What IS A Vaginal Microbiome Anyway?

Most of you have probably heard about the gut microbiome (see Five Things That Mess With Your Microbiome) and how important it is in life. Your intestinal bacterial make-up not only predicts your general health and risk for disease, but more importantly what parties you get invited to, where you get into college and how many bad hair days you are likely to have while on a beach in Florida. That being said, it isn’t the ONLY microbiome in town.

Your body has MANY different microbiota (didn’t see THAT coming as the plural did ya?) Your vaginal microbiome will not be ignored. It is no longer the ugly stepsister. Your vaginal MB refers to the intricate balance of bacteria, yeast and viruses living there and is critical to keeping women healthy.

A healthy vaginal microbiome can….

  • Lower your risk of catching a sexually transmitted infection
  • Lower your risk of getting urinary tract infections, yeast infections and BV or bacterial vaginosis
  • Reduce your chances of getting HPV infections, cervical cancer and genital warts
  • Protect you from developing Pelvic Inflammatory Disease
  • Reduce your risk of infertility from tubal disease and increase your chances of a successful IVF cycle with embryo transplantation
  • Reduce risks of pregnancy complications including preterm delivery, post-partum endometritis (infection of the uterus after delivery)
  • Can impact the health of your baby during vaginal delivery, as this is one of the most important ways that a baby’s eventual gut microbiome develops and can certainly give your kid a leg up in the world regarding protection from allergies, autoimmune disease and asthma

What determines the health of your vaginal flora?

There are a number of things that can make or break the health of your vaginal ecosystem. Here are a few vagina enemies….

  • Antibiotics — They kill the good bacteria of your vagina and increase the chance that yeast will overgrow and take over. Don’t forget, it’s not just the overprescribed and mostly unnecessary prescription antibiotics you take, but the antibiotics that are fed to the livestock we end up consuming. Gross, I know.
  • Sugar Diet — There is nothing that yeast and pathogenic bacteria like better than sugar and processed foods.
  • Partner exposure — What is THEIR genital microbiome up to? This is sort of rhetorical, but nonetheless a good question.
  • Toxins that kill beneficial bugs — think pesticides in our food, chlorine and other pollutants in our drinking water, over the counter medications like NSAIDS, Tylenol, acid blockers, anti-depressants and anti-seizure medications to name a few.
  • Gut dysbiosis — If you’ve got your share of intestinal disturbances (colitis, IBS, heartburn, bloating, constipation, diarrhea, belching, bad breath, excessive flatulencd) you might have some unsavory characters in your gut that will definitely impact your vagina.
  • Alcohol — You know how you rub alcohol on a wound to kill off infection? Imagine what that is doing to your friendly neighborhood beneficial bacteria when you pound down a few at happy hour.
  • Metabolic syndrome or diabetes — This is related to sugar.
  • Fragrances and chemical exposures— What’s lurking in your fancy schmancy “parfums” and “hope in a jar” face creams? The devil. The devil is in your face cream.
  • Things that change your vaginal acid-base balance — Your vagina likes to be acidic. Like my wit. Anything that reduces vaginal acid spells trouble for your favorable bacteria. Menopause or any reason for loss of estrogen, exposure to semen and saliva, douching with god knows what chemicals and the aforementioned parfums, can all mess with your vaginal acid balance.

All of these things can diminish the GOOD guys and allow opportunistic BAD guys to take over.

What’s a vagina to do? Here’s a roadmap to a healthy vagina.

Balance Your Blood Sugar

Guess what LOVES to eat sugar? Well me, but that’s just a fun fact. Yeast, pathogenic bacteria, viruses — they LOVE to consume sweets.

Avoid sugar, refined carbs, alcohol and processed foods — what’s left to eat you say? Google “Paleo” and see what you find. It’s the standard issue of vegetables, healthy fats, fiber rich foods, healthy proteins, nuts, eggs and a bit of low sugar fruits.

Repopulate Your Vaginal Good Guys

Who are the good guys? The majority of your beneficial vaginal critters are part of the Lactobacillus family, specifically Lactobacillus reuteri, rhamnosus, and crispatus or were those character names from Game of Thrones? Hard to say.

Here are two probiotics I use because they are designed specifically for vaginas. Take 2 Orally and 1 Vaginally x 3 months if you are having problems with recurrent vaginal or bladder infections.


Proflora Women’s Probiotic by Integrative Therapeutics.

Make Way For Prebiotics

What IS that? It’s food for you beneficial bacteria in the form of fiber we can’t digest.

What do they eat you say? VARIETY. You can’t have a carrot and a pathetic piece of iceberg lettuce and expect that your vaginal bacteria will be happy. Would you be psyched if THAT’S what you got to eat day after day? Night after night? Week after week? Your vaginal buddies need variety people! Show your vagina some love.

Here’s a list of top prebiotic foods. Literally find vegetables you can’t name and eat them. Change it up and broaden your horizons.

Don’t douche and avoid applying fragrances.

Your vagina is self cleaning. Not unlike an oven except you don’t have to figure out how it works. Douching definitely disrupts the vaginal ecosystem. If you have ever read the ingredients in douches they are generally a list of crazy horrible unpronouncible chemicals. They can double the risk of getting vaginal infections.

Tip of the Day: Do not try to mask vaginal odor. If there is a funky odor going on down there, go to your gynecologist and get checked out. It’s a sign that all is not well.

Use organic pads and tampons. This will help you avoid internal exposure to fragrances, chemicals and bleach. Yes. I said BLEACH. Those WHITE tampons didn’t get that way naturally. Your vaginal tissue is highly absorptive so that stuff coating those scented tampons gets into your body AND they also harm the beneficial vaginal ecosystem.

A word about thongs.

Don’t shoot the messenger, but bacteria from your buttock region can use that thin tight rope to sachey it’s way into the vagina.  Just saying.

Heal Your Gut

This may take some doing depending on what is going on with you. There are 4 important components to a gut healing program:

Remove — Take out the bad. The inflammatory foods, drugs, alcohol, toxins, and infections like yeast, parasites or bad bacteria.

Repair — Start healing the inflammation and repair the gut lining. What does your gut need? Nutrients,

Replace — Bring back what you need to properly digest your food. You may need digestive enzymes, HCL stomach acid or bile acids.

Reinoculate — Bring back the good guys. This is about probiotics that travel through and help support your beneficial bacteria and prebiotics to nourish them.

Working with a functional practitioner may help you nail down the problems your little tum tum is having. You can’t JUST eat healthy if you have infections that need to be addressed. You can’t JUST take a probiotic and call it a day. A probiotic is not an all-knowing, all-powerful maker of magic. It’s part of an overall gut healing program. Find out what your body needs specifically.

What about your sexual partners and your sexual escapades?

Here are some quick facts you should know. Your partner has their own particular microbiome. It may not mesh with yours. Do they read the same books? Like the same movies? Share the same interests? These are important questions to pose.

  • Semen and saliva can change vaginal pH and effect your vagina. And not in the good way.
  • Lubricants can change your vaginal flora — try to find vaginal friendly options. Here’s one that may fit the bill. Olive oil and coconut oil are always helpful in a pinch. Hold the balsamic vinegar.
  • A new penis may not receive a friendly greeting. Methinks that statement stands alone, but I’ll go ahead and explain. Your vagina may mount an inflammatory response against the new bacteria that are hanging round the penis, putting you at risk for UTI’s, yeast and bacterial vaginosis infections. Condom use may be helpful here.
  • Oral sex can trigger bacterial infections due to whatever is going on with mouth pH. I mean, how am I allowed to say all this? Oh, that’s right, I’m a doctor.
  • Sex toys can cause recurrent bacterial infections depending on how they are cleaned, how they are used and the material of which they are made. The bottom line is ….. always keep a close eye on your sex toys and know where they’ve been – in fact, flea markets, garage sales and eBay are not where you should procure these devices. And don’t be afraid of soap.

You too can have a happy and healthy vagina by taking these steps to a happier and healthier you!!!

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For more information about my wellness programs and my practice, check out my website DrSadaty.comHey look! You are already here!!

Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendation, please contact your doctor to be sure any changes you wish to consider are safe for you!