Every woman wants a healthy vagina. Concerned that your vagina may be ”out-of-whack”?

There is a lot of talk about the importance of health and balance these days – and the vagina is no exception!What makes for a healthy vagina? When the vagina is comfortable and there are no symptoms of abnormal discharge, unpleasant odour, itching, dryness, irritation or discomfort, the vaginal environment is likely to be in balance. (By the way, there are six key areas to focus on to resolve vaginal dryness).

A healthy vagina contains high populations of good bacteria – mainly lactobacilli.

These are similar to the ‘’good bugs’’ present in a healthy digestive system, but may be slightly different species. Higher amounts of lactobacilli are associated with reduced dryness in menopausal women, and those with more diversity of species had more dryness. In women of menstruating age, there is a reduction of lactobacilli during the menstrual period.

The lactobacilli help maintain a protective acidic environment in a healthy vagina.

The higher the lactobacilli, the lower the other bacteria. Where there is more variety of bacteria, the pH is higher (that is, the vagina is less acidic). So, the vagina is a case where less variety is actually a good thing! Lower amounts of lactobacilli in the vagina increases the risk of both sexually-transmitted infections and bacterial vaginosis. This can be associated with miscarriage or premature rupture of membranes in pregnancy. An increase in the ‘’bad’’ bacteria is present in what has been recently called ‘’aerobic vaginitis’’, which is a state of inflammation in the vagina.

What helps promote these good bacteria? Firstly, good oestrogen levels. Oestrogen helps promote lactobacilli, which keep the vagina acidic and help to fend off harmful bacteria. Interesting though, oestrogen also promotes the growth of thrush, which is why it is common to increase during pregnancy and while on the Pill. The acidic environment does not therefore fully defend against thrush, but certain species of lactobacillus do help resist Candida albicans (thrush) colonisation.

Secondly, avoiding artificial hormones and implants helps promote normal healthy vaginal flora. The balance tends to shift with the use of not only the oral contraceptive Pill, but the IUD (intra-uterine device). Studies have shown an increase in the harmful bacteria in the vagina, which does not occur when using condoms for contraception.

Thirdly, the balance of gut flora has an influence on the vaginal flora. As the vagina and the anus are in such close proximity, the bowel flora tend to ‘’migrate’’ to the vagina. It is therefore important to have a good balance of gut flora by eating fermented foods and/or taking probiotic supplements, as well as avoiding unnecessary antibiotics. Stress depletes the good bugs within hours, so this is our fourth important factor – improving stress management!

So what do you do when your vaginal flora is ‘’out-of-whack’’?

It’s important to have a swab test with the GP if you have any symptoms of itching, irritation, change in discharge or pain with passing urine. There are also naturopathic treatment approaches for unbalanced vaginal flora, many of which have research studies to support them.

It is sometimes hard to know if your vaginal discharge is normal. This depends both on the general characteristics of the discharge, as well as how it might vary from what you’ve experienced previously. A few guidelines can help you work out if it is part of a healthy pattern of variation or not.

If you are concerned that you are out of balance from the vaginal perspective, make an appointment at Equilibria for tips on how to get this tested as well as possible treatment options.

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