Understanding Vaginal Dysbiosis
Vaginal Dysbiosis: What You Need to Know
Our vaginal microbiome plays a crucial role in overall vaginal health, but it's easy for things to fall out of balance. When that balance shifts, it's called vaginal dysbiosis, which can lead to a range of symptoms affecting not only vaginal health but also general wellbeing.
What is Vaginal Dysbiosis?
Vaginal dysbiosis refers to an imbalance in the vaginal microbiome, which is composed of different types of bacteria. In a healthy state, Lactobacillus species dominate, helping to maintain a protective vaginal pH. When this balance is disrupted and Lactobacillus levels decrease, conditions such as Bacterial Vaginosis (BV), Vulvovaginal Candidiasis (Thrush), and Aerobic Vaginitis (AV) can occur.
Common Conditions Linked to Dysbiosis:
Bacterial Vaginosis (BV):
Symptoms: Thin, grey-white, often "gushy" discharge with a distinct fishy smell, especially noticeable after intercourse.
pH: Vaginal pH is typically above 4.5, indicating a less acidic environment.
Microbiome Changes: A decrease in protective Lactobacilli with an overgrowth of anaerobic bacteria like Gardnerella vaginalis and Prevotella.
Vulvovaginal Candidiasis (VVC) (Thrush):
Symptoms: Thick, curd-like white discharge (sometimes yellow or green), often accompanied by itching, redness, and irritation.
pH: Vaginal pH usually remains normal (3.6-4.5) but may rise slightly if there’s a mixed infection.
Microbiome Changes: Overgrowth of Candida species, leading to fungal dysbiosis.
Risk factors: Antibiotic use and pregnancy.
Aerobic Vaginitis (AV):
Symptoms: Dryness, itchiness, pain, and a white to yellow discharge with a foul odour.
pH: Vaginal pH is elevated, typically between 4.5 and 7.
Microbiome Changes: Overgrowth of aerobic bacteria like Streptococcus and Escherichia coli.
The discomfort caused by itching, discharge, or odour is only part of the problem. Left untreated, vaginal dysbiosis can increase your risk of sexually transmitted infections (STIs) and affect fertility and pregnancy. For those planning a pregnancy, it's important to address this imbalance. Studies show that conditions like BV, even when asymptomatic, can increase the risk of preterm birth, miscarriage, and infections during pregnancy.
Do You Need to Test?
A basic swab, microscopy, or culture can provide helpful information, especially for identifying specific BV or Candida presentations. However, a full microbiome profile can offer a deeper understanding of your vaginal environment, which is especially useful when:
Symptoms are atypical: If your symptoms don’t fit clear patterns or haven’t responded to typical therapies, a microbiome test can provide clarity.
Resistant or Polymicrobial Infections: If resistant microbes or multiple pathogens are suspected, testing can identify the exact organisms involved, guiding more effective treatment.
Optimising Treatment: Understanding the balance of beneficial and harmful bacteria can help tailor treatments to increase Lactobacillus and decrease harmful pathobionts. It may also uncover resistant microbes that basic tests might miss.
It’s best to test when symptoms are active to get the most accurate results.
Holistic Treatment for Symptoms
A holistic approach considers not just external factors but also internal drivers, such as hormonal imbalances, stress, and immune system support. Intra-vaginal treatments, including creams, oils, rinses, pessaries, or intravaginal probiotics, may be used to soothe irritated tissues, promote healing, and restore microbial balance.
Herbal Remedies: Herbs can help target microbiome imbalances and support other aspects of health, such as stress or hormone regulation. Examples include:
Pomegranate: Restores microbial balance by reducing microbes and supports lactobacillus levels.
Garlic: Antimicrobial, useful for reducing pathogenic bacteria and fungi.
Calendula: Reduces anaerobic bacteria and Candida.
Green Tea: Supports Lactobacilli growth and reduces anaerobes.
Sea Buckthorn: Anti-inflammatory, supports Lactobacillus.
However, it’s important to avoid harsh or inappropriate treatments, which can worsen the condition. Always consult a healthcare professional to ensure the right approach.
Targeted Probiotics and Prebiotics: Strain-specific probiotics can be prescribed both orally and intravaginally to maintain a healthy pH, increase beneficial bacteria, and crowd out harmful microbes.
A holistic approach also includes addressing broader aspects of health:
Managing Stress
Regulating Blood Sugar and Metabolic Health
Balancing Oestrogen Levels
Supporting Immune Function
Reducing Inflammation
Tips for Maintaining a Healthy Vaginal Microbiome:
Maintaining that delicate balance doesn’t have to be difficult. A few small lifestyle changes can make a big difference:
Avoid Over Washing: It’s tempting to over-clean, but using anything more than water can disrupt your vagina’s natural balance. Less is more here!
Wear Breathable Fabrics: Choose natural, breathable fabrics like organic bamboo to keep moisture at bay. I’m a big fan of bamboo undies like those from Jaymes!
Watch Your Diet: Your gut and vaginal microbiomes are closely linked, so a balanced diet that supports gut health will help support vaginal health too.
Use pH-Friendly Lubricants: If you’re using lubricants, look for microbiome-friendly ones that won’t disrupt the natural pH. Some great brands include Bed Intentions and Yes!
Use barrier methods such as condoms when treating the dysbiosis
Next Steps for Treatment
Testing: We can assess your vaginal microbiome in detail to identify imbalances.
Identifying Underlying Issues: Whether due to recurring infections, hormonal imbalances, or stress, we’ll work together to find out what's disrupting your vaginal health.
Restoring Balance: Through tailored treatments, we’ll aim to restore a healthy vaginal microbiome.
Emotional Support: Addressing the emotional side of your condition is just as important as physical treatments.
If something feels off, don’t hesitate to reach out. I’m always here to help with testing, advice, and guidance.
