Taking antibiotics.
- Stress and lack of sleep.
- Vaginal deodorants, powders and douching – which is not necessary! The vagina is a self-cleaning system, put the products DOWN!
- Hot weather and synthetic underwear, leggings, stockings or tights.
- Taking the contraceptive pill (particularly a high oestrogen dose).
Just know that there are no evidence-based dietary strategies at this time for Candida or thrush, so before you start applying yoghurt to your vagina, see a medical professional for diagnosis and treatment.
So, What Can You Do?
Luckily for us, nutrition and what we eat can help! So, here are my 3 top tips to keeping your vaginal microbiome healthy!
- Incorporating foods rich in prebiotic fibre – firstly prebiotics are types of dietary fibre that feed our friendly bacteria, much like soil to plants – these foods are fruit, veg, legumes, beans, nuts and seeds.
- Incorporating foods rich in probiotics – these provide extra healthy bacteria to our gut microbiome, which may aid the vaginal microbiome composition. These are like the flowers or plants themselves in the garden, rather than just the soil – these foods include yoghurt, kefir and fermented foods (sauerkraut, kimchi and kombucha), some of which are not appropriate for pregnancy, so get around your probiotic yoghurts, ladies!