Understanding the Vaginal Microbiome and Fertility
In the last decade we have all become well aware of the gastrointestinal microbiome and its effects on our health. But the gut isn’t the only part of our body playing host to important microbes - our skin, mouths and even vaginas have their own unique microbiomes that play crucial roles in our health and wellbeing. The vaginal microbiome is particularly interesting because of its role in influencing fertility and reproductive health, and even influencing the future health of our babies. In this article, we’ll explore the composition of the vaginal microbiome, factors that disrupt it, its impact on fertility, and naturopathic approaches to restoring and maintaining health vaginal microflora balance.
What is the Vaginal Microbiome?
The vaginal microbiome is a dynamic ecosystem of bacteria, fungi, and other microorganisms that help maintain vaginal health. The exact balance of microbiota is unique to each person, but a healthy vaginal microbiome is dominated by Lactobacillus species. These bacteria produce lactic acid which helps to keep the vaginal pH low (around 3.8-4.5), preventing the overgrowth of harmful bacteria and pathogens.
Functions of a Healthy Vaginal Microbiome:
The vaginal microbiome performs several really important functions, including:
Prevention of infections: Lactobacillus spp. in the vagina secrete lactic acid, helping to maintain an acidic pH to prevent growth of harmful pathogens like Candida (thrush) and Gardnerella (BV)
Supports immune function: A balanced microbiome enhances immune defense mechanisms.
Impacts fertility and pregnancy: A balanced vaginal microbiome creates a favorable environment for conception and reduces the risk of pregnancy complications.
Factors That Disrupt Vaginal Microbiome Balance
There are many lifestyle and environmental factors that can disturb the delicate balance of the vaginal microbiome. Disruption to normal vaginal microbiota populations can lead to issues such as infections, irritation, and fertility issues. Some factors that can disrupt the vaginal microbiota include:
Antibiotic use (including oral antibiotics): Broad-spectrum antibiotics kill beneficial Lactobacillus bacteria, allowing opportunistic infections to take hold. This is particularly concerning because of how frequently broad-spectrum antibiotics are prescribed.
Hormonal fluctuations: Changes in oestrogen levels throughout the menstrual cycle can influence the vaginal microbiome, because oestrogen can influence the vaginal pH. This is part of the reason why opportunistic infections like thrush can become much more common during perimenopause, when oestrogen fluctuations become more significant and oestrogen declines overall
Soaps and harsh feminine hygiene products: These can disrupt pH and beneficial bacteria - never use soap to wash your vulva!
High sugar diet: Diets high in sugar can encourage the growth of harmful bacteria and yeast, leading to issues like thrush
Sexual activity: Unprotected sex, new sexual partners, or exposure to semen (which has an alkaline pH) can alter vaginal pH.
Stress: Chronic stress affects immune function and gut health, indirectly impacting vaginal microbiota.
How the Vaginal Microbiome Impacts Fertility
A healthy vaginal microbiome is crucial for fertility and reproductive success, and this is something that we may investigate and address as part of your fertility journey. Here’s some of the ways the vaginal microbiome might impact your fertility and chances of conception:
Sperm Viability: A healthy vaginal pH helps sperm survive and reach the egg. An imbalanced microbiome with high pH may reduce sperm motility.
Cervical Mucous Quality: Beneficial bacteria contribute to optimal cervical mucous consistency, which aids sperm movement.
Inflammation and Implantation: Microbial imbalances can cause chronic inflammation in the reproductive tract. This can affect embryo implantation.
Impact on Pregnancy Outcomes
Vaginal dysbiosis can also impact pregnancy outcomes, including:
Preterm Birth Risk: An imbalance in vaginal flora has been linked to preterm labour and low birth weight.
Infections During Pregnancy: BV and yeast infections increase the risk of pregnancy complications and preterm rupture of membranes.
Postpartum Recovery: A well-balanced microbiome supports vaginal healing after birth.
The vaginal microbiome also plays in important role in facilitating the initial colonisation of baby’s own microbiome during birth, which helps with early immune function.
Naturopathic Approaches to Supporting Vaginal Microbiome Health
A fertility naturopath uses holistic approaches to restore balance and enhance reproductive health by focusing on gut health, diet, lifestyle changes, and natural remedies. Below are just some of the ways we might address vaginal dysbiosis for fertility support.
Testing for Vaginal Microbiome Imbalances
If an imbalance in the vaginal microbiota is suspected, we may refer you for testing to identify the imbalance and so we can target treatments appropriately, and this is often an ideal starting point before we begin to make big changes to your diet or lifestyle. Possible tests include:
Vaginal pH testing
Comprehensive vaginal microbiome assessments
Stool testing to evaluate gut health (as gut imbalances often correlate with vaginal dysbiosis)
Increase Probiotic-Rich Foods
Probiotics help populate the vaginal and gut microbiomes with beneficial bacteria. Fermented foods such as sauerkraut, kimchi, miso, kefir, and yoghurt are all amazing options. When looking at yoghurt, be sure to choose options that don’t contain added sugars - a plain Greek yoghurt is ideal.
Prebiotic Foods to Feed Good Bacteria
Prebiotics are fibres that feed beneficial bacteria. We want to include plenty of these foods in our diet to ensure we are maintaining populations of healthy bacteria. Prebiotics can be found in a wide variety of foods, including garlic, onion, leeks, asparagus, apples, bananas, legumes, and whole grains.
Reduce Sugar and Processed Foods
High sugar intake encourages yeast overgrowth (Candida), which can contribute to infections and dysbiosis.
Herbs for Vaginal Microbiome Balance
There are some herbs that can be fantastic at restoring healthy vaginal microbiome, including garlic, calendula, echinacea, and chamomile. The right herbs for you will of course depend on your health history. Always speak to a herbalist or naturopath before starting any herbal medicines, particularly if you are pregnant or trying to become pregnant.
Choose Chemical-Free Feminine Products
Opt for organic cotton tampons and pads and avoid scented wipes and douches. Ideally, we would steer clear of plastics altogether when it comes to menstrual health. Cloth pads, period underwear, and reusable menstrual discs are all fantastic options. Never use anything scented on your vulva!
Manage Stress Levels
Chronic stress impacts immune and gut health, indirectly affecting vaginal microbiota. You can help to reduce the effects of stress by using practices such as meditation, deep breathing, gentle exercise (yoga and walking are both fantastic), and prioritising sleep.
Wear Breathable Underwear
Much of the underwear on the market right now are made with synthetic fibres, but these can worsen vaginal microbiota issues and worsen issues like thrush. Cotton underwear helps maintain proper airflow and prevents excessive moisture, reducing the risk of infections.
Restoring Microbial Balance with Probiotics
There are many options when it comes to utilising probiotics for improving vaginal microflora. The right pathway for you will depend on your individual presentation and symptoms. It’s also important to note that probiotics are just one part of the solution here. We also need to address the underlying causes that led to the imbalance in the first place, to ensure we are removing those factors and preventing a recurrence of issues down the track. Probiotics can be used either orally (to improve gut and vaginal microflora simultaneously) or we can use high-dose Lactobacillus suppositories to target the vaginal microbiome directly.
Let’s Work Together
If you’re experiencing recurrent infections, fertility struggles, or pregnancy-related concerns, working with a pregnancy naturopath can provide personalized support to optimize your vaginal and reproductive health. To learn more about how we can work together, book a free discovery call.
About the Author
Lizzie Stow is a clinical naturopath from Newcastle, Australia.
To find out more about Lizzie, click here.
Book an appointment with Lizzie here.