For women of reproductive age, achieving a successful pregnancy is dependent on the normal function of endocrine hormones – thyroid, adrenal glands and sex hormones – and the health of the reproductive tract environment. Having balanced sex hormones plays a pivotal role in promoting egg development, regulating cycles and maintaining fertility. Meanwhile, a healthy reproductive tract – which includes every part of a woman's reproductive organs from the vagina and cervix up to the fallopian tubes and ovaries – promotes successful embryo implantation and supports a full-term pregnancy. Keep reading below to learn about the vaginal microbiome, its role in the reproductive tract, and how your vaginal microbiota can impact fertility.
What is the Vaginal Microbiome?
If you’ve never heard of your vaginal microbiome or have no idea what it actually does, don’t worry - we’ve got you covered! Your body is home to trillions of tiny organisms called microbes. Microbes play an important role in our body by helping us digest food, fight off infections, bolster fertility and even protect a pregnancy. Your vaginal microbiome is a complex ecosystem of bacteria and fungi that lives in your vagina and plays a crucial role in your overall health.
The Vaginal Microbiome Changes Throughout Your Life
The composition of the vaginal microbiota is in constant flux and will vary throughout a woman's life. It is greatly impacted by hormonal shifts such as puberty, pregnancy, post-partum and menopause. During a woman's reproductive years, the hormones that dictate our menstrual cycles, such as oestrogen and progesterone, have a significant influence on the vaginal microbiome.
The levels of these hormones will directly affect components of the female genital tract and defensive barriers, including mucous (discharge) viscosity which changes throughout the month, endometrial thickness (the lining of the uterus which sheds each month during a period), immune cells and normal vaginal bacteria. When these hormones are out of sync, it can lead to an imbalance in our ‘good’ bacteria.
The Importance of the “Right” Bacteria
The vaginal ecosystem has its own very distinct bacterial microbiome. The composition of this is extremely important to our overall health and often gets overlooked when it comes to fertility. Dysbiosis – an imbalance of healthy bacteria – within the vaginal microbiome can play an integral role in infertility, frequent miscarriage, endometriosis, pre-term birth, frequent urinary tract infections, and bacterial vaginosis. Understanding if your microbiome is healthy is important, especially if you are struggling to conceive.
What Makes Up a Healthy Microbiome?
A healthy ecosystem is mainly dominated by a bacteria called Lactobacillus, which feeds off glycogen (essentially a natural sugar food source) produced by vaginal wall cells. This then produces lactic acid, which creates a low pH environment that enables beneficial bacteria to thrive, limiting pathogenic strains, (bacteria which can cause infertility, from becoming dominant.
IMPORTANT FACT! Up to 30% of women who are struggling with fertility have links to pathogenic bacteria in their vaginal tract.
Having a healthy balance of bacteria in the endometrium is fundamental for successful implantation, and low levels can reduce chances of conception. There are several easy ways to take care of your vaginal microbiome including drinking plenty of water, wearing cotton underwear, going to the bathroom after sex and avoiding wearing a wet bathing suit for too long.
What are the Benefits of a Healthy Microbiome?
- Enhances fertility
- Reduces antisperm immunity (an immune system that attacks sperm)
- Reduces the risk of sexually transmitted disease (STI’s)
- Protects against urinary tract infections (UTI’s)
- Protects against cervical cancer
Common Causes of Vaginal Imbalance
When you don’t have enough lactobacilli in your vaginal microbiome, various types of bacteria have the opportunity to grow and thrive – if this happens, it results in an imbalance called vaginal dysbiosis. Infections are a leading cause of vaginal dysbiosis and can cause unwanted symptoms like itching, burning, irritation or pain. Upper genital tract infections can affect areas of the reproductive tract, such as the endometrium, fallopian tubes, ovaries and pelvic cavity. Lower genital tract infections (vagina, vulva, cervix), most commonly caused by STIs, can increase the risk of pelvic inflammatory disease (PID).
The most common factors that can displace beneficial vaginal microbes include:
- Antibiotic use
- Excessive vaginal washing
- Hormonal shifts
- Multiple sexual partners
- Increased frequency of intercourse
- Use of a diaphragm
- Recurrent UTIs
- Candida (thrush)
- Bacterial Vaginosis
- Group B Strep
How Do I Know If I Have an Imbalance?
To help determine if you have an imbalance in your vaginal microbiome, it might be helpful to look at any symptoms you may have. Are you experiencing any itching or burning? Is there a fishy odor or change in discharge smell or color? While you may experience symptoms from an imbalance, it is worth noting that not all bacterial imbalances will have obvious symptoms. As a nutritionist, we encourage our fertility clients to do a comprehensive vaginal microbiome swab test to check all the levels of good and bad bacteria in the vaginal tract. Some ‘bad’ bacteria in the vagina can prevent sperm from reaching the egg and overgrowth of pathogenic strains of bacteria such as E-Coli may lead to urinary tract infections which can cause infertility.
Improving Your Vaginal Microbiome Balance
Your vaginal microbiome is dynamic and changes over time. Its balance can be affected by things like sex, sugar, changing hormones, pregnancy, and menopause. Depending on the exact balance and ph of your microbiome, a blend of nutritional support, natural supplements, probiotics and ph balancing products can help to rebalance your bacteria levels.
It is also quite common that women who have gut issues (such as IBS) likely have an imbalance in their gut microbiome, which means they are more susceptible to UTIs and vagainal infections such as BV & thrush. For this reason, it is always important to work from the top down when looking at the other microbiomes in the body first (oral and gut) and rebalance those.
If you are experiencing any gut issues, I would highly recommend speaking to a nutritional therapist to rectify this at the same time. A comprehensive stool analysis may also be highly beneficial here too.
Understanding Your Vaginal Microbiome
If you have been struggling to conceive, it may be worth looking into your vaginal microbiome and pH levels. Sometimes, it’s just a case of treating an underlying infection, or rebalancing the microbiota via pre and probiotics through diet and supplementation.
Every woman’s microbiome is different and fortunately, there are many natural interventions which can be used to improve fertility. If you’re having trouble conceiving and want to know more about your vaginal microbiome, speak to your health practitioner.
About Gail Da Silva Madalena
Gail Da Silva Madalena is a registered nutritional therapist specializing in fertility, pregnancy and women’s health. Her expertise lies in hormonal imbalances, such as irregular cycles, debilitating PMS, PCOS, endometriosis, thyroid issues and sub-optimal fertility. Gail is the fertility and pregnancy specialist at The Natural Balance based in London