We already know how important the gut is for overall health, but researchers are starting to unveil how the gut plays a role in vaginal health as well.
Your gut flora is composed of a mix of billions of bacteria – some good, some bad – that coexist and play a vital role in a series of functions, like digestion, skin health, immune system functioning, and yes, even vaginal health.
The vaginal microbiome
The vaginal microbiome is still fairly mysterious, and researchers are only just starting to understand how it impacts our overall health.
A healthy vaginal microbiome has been linked to a lower risk of contracting STIs and pelvic inflammatory disease, a lower risk of developing certain gynae cancers, and even a lower risk of experiencing miscarriage and preterm birth.
Similarly to the gut, your vagina is made up of millions of bacteria. “In health, the gut is rich in bacterial diversity, with thousands of species living in a harmonious state,” says Dr. Harriet Protheroe, a GP registrar with special interest in women's health.
While your gut and vagina will be composed of similar bacteria, so some species will overlap, the complete makeup is different. “The vagina is more selective,” explains Dr. Protheroe, “with high proportions of friendly Lactobacillus species observed in healthy vaginas and lower rates of bacterial diversity.”
A “healthy’ vagina is one brimming with lactobacilli, the “good” bacteria responsible for keeping infections like thrush and bacterial vaginosis (BV) at bay.
Lactobacilli serve a few functions in order to keep the vagina healthy, chiefly by producing lactic acid in order to lower the vaginal pH and keep it acidic (below 4.5).
Much like with the gut, from time to time your vaginal microbiome can be thrown out of whack. Both biological and external factors can throw a spanner in the works – anything from your period, unprotected sex, to medications and improper intimate hygiene can disrupt your vaginal microbiome.
When the vaginal environment becomes alkaline, the pH of the vagina rises and pathogens start to take over, initiating a vicious cycle that encourages more bad bacteria to colonise – this is known as “dysbiosis” (imbalance).
How are the gut and vagina linked?
Aside from being the MVPs of your vaginal microbiome, lactobacilli play an important role in gut health.
“Whilst lactobacilli make up the majority of bacterial species in the healthy vagina, they form a much smaller population within the bowel. Despite this, they have a big impact, maintaining balance and preventing overgrowth of ‘bad’ bacteria such as E.coli and Streptococcus,” says Dr. Protheroe.
On top of sharing lactobacilli, our bowels and vagina can actually communicate in a number of ways.
“The gut and vagina communicate directly due to the close proximity of the vagina to the anus allowing transposition of gut bacteria," says Dr. Protheroe.
"The gut may communicate with the vagina more indirectly via the ‘gut-vagina-axis’, whereby a healthy gut can reduce whole-body inflammation and help to promote a healthy vagina.”
Similarly, lower levels of lactobacilli in the gut can allow pathogens like E.coli and strep to colonise, and make their way to the vaginal canal, resulting in infection. So if gut dysbiosis can affect the vagina, does this mean people with gut disorders like IBS are more at risk of vaginal infections like BV?
“There is not enough reliable evidence to link IBS and BV just yet, but anecdotally, we see the same conditions crop up time and again in the same patients,” says Dr. Protheroe.
“It seems to be a particular problem of the perimenopause – perhaps suggesting the multifactorial nature of the problem and the interaction of microbiome and hormonal factors.”
So… can our diet affect vaginal health?
You’ve probably read online that eating certain foods rich in probiotics, like yogurt, can help prevent vaginal infections like thrush, and that’s probably because of the link between your gut and vagina.
Likewise, you may have been recommended to avoid certain foods during a bout of thrush, so does diet really influence your vaginal health? After all, we know a varied diet is key to maintaining a healthy gut microbiome…
“Candida albicans is a yeast that is found at many body sites without causing too many problems, however it has a penchant for the vagina, where we commonly know it as thrush,” explains Dr. Protheroe.
“Candida can run riot when there is vaginal dysbiosis. The anti-Candida diet involves cutting out sugar, carbs, yeast and alcohol in an attempt to stop feeding the Candidal source. This diet has not been demonstrated to prevent or treat thrush in healthy women. The origins of this diet may stem from the fact that diabetic women are more susceptible to Candidal infections, as the urine excreted is rich in glucose, providing the ideal environment for Candida to thrive.”
So no, that doughnut probably isn’t the reason you have thrush, but more research needs to be done on the link between diet and vaginal health.
What’s the deal with probiotics for vaginal health?
Given that dysbiosis is an unfavourable ratio of good to bad bacteria in the vagina, it would make sense that increasing the levels of good bacteria with a probiotic supplement may be beneficial.
But to do so, it’s important to consider the specific strain of lactobacilli. Most of the research conducted on probiotic supplementation for vaginal health has been done on the Lactobacillus species.
“There is high-quality evidence in support of the use of probiotics for IBS, so much so that the British Dietetic Association feels comfortable in recommending their use. There is a weaker evidence base for probiotics for vaginal health however recent meta-analyses have demonstrated the success of oral probiotics containing Lactobacilli in preventing recurrent BV and augmenting the treatment of BV and thrush when combined with antibiotics.”
When taken orally, probiotic supplements need to survive the digestive tract, so they can reach the gut alive and migrate to the vagina, where they can colonise.
“Oral probiotics are suggested to work by ascending the vagina following passage from the rectum,” says Dr. Protheroe.
“Vaginal probiotics are inserted directly into the vagina and it is more feasible that the bacteria introduced are able to act locally.”*
Looking after your gut health could be beneficial for your vaginal health, and could be a good management tool especially for those who suffer from recurring BV or thrush, but we won’t know for sure why that is until more research is done on the topic.
For now, you can look after your vaginal health by staying clear of feminine hygiene soaps, practising safe sex, and (if you feel like it), supplementing with a good-quality probiotic supplement.
Daye ProViotics are freeze-dried and are proven to reach the gut alive. They can help you strenghten your gut health and will keep your vagina safe from infections.