Our vaginas are hosts to a microecosystem of billions of microbes which are referred to as the vaginal microbiome. 

When we are healthy this symbiotic relationship is beneficial to both us and our tiny friends. We, as generous hosts, provide a humid, nutritious, warm habitat and in return the microbes have an antimicrobial and anti-inflammatory effect and provide a first line of defense against infectious microorganisms. I guess we could think of it like a party. We are the generous hosts providing drinks and food to our friends such as Lactobacillus crispatus and we don't want the gate crashers turning up and ruining the fun.

The make up of this microbiome varies between individuals and although there is no definitive ‘normal microbiome’ there is good evidence that a predominance of particular strains of Lactobacilli (friends) are the hallmarks of a healthy microbiota*. One of the beneficial activities of the strains of Lactobacilli present in the vagina is the production of lactic acid and hydrogen peroxide resulting in vaginal acidification (low pH). This low pH is protective against other infection causing microbes (gatecrashers)**. 

When the vagina is healthy it should be free from itching and stinging, free from overpowering unpleasant odours, it should be comfortable, lubricated and supple, isn’t sore and has a clear mucus discharge (remember your discharge will change in consistency through your menstrual cycle so try and notice what is normal for you). 

If this delicate balance is disrupted it will result in an imbalance we refer to as dysbiosis and allows unwelcome bacteria and candidiasis to flourish resulting in infections that over 70% of women will experience at some point in their lives, thrush, BV (bacterial vaginosis) and UTI (urinary tract infections).

Unfortunately this delicate microbiome can be disrupted by a variety of factors including age, menstrual cycles, use of antibiotics and antifungals, stress, diabetes, sex, clothing, contraception, diet, menopause, smoking, hygiene products and lubricant use. 

So What Can We Do?

• Understanding the health of your vagina is key. If you are concerned you should discuss your symptoms with your GP, nurse practitioner or pharmacist, it is really important to rule out sexually transmitted infections, dermatological conditions or other gynaecological conditions.

• Check your hygiene practices! Never use douches and avoid scented and concentrated feminine hygiene products that will disrupt the microbiome. Unfortunately poor advertising and cultural pressure has caused many women to believe that their vaginas are unclean and this has perpetuated the use of unhealthy products***. We only sell and recommend external vulval washes that contain no irritating chemicals and are pH matched to the vulva. 

• Tight clothing, thongs and synthetic fabrics, that hold moisture close to the skin especially when exercising or hot can increase the risk of infections. Try wearing cotton underwear in the day and sleeping without underwear.

• If you are experiencing gynaecological changes around the menopause talk to your doctor or pharmacist about vaginal oestrogen. Many women find that the frequency of infections increases during perimenopause and menopause. This is because oestrogen plays an important role in maintaining the vaginal mucosa and vaginal lubrication. A drop in oestrogen and the resultant gynaecological changes results in a drop in lactobacillus and a rise in pH allowing unhealthy microorganisms to flourish.

• Try our daily, oral probiotic, Ultimate V. This is an award winning and patented blend of vaginal Lactobacillus strains that are scientifically proven to reach the vagina. It is important to understand that there are different strains of healthy bacteria and they may offer different functions within the body. Lactobacillus strains that are important in skin or gut health will be different to strains that predominate in a healthy vaginal microbiota. Ultimate V contains 4 Lactobacillus key to a healthy vaginal microbiome****:

Lactobacillus crispatus LBV88

Lactobacillus rhamnosus LBV96

Lactobacillus gasseri LBV150N

Lactobacillus jensenii LBV116

• Only use lubricants and vaginal moisturisers that are designed to be pH matched and osmotically matched to the vagina. Explore our range of vaginal lubricants and moisturisers here.

We know that your gynaecological health is often difficult to talk about, however if you are worried about any of your symptoms it is really important to discuss them with your GP. Don’t worry they are completely happy to talk about things you may find embarrassing. In most instances you will know when you have an infection; commonly you will notice a change to your comfort and there may be itchiness or pain. Thrush is often identified by a thick white discharge and itching; BV can cause pain and itchiness and a change to discharge but unhelpfully does not cause symptoms in over half of women but is important to identify as it is linked to Pelvic Inflammatory Disease. UTIs are associated with pain on urination and  urinary frequency and occasionally blood in your urine. It is also important to rule out sexually transmitted infections so visiting your local STI clinic or discussing this with your GP or nurse specialist, or getting an STI test from your pharmacy is as always, really important.

*The Female Vaginal Microbiome in Health and Bacterial Vaginosis. Xiaodi, Chen., Yune, Lu., Tao, Chen., Rongguo, Li.  Front Cell Infect Microbiol, 2021; 11: 631972 https://www.frontiersin.org/articles/10.3389/fcimb.2021.631972/full

**Lactobacilli and Their Probiotic Effects in the Vagina of Reproductive Age Women. Pendharkar. S., Skaffe-Holm. A., Simsek. G., Haahr. T. Microorganisms, 2023, 11(3), 636 https://www.mdpi.com/2076-2607/11/3/636

***The Vaginal Microbiome in Health and Disease - What Role Do Common Intimate Hygiene Practices Play. Holdcroft. A. M., Ireland. D.J., Payne. M.S. Microorganisms, 2023, 11(2), 298 https://www.mdpi.com/2076-2607/11/2/298

****Impact of Lactobacillus crispatus - containing oral and vaginal probiotics on vaginal health: a randomised double-blind placebo controlled clinical trial. Mandar. R. et al. Benef Microbes,  2023 Apr 18; 14(2): 143-152 https://pubmed.ncbi.nlm.nih.gov/36856121/