This blog was updated on 08/30/2023
We already know all about the importance of good gut health, and how to maintain it — advice around keeping a healthy gut seems to be everywhere these days. And no, it’s not just because of the astronomical rise in the popularity of kombucha.
Researchers, like the US-based gastroenterologist Dr. Liz Cruz, are starting to uncover how the gut plays a role in vaginal health, too. Your gut flora is made up of billions of bacteria — some good, some bad — that coexist and play a crucial role in a series of functions, like immune system functioning, digestion, skin health, and yes, even your overall vaginal health.
As Dr. Cruz says, “Your health begins with the gut. It affects every part of you.” This can include your vagina. So, what can you do to maintain a healthy vagina?
What is vaginal flora?
Your vaginal flora, otherwise known as your vaginal microbiome, is still pretty mysterious, and researchers are only just beginning to understand how these trillions of microbes impact our overall health and wellbeing. But ultimately, a healthy, balanced vaginal microbiome is extremely important for your intimate — and overall — wellbeing.
Your vaginal flora affects everything from your ability to fight off infections to your likelihood of getting pregnant and even developing certain gynae cancers. It’s also been linked to a lower risk of contracting STDs and pelvic inflammatory disease, and a lower risk of experiencing a miscarriage and preterm birth.
So yeah, this microbiome is a pretty big deal. Like the gut, your vagina is composed of millions of bacteria. “In health, the gut is rich in bacterial diversity, with thousands of species living in a harmonious state,” says Dr. Harrier Protheroe, a GP registrar with a particular interest in women’s health.
While gut bacteria and vagina bacteria will have microbes that overlap, the complete flora makeup is different. “The vagina is more selective,” says Dr. Protheroe, “with high proportions of friendly Lactobacillus species observed in healthy vaginas and lower rates of bacterial diversity.”
A healthy vagina is full of lactobacilli, which is the ‘good’ bacteria needed to keep infections like thrush and bacterial vaginosis far from your lady bits. They’re basically the bodyguard of your vaginal microbiome, and this is done primarily by producing lactic acid and lowering the vaginal pH to acidic levels.
Here’s a fun fact: The pH balance of a healthy vagina is around 4.5, which is around the same as tomatoes, beer, and wine!
What happens when you have a vaginal flora imbalance?
Like the gut, sometimes your vaginal microbiome can get a bit topsy-turvy. There are a number of biological and external factors that can throw your microbes out of whack — anything from unprotected sex and your period, to high-sugar diets, medications, and improper intimate hygiene.
As well as sharing lactobacilli, our gut (plus bowels) and vagina can communicate in a few different ways. Due to close proximity allowing transposition of gut bacteria, the gut and vagina communicate directly. There’s also the ‘gut-vagina-axis’, whereby a healthy guy can reduce whole-body inflammation and help to promote overall vaginal health — which is why maintaining balance and preventing overgrowth of bacteria is especially important.
When things get a bit unbalanced, pathogens start to take over — this can start a vicious cycle that encourages bad bacteria to colonize. This ‘bad bacteria’ growth can lead to:
Negative intergenerational consequences
Bacterial vaginosis (BV)
Yeast infections, otherwise known as thrush
Frequent urinary tract infections (UTIs)
Your overall health can affect your normal vagina flora, and while it’s not unusual for this to happen occasionally, especially when your immune system is weakened by a cold or other illness, good intimate hygiene will promote healthy vaginal microbiome.
How to keep your vagina clean
The vagina is an extremely sensitive area and even the smallest of changes can cause imbalances, including how you choose to clean your vagina. For starters, did you know that the vagina is self-cleaning? That means you don’t need strongly perfumed body washes to clean your vagina properly.
Using strong soaps and fragranced products can actually disrupt your normal vagina flora and PH levels and cause ongoing issues such as thrush. This cycle is likely to continue. Instead, you should simply use water or scent-free, dermatologist-tested, and hypoallergenic products.
How to wash your vulva
Maintaining good bacteria in your vagina requires proper hygiene, without over-washing your intimate area. To keep your vulva clean, here’s a simple routine to follow:
In the shower, use warm water or a small amount of plain soap to clean your vulva.
Using your hand or a washcloth, gently clean around the folds and the area between your vagina and anus — this should be done front to back to prevent bacteria from spreading to the vagina.
When you get out of the shower, gently pat the area dry with a clean towel (don’t rub too hard).
Changes for a healthy vaginal microbiome
There are a number of fairly straightforward changes you can incorporate into your routine to protect your vaginal flora and ensure you keep it in balance. For example:
Add probiotics into your diet
In case you need another reason to stock up on greek yogurt and kombucha, eating or drinking probiotics that bring up lactobacillus are good for both normal vaginal flora and gut flora. Ultimately, they’re healthy bacterias that evolve with us. One study found that the vaginal microbiome in women with bacterial vaginosis (BV) was restored after 2 months of daily intake of two clinically-proven strains of probiotic.
Wear breathable underwear
Cotton underwear is breathable and absorbent, and not to mention often a lot more comfortable! When your vagina can’t breathe, this may encourage heat and moisture to become trapped, which can increase the risk of yeast infections — a common problem with undergarments made of some synthetic materials. Stick to cotton and your vagina will be much happier, especially in the summer months.
Douching has long been thought of as one of the primary causes of vaginal flora imbalance, but overwashing in any way can take its toll on your vagina’s health. Your parts are self-cleaning. They don’t need perfume, very sudsy soap, or anything else. When it comes to intimate hygiene, stick to cleaning your vagina with water, or alternatively opt for scent-free, hypoallergenic products that come recommended by dermatologists.
Discover what works best for you
It’s all about biohacking. Just like with ‘hacking’ for overall health, vaginal wellbeing is all about finding what works best for you. Being able to understand (and track) what’s happening in your body over time is invaluable. The pelvic exam doesn’t simply act as a single test, but works well for women trying to self-experiment.
Does it help if I eat more yogurt? Would I benefit from only having sex at certain times? It’s all about understanding your own floral health and discovering what works and what doesn’t.
Of course, if you have any doubts or concerns, share them, and seek medical advice if necessary. We’ve said it once, we’ll say it again, but vaginas are mysterious (and complex!), so beginning to understand their intricacies from a professional will help.