Your body is full of helpful bacteria, also known as flora, that keep everything in check. The same is true for your vagina. You may never have thought about your vaginal flora before if it’s never become imbalanced. However, you’d be an exception to the rule because most women will have to deal with an imbalance and its consequences at least once in their life. Here’s everything you never learned in sex education about vaginal flora, bacterial imbalances, and the surprising solution researchers are exploring to make women’s lives easier.
When “Bad” Bacteria Take Over
Healthy vaginal flora comprises many different microbes, but Lactobacillus bacteria are “good” bacteria that mainly populate it. The job of this bacteria is to protect the vagina and help keep the “bad” bacteria from invading the tissues. Unfortunately, problems arise when Lactobacillus bacteria fail to do so. That’s when you can find yourself with an uncomfortable and potentially difficult-to-treat infection.
Urinary Tract Infections
One common problem many women face as a result is Urinary Tract Infections (UTI). This type of infection targets the urinary tract, which consists of the kidneys, bladder, and urethra, and is caused mainly by two common bacteria: E. Coli or Staph. UTIs are usually a result of bacterial contamination via sex or lack of thorough cleaning, but some women are simply more prone anatomically. Many women with chronic or frequent UTIs also show a lack or imbalance of lactobacilli, which could be the source of the recurrent problem. Antibiotics are typically the first course of treatment for urinary tract infections.
Bacterial Vaginosis
Bacterial vaginosis (BV) is another common infection caused by the overgrowth of “bad” bacteria naturally found in the vagina. This overgrowth upsets the vagina’s natural balance, resulting in elevated pH and low lactobacilli. Bacterial vaginosis most often affects women in their reproductive years, but not always. It is often asymptomatic but can also come with a variety of unpleasant indicators. Bacterial vaginosis is typically treated with antibiotics in the form of oral medication or vaginal cream or gel.
Yeast Infections
Last but not least…. yeast infection. A vaginal yeast infection (also called vaginal candidiasis) happens when the fungus candida, which normally exists in the vagina in small amounts, grows out of control. Yeast infections are common, affecting up to 75% of women at least once during their lifetime. Yeast infections are typically treated using anti-fungal medications in the form of a vaginal cream or a medication that’s inserted vaginally (a suppository). For many women, over-the-counter options provide effective treatment, but prescription medication may be recommended in some cases..
Who’s the most likely to develop an infection?
Some people are more likely to develop these infections than others. For example, women are more prone than men to get UTIs because of their shorter urethras, which means bacteria don’t have to travel as far.
When it comes to bacterial vaginosis, you may be more likely to get it if you use menstrual cups for menstruation or an IUD for birth control, both of which can attract a thin layer of bacteria known as a biofilm. Cervical contact during sex may also increase the likelihood of BV. If you’ve had BV once, it’s likely to return. Unfortunately for those women who have taken antibiotics for BV, it can cause a subsequent yeast infection.
Hormones can also have a role in upsetting the balance of natural flora. For example, estrogen (or lack thereof) affects lactobacilli’s ability to colonize the vaginal walls. Therefore, particularly in menopause, low estrogen leads to low lactobacilli, leading to poorer vaginal health. In these cases, Bio-identical hormone therapy may be used to help restore lactobacilli and promote vaginal happiness.
Restoring the Balance
While antibiotics or anti-fungal medications are necessary in some cases, they are not always the only answer. As bacterial resistance and recurrent infections continue to be problematic, using probiotics is also becoming more common to help restore natural flora balance. In these cases, the lactobacillus capsule is inserted directly into the vagina.
It creates an environment for restoring “good” bacteria rather than the return of bacteria or fungus overgrowth that feeds recurrent infections.
These positive effects have been studied in groups using a probiotic instead of antibiotic treatment and those using it in addition to antibiotic treatment.
In one study of women with confirmed BV, the first group of women used the antibiotic metronidazole, while the second inserted a lactobacillus capsule vaginally. After 30 days, the antibiotic group showed a cure rate of 50%, while the probiotic group had a cure rate of 88%.
Clinical study comparing probiotic Lactobacillus GR-1 and RC-14 with metronidazole vaginal gel to treat symptomatic bacterial vaginosis. Anukam KC, Osazuwa E, Osemene GI, Ehigiagbe F, Bruce AW, Reid G. Microbes Infect. 2006 Oct; 8(12-13):2772-6.
In another study, both groups were given the antibiotic metronidazole. In addition, the first group inserted a placebo, while the second inserted a lactobacillus probiotic. After 30 days, the placebo group showed a cure rate of 70%, while the probiotic group had a cure rate of 100%.
Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Anukam K, Osazuwa E, Ahonkhai I, Ngwu M, Osemene G, Bruce AW, Reid G. Microbes Infect. 2006 May; 8(6):1450-4.
The studies mentioned above are only a couple of examples showing the benefits of adding probiotics for treating all three infections and how easily women can treat themselves with vaginal suppositories. Based on my professional experience and research, I believe using vaginal Lactobacillus, especially for those prone to recurring infections, promotes a positive vaginal environment and decreases infections.