Updated: Feb 13
Vaginal health is absolutely crucial to our comfort, our overall health and our self-confidence.
Hormones have a strong role in vaginal health, so there are many phases in a woman's life that are more vulnerable to vaginal health issues: pregnancy (or preventing it!), breastfeeding, perimenopause, menopause... and any times of increased stress or ill health.
In short, the vagina needs all the support we can give it.
How to Live Like You Love Your Vagina
Our microbiomes are heavily influenced by our daily lives. It's logical, then, that there are daily habits that can either support or stress our vaginal microbiome.
This article will discuss a range of daily influences that might be used to better support the microbiome to maintain vaginal health. The topics include:
Lifestyle strategies are a wonderful way to support a healthy microbiome and reduce the incidence of problems arising. They can also be used in combination with other treatments to manage an issue if one has occurred.
Eating For Health and Vaginas
The media would like us to think dietary facts are easily tested and highly reliable. They are not.
There are too many variables in diets and in the humans consuming them.
Some of our most-quoted diet data comes from very old studies that put entire populations of mental asylums on the tested diet. It was a convenient way to control some of the variables – and eliminate the annoying problem of finding actual willing volunteers.
Am I confident that I metabolise foods exactly the same way as a man who might be twice or half my size, who was probably on a cocktail of medications?
When it comes to vaginal health and we add in more variables - menstrual cycle stage, age, hygiene habits, pregnancy, and more – studies are difficult to control and funding is hard to come by. Regardless, Googling ‘vagina diet’ will call up no end of articles promising 8 or 10 or 15 foods that will make your vagina happy.
I think it’s safe to say that eating well makes for whole-body health, which of course contributes to vaginal health.
The eating style that currently has the most scientific backing for general health involves a high proportion of plant-based foods: fruits and vegetables, whole grains, legumes and nuts. Science also finds in favour of including quality proteins and oils.
The idea is that we will have little room left for highly processed foods!
Can we be any more specific with regard to vaginal health?
Studies have observed that low levels of Vitamin D, iron or protein appear to contribute to vaginal microbiome imbalances. So it may be worth looking at your eating habits with those targets in mind.
It's well researched that high sugar intake enhances growth of yeast cells, and we know yeast cells are very unpleasant when they overgrow in the vagina – Australians call it Thrush, Americans call it Yeast Infection, and scientists call it Vaginal Candidiasis.
Yeast cells eat simple sugars, but consider this: putting chocolate cake in your mouth does not cause sugar to appear in your vagina. The main source in the vagina is the glycogen produced in processes involving estrogen - the more estrogen in the system, the more likely you are to have higher glycogen levels in the vagina.
However, vaginal yeast overgrowth is almost always associated with gut yeast overgrowth. So reduced sugar consumption may reduce yeast in the gut, cutting off the home base of yeast overgrowth before the yeast sets up an outpost in the vagina.
High sugar consumption has also been found to promote yeast’s ability to produce a kind of glue that helps it stick to surfaces, and we don’t want to help yeast with the ability to literally stick around.
This is not evidence that we should “quit sugar” for vaginal health, but it does suggest that a moderate intake is healthier than a high intake.
(PS Don't put sugary foods in your vagina. Apparently people did this after watching 50 Shades of Grey. They got 50 Shades of Thrush.)
The Ins and Outs of Contraception
The Oral Contraceptive Pill contains estrogen, and this has an effect on the environment in the vagina. Higher estrogen levels means more glycogen available for microbes who depend on it.
The results are quite logical:
Good: the pill results in glycogen production which increases Lactobacilli numbers and therefore reduces unwanted bacterial conditions.
Bad: the pill increases the risk of Thrush because the increased glycogen is also food for yeasts.
In other words, the results are logical and yet annoyingly inconclusive. Microbiome health is not going to be grounds for making a choice about the pill.
Intra-uterine systems: the Mirena implant and the copper IUD have both been found to reduce numbers of our good Lactobacilli bacteria. This doesn’t mean they actually cause infections, but may make some people more susceptible.
The Mirena and similar implants are the first line, preferred method of managing many cases of heavy menstrual bleeding. Don’t avoid the implant only because of the potential microbiome effects, just be aware that making an effort to support the vaginal microbiome may be helpful.
Condoms have been found to protect Lactobacilli numbers. There are a few factors involved here, the most obvious being that condoms prevent the sharing of loads of microbes from one person to the next, which means the Lactobacilli aren’t reduced by going into battle against invaders.
A less obvious but quite powerful second factor relates to the presence of semen in the vagina – or no semen, if a condom is used. Semen has an alkaline pH (7 to 8) and alters the acidity of the vagina, reducing its natural protection. Keeping the semen out, therefore, protects the natural acidic environment that Lactobacilli thrive in.
Condoms often feature a layer of lubrication. This is usually a silicone compound: silicone doesn’t effect vaginal pH and hasn’t to date been found harmful to the vagina.
Spermicides added to condoms have been found to have significantly irritating effects, without adding any worthwhile benefit in terms of contraception. The World Health Organisation recommends avoiding condoms with added spermicide. (They did a tonne of research because of the huge volume of condoms supplied to developing nations.)
Dress for Vaginal Happiness
Cotton underwear is the go-to for keeping fresh, right? In fact there’s been very little research to prove this, but nor has anything been found to argue against it. So it seems reasonable to assume that since cotton is absorbent and breathable, it will be vagina-friendly.
This idea of breathability is supported by some research looking at using panty liners with waterproof backings. With these, it was found that there was an increase in humidity and also in pH – meaning the area outside the vagina became slightly less acidic.
The result of this change was an increase in aerobic bacteria – not the kind we want to encourage. However, the increase was external (not within the vaginal passage) and didn’t result in infections during the time of the study.
Panty liners are not alone in their ability to create humidity. Anything close-fitting and with poor breathability will do the same thing.
A study looking at use of nylon stockings found that they tripled the incidence of yeast infections.
Wearing loose clothing has been found, in tests, to reduce numbers of candida yeasts.
It seems that we can tolerate some change in breathability, but how long we can tolerate humidity for is likely to depend on the person and the bacteria they have in residence.
Bamboo fabrics have a great reputation for breathability and absorbancy. Bamboo fabrics are actually viscose, which is the same thing as rayon – something historically viewed as a man-made fibre. They are made from cellulose, usually wood pulp. (Note: viscose and rayon are not the same as nylon.)
Many claims have been made about bamboo being anti-bacterial, but our friendly bacteria are not in danger from bamboo. The antibacterial compound in living bamboo plants is not present once it's processed into fabric. (Another advertising myth never entirely dispelled by the truth arriving late.)
The anti-smell factor of bamboo is mainly due to its ability to wick moisture away from skin, so humidity - and bacteria - doesn’t increase. Wicking away excess moisture and reducing the reproduction of external bacteria in our undies seems like a good deal.
At this stage it appears that bamboo is a healthy choice if you prefer it to cotton.
One final study result: G-string undies and liners don’t cause an increase in E.coli (rectal) bacteria in the vagina.
It seems a g-string is not a hiking trail for bacteria.
In summary, research to date suggests that vaginally healthy clothing choices include:
wearing loose clothing
wearing cotton or bamboo fabrics
reducing use of nylon stockings
limiting time spent in clothing that increases humidity around the perineum.
The Impact of Stress
Stress effects our health. Whether it’s physical or psychological, it’s an added load that our bodies must deal with.
Neurocience suggests that moderate stress is not such a bad thing – in fact, if everything is too easy we are liable to feel a bit aimless due to a lack of challenge in our lives! But for each person there is a balance, and sometimes life pushes a person past their balance point.
There has been tonnes of research into the effects of stress, but even so it might be surprising to hear that the relationship between stress and vaginal health has been put to scientific test.
A study of over three and a half thousand women specifically assessed their stress levels and their incidence of bacterial vaginosis.
Women who were under greater psychological stress were more likely to have bacterial vaginosis, and they were likely to get it more often.
This study did compensate for a number of the other variables that are likely to influence BV (such as sexual activity), so it seems the results are related directly to stress levels rather being because of the things we might do when we feel stressed.
Managing your vaginal microbiome might remove one stressor from your life. Lowering your stress levels might help manage your vaginal microbiome. Either way, stress management is highly recommended by all kinds of psychologists, neuroscientists, therapists and coaches.
What managing stress means to you is entirely up to you. It might mean saying no to some demands on your time, or it might mean saying yes to something that makes you happy or lets you spend time with good people. It might mean getting some fresh air and sunshine, or reading a good book, or having coffee with friends. Maybe it’s meditation, but maybe it’s rock-climbing or running. Maybe it’s just a deep breath when you really need one.
There is a reason for the many deep breathing techniques found in meditation, yoga, and other relaxation activities. Deep breathing stimulates the vagus nerve, and that does things like help settle our heart-rate and lower our blood pressure. It doesn’t cure everything under the sun like some online promotions would like to sell, but there is real science behind deep breathing assisting relaxation.
So… just take a breath.
It's good for your (vaginal) health.
Vagina-friendly Lifestyle in Summary
Eat a healthy varied diet, keeping up the protein, iron and Vit D - but avoiding sugar overload
Contraceptive pills and implants are likely to make the vagina more vulnerable
Condoms can be protective, but avoid added spermicides
Dress for air circulation and reduced humidity
Find stress management strategies that work for you
Check out the rest of the ongoing series on Vaginal Health HERE!
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