The vaginal microbiome refers to the community of microorganisms, including bacteria, fungi, viruses, and other microbes, that live in the vaginal environment. The composition and balance of these microbes are crucial for maintaining vaginal health and protecting against infections.
Factors That Affect the Vaginal Microbiome:
- Hormonal changes
- Antibiotics
- Sexual activity
- Personal hygiene practices
- Diet and lifestyle
Vaginal discomfort is one of the top reasons women seek healthcare, and more than 90% of these cases are linked to imbalances in the vaginal microbiome. These imbalances can lead to conditions like yeast infections, bacterial vaginosis (BV), cytolytic vaginosis (CV), aerobic vaginitis (AV), and more.
However, your vaginal microbiome impacts much more than just your vaginal health. An imbalance is also connected to issues like infertility, pregnancy complications, sexually transmitted infections (STIs), and potentially even cancer. So, why is it still such an enigma?
How does the vaginal microbiome work?
Microbiome research is a rapidly advancing field, but while scientists have studied the microbiomes of other parts of the body, such as the gut and skin, the vaginal microbiome hasn’t received the attention it truly deserves—largely due to the gender health gap. And that’s exactly why we’re here to change that!
Lactobacilli are the heroes of the vaginal microbiome, playing a vital role in maintaining the health and safety of your vagina. They protect it in several keyways:
- Maintain Low pH: They produce lactic acid, keeping the vaginal environment acidic (pH 3.8–4.5), which prevents harmful bacteria from thriving.
- Prevent Pathogen Overgrowth: By outcompeting harmful bacteria for space and nutrients, they help prevent infections like yeast infections and bacterial vaginosis.
- Produce Antimicrobial Substances: Lactobacilli produce hydrogen peroxide and other antimicrobial compounds that kill harmful pathogens.
- Form Protective Biofilms: They create a protective layer on the vaginal walls, making it harder for harmful microbes to adhere and cause infections.
- Regulate Immune Response: Lactobacilli help modulate the local immune system, boosting the body’s defenses against infections.
When there aren’t enough protective bacteria like Lactobacilli in the vaginal microbiome, harmful bacteria such as Gardnerella, E. coli, and Mycoplasma can overgrow, leading to vaginal dysbiosis. Vaginal dysbiosis refers to an imbalance in the vaginal microbiome.
This imbalance can result in infections like bacterial vaginosis, yeast infections, urinary tract infections (UTIs), and more, causing symptoms such as itching, burning, irritation, and abnormal vaginal discharge.
Vaginal infections and the microbiome
The most common form of vaginal dysbiosis is bacterial vaginosis (BV), which occurs when disruptive bacteria overgrow in the vaginal microbiome, often due to a depletion of Lactobacilli. This allows pathogenic bacteria to take over.
Each year, one in three women will experience BV, and up to 84% of cases are asymptomatic. BV disproportionately affects Black and Hispanic women, though research into the reasons for this disparity is limited.
However, BV is not the only type of vaginal dysbiosis—other infections such as yeast infections, aerobic vaginitis (AV), and cytolytic vaginosis (CV) also occur. These conditions often share similar, frustrating symptoms, including itching, abnormal discharge, and burning.
If you’re struggling with recurring vaginal infections, you’re not alone. Bacterial vaginosis is the most common cause of vaginal symptoms, and at any given time, 1 in 3 women are affected. Additionally, 1 in 3 women will have a urinary tract infection (UTI) by the time they’re 24, and half will experience one at some point. Even more concerning, 75% of women will have a yeast infection at least once in their lifetime. Despite vaginal discomfort being one of the top reasons women and people with vaginas seek healthcare in the U.S., misdiagnosis and recurrence rates remain high, with over 50% of cases experiencing either issue.
The impact of the vaginal microbiome on overall health:
- Immune System Function
A balanced vaginal microbiome supports the body’s immune defenses by regulating the local immune response. This helps protect against infections, such as bacterial vaginosis (BV), yeast infections, and sexually transmitted infections (STIs), by enhancing the body’s ability to fight off harmful microbes.
- Reproductive Health
An imbalanced vaginal microbiome, known as dysbiosis, is linked to infertility and pregnancy complications. It can affect conception, increase the risk of preterm birth, and contribute to conditions like pelvic inflammatory disease (PID), which can impact fertility.
- Urinary Health
The vaginal microbiome influences urinary tract health. Imbalances can increase the risk of urinary tract infections (UTIs), which are common, especially among women. The presence of certain bacteria in the vaginal microbiome can spread to the urinary tract, leading to infection.
- Mental Health and Well-being
Research is emerging on the connection between the vaginal microbiome and mental health. For instance, disruptions in the microbiome can affect overall hormone balance, potentially influencing conditions like anxiety, depression, and stress.
- Sexual Health
The state of the vaginal microbiome affects sexual health, as infections like BV or yeast infections can cause discomfort, itching, pain during intercourse, and an increased risk of acquiring sexually transmitted infections (STIs), including HIV.
- Risk of Cancer
Emerging research suggests that an imbalanced vaginal microbiome may be associated with an increased risk of certain cancers, such as cervical cancer. Harmful bacteria may alter the local immune environment, potentially making the body more susceptible to carcinogenic changes.
- Systemic Health Implications
Studies indicate that the vaginal microbiome may influence overall systemic health through its interaction with other microbiomes, such as the gut microbiome. An imbalanced vaginal microbiome can contribute to a broader microbial imbalance in the body, potentially affecting conditions like autoimmune diseases, diabetes, and obesity.
By learning the composition of your unique vaginal microbiome, you can uncover how to proactively support its protective function and take a proactive approach to your long-term health.
Not all vaginal microbiomes are the same
Just like blood types, research has found that most vaginal microbiomes fall into one of five main categories, known as “Community State Types” (CSTs).
The CST is determined by which microbes are most dominant in your microbiome, and studies have shown that different CSTs are associated with varying symptoms, infections, and health outcomes. The good news is that, unlike blood types, you can shift from one CST to another as your microbiome changes over time.
Want to know your vaginal microbiome CST?
While research on vaginal microbiome types is continuously evolving, testing can offer valuable insight into your unique microbial composition, both currently and as it changes over time with your lifestyle. Our team utilizes the latest data and advanced testing techniques to help you understand what your microbiome type means for your health and provide guidance on how to improve it.