Healthy Vaginal Microbiome

Somebody has to talk about it and because it falls under my scope of studies I am going to be the person who shines the light on the topic. It’s such a big area of study there’s  Vaginal MicroBiome Consortium which leads research studies on 1000s of women around the world. So what exactly am I referring to?

Disclaimer- I am not a medical doctor, I am a graduate student of nutritional sciences who has extensively studied this topic and everything I am providing will be cited at the end of my blog post. I am not telling you to stop any medications but I am suggesting that OTC and Rx yeast infection medications as well as antibiotics for bacterial infections could be making them worse.

In a nutshell our body is controlled by diverse communities of bacteria which is our microbiome. When people think of microbiome they think of gut microbiome but we also have our mouth and our vaginal microbiome. Throughout our lives our vaginal microbiome actually changes but most importantly a healthy vaginal microbiome produces lactic acid which can prevent diseases and kill pathogens. When we disrupt the vaginal microbiome with medications, unprotected sex and poor diet we can cause an overgrowth of bad anaerobic bacteria and prevent the good bacteria (Lactobacilli) from growing. This can eventually building up a strong biofilm in the vaginal wall which is  resistant to medication and traditional Rx treatments. Infections may seem to be treated temporality but will often reoccur because the traditional antibiotic we are prescribed can not eradicate the anaerobic bacteria in the biofilms.  Simply put -the drugs being prescribed (antibiotics) are actually causing the biofilms to develop and preventing infection from ever going away.  One of my favorite studies on this can be found here  So let’s talk more about this and how we can work to keep a healthy vaginal microbiome as well as treat some infections at home with a simple homeopathic treatment.

Bacterial Vaginosis (BV) is the most common vaginal infection found in women worldwide.  It is associated with many serious problems such as preterm delivery and acquisition or transmission of STDS and problems with fertility . When BV is a present vaginal biofilm develops which serves as a breeding ground and safe house for Gardnerella vaginalis  – the bad bacteria which forms during BV which kill or prevent the growth of Lactobacilli (healthy bacteria) . This creates an unhealthy PH and constant cycle of BV in many women.²  Taking antibiotics to treat BV is feeding the biofilm rather than killing the G.Vaginalis . Because the vagina is anaerobic  it creates an ideal environments for G. Vaginalis and other anaerobes to develop and live. (3,4)

Yeast is very similar as are Urinary Tract infections (UTIs) evidence shows that they are all affected by lactobacilli and pathogens. (5,6)

Some things to consider when trying to avoid BV- BV is not a STD however it can develop after sexual intercourse as well as digital and oral sex. (7)  If you think about it, the mouth has more bacteria than any other part of the body so it makes sense. Lubricants are full of chemicals which can also breed bacteria as well as unwashed hands. It’s always best to use a condom to avoid BV, make sure hands are washed well and (I know this sucks) avoid having oral sex performed on you if you are at a stage where you have recurring issues. If you aren’t using a condom and you have one sexual partner I would also consider avoiding oral sex on him then having vaginal sex because your mouth is just as full of microbes as his. (I never said my advice was an ideal situation but sometimes we must sacrifice to gain an healthy microbiome)

Interesting random fact I found while doing some research- African American women are twice as likely as women of European descent to get bacterial infections & have premature births because women of European descent can breed more Lactobacilli. ¹

Ok now that you killed my sex life while trying to kill bad bacteria what can I do to get a healthy vaginal microbiome? 

Natural remedies include probiotics however oral probiotics don’t go directly to the source and the capsule on probiotics is made to survive stomach acid so it can dissolve in your gut which means it will have a hard time dissolving in the PH of your vagina so you have to open up the pill and get the probiotics out to insert vaginally. I’m open to suggestion on other ways to do this but after some research as reading I have found that the safest most efficient way is to take the powder of the probiotic and mix it with a small amount of ORGANIC virgin coconut oil. It is very important that you use organic coconut oil to ensure it was not treated with harsh chemicals. The Lauric Acid in coconut oil has been studied extensively in treating bacterial, fungal and viral infections(8,9)

Clinical trials are currently underway and studies have been published using coconut oil as a delivery system for vaginal medication to treat candida (yeast) (10) And many studies and clinical trials have been done using vaginal delivery of probiotics for treating BV (11,12). I know there are a ton of blogs and non credible articles online which say coconut oil can be bad for yeast infections but the truth is organic virgin coconut oil is safe. There have been many studies using coconut oil as a transport system for vaginal candida treatments. If you read a blog or article always look for citations which lead to scientific studies to back up the evidence they are stating. You will see mine at the bottom of this post. Hopefully one day soon we will have an actual product which can be purchased to treat Yeast and/or BV which is purely probiotics and an alternative to the OTC and prescription medications we are offered now. Until then here’s my simple suggestion:

1 probiotic pill (women’s health or women’s probiotic with lactobacillus) . Small dollop of coconut oil,  open pill to empty out powder into a bowl & mix with coconut oil  to create an emulsion.  You can make it into a small ball or lay it out flat. Place in freezer for a couple minutes until hardened. Once hard insert into vagina with clean hands. Keep in mind coconut oil will quickly become liquid at 76°F so it WILL run out of your body if you are standing or moving around. I highly suggest doing this at night and laying down. I have no other solution to prevent this so for now it’s the best I can offer. I’m open to suggestions, I’m not a compounding pharmacist just a grad student of nutritional sciences. 

How often do you need to do this? Studies using vaginal probiotics were done for 5 days, I would suggest 2 nights, see how you feel. You have to play around with this for yourself. It also would depend on if you are being preventative, treating an infection or trying to kill off a biofilm which has developed in your vaginal walls.

In addition to this regime I highly suggest you look at your diet. If candida is an issue and you have recurring yeast infections I suggest you eliminate alcohol, sugar and processed carbohydrates (including dairy) while increasing your pre & probiotic foods for at least a week to see if this helps. The Candida Diet is a strict protocol which eliminates all sugar containing food products but a lifestyle change of less sugar, alcohol and refined grains can help balance the yeast in your body.

Something to keep in mind if you use coconut oil as lubricant during sexual activities is that it can break latex condoms or affect latex toys. Non polar solvents degrade latex . If you follow my social media you may remember a few months back I found out MCT oil dissolves styrofoam when it melted a cup of hot coffee in my hands. It’s the same concept here!

I hope this helped you understand what is occurring in your body during the cycle of recurring yeast or bacteria infections and clarified some of the other blogs out there which have conflicting information without any citations. If you do understand how you read research I highly recommend checking out some of the sources listed below and reading more about this for yourself.  One of my favorite recent clinical trials . We are at the beginning stages of understanding the most complex part of the human body- the microbiome!

 

 

 

1. Fettweis JM et al. Differences in vaginal microbiome in African American women versus women of European ancestry    Microbiology. 2014 Oct;160(Pt 10):2272-82. doi: 10.1099/mic.0.081034-0. Epub 2014 Jul 29.

2. Hardy, Liselotte et al. “The Presence of the Putative Gardnerella VaginalisSialidase A Gene in Vaginal Specimens Is Associated with Bacterial Vaginosis Biofilm.” Ed. Caroline Mitchell. PLoS ONE 12.2 (2017): e0172522. PMC. Web. 27 Oct. 2017.

3. Machado A  Cerca N Influence of Biofilm Formation by Gardnerella vaginalis and Other Anaerobes on Bacterial Vaginosis.  J Infect Dis. 2015 Dec 15;212(12):1856-61. doi: 10.1093/infdis/jiv338. Epub 2015 Jun 16.
4. PATTERSON JL, GIRERD PH, KARJANE NW, JEFFERSON KK. Effect of biofilm phenotype on resistance of Gardnerella vaginalis to hydrogen peroxide and lactic acid. American journal of obstetrics and gynecology. 2007;197(2):170.e1-170.e7. doi:10.1016/j.ajog.2007.02.027.
5. Reid G, Cook RL, Bruce AW. Examination of strains of lactobacilli for properties that may influence bacterial interference in the urinary tract. The Journal of Urology. 1987;138(2):330–335.
6. Shalev E, Battino S, Weiner E, Colodner R, Keness Y. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Archives of Family Medicine. 1996;5(10):593–596.
7.  Fethers KA, Fairley CK, Morton A, et al. Early sexual experiences and risk factors for bacterial vaginosis. J Infect Dis. 2009;200:1662–70
8. Sado-Kamdem SL, Vannini L, Guerzoni ME. Effect of α-linolenic, capric and lauric acid on the fatty acid biosynthesis in Staphylococcus aureus . International Journal of Food Microbiology. 2009;129(3):288–294.
9. Khoramnia A, Ebrahimpour A, Ghanbari R, Ajdari Z, Lai O-M. Improvement of Medium Chain Fatty Acid Content and Antimicrobial Activity of Coconut Oil via Solid-State Fermentation Using a Malaysian Geotrichum candidum . BioMed Research International. 2013;2013:954542. doi:10.1155/2013/954542.
10. https://www.ncbi.nlm.nih.gov/pubmed/24503350
11. Mastromarino P¹, Vitali B, Mosca L. Bacterial vaginosis: a review on clinical trials with probiotics. New Microbiol. 2013 Jul;36(3):229-38. Epub 2013 Jun 30.
12. https://www.ncbi.nlm.nih.gov/pubmed/26142892