What's my vaginal microbiome?
Every day, your vagina performs the equivalent of modern health miracles.
Every day, your vagina performs the equivalent of modern health miracles.
It can fight off infections, bolster fertility, protect a pregnancy, and possibly even defend against cancers.
The key to all of it? The complex ecosystem of bacteria & fungi known as the vaginal microbiome. It’s similar to the microbiomes that exist in your gut or on your skin, but when it comes to your vagina, the microbiome has been overlooked -- despite ample research showing its importance to overall female health. Evvy exists to change that.
Research has shown that most vaginal microbiomes fall into one of 5 general categories¹, sometimes called "Community State Types” (CSTs). While research on the types is evolving, they can be a helpful way to get a sense of the symptoms and health outcomes that may be associated with your results. You can read more about the types in our overview here.
Vaginal Microbiome 101
Given that the vagina is the structural connection between the outside world and some of our most important reproductive organs, the local microbiome has evolved to serve as a critical layer of protection against pathogens entering our bodies.
While there is a variety of bacteria and fungi that can exist in the vagina, Lactobacillus are the local heroes. Lactobacilli ensure that the vaginal environment is inhospitable for potential pathogens in a variety of ways:
- Producing lactic acid that helps keep the pH low and healthy (ideally between 3.8 and 4.5)
- Taking up space on the vaginal wall, preventing other pathogens from being able to thrive
- Producing bacteriocins, which further inhibit pathogens
- Keeping inflammation down in the genital tract
The DL on dysbiosis
When Lactobacilli are not present, pathogens can start to colonize the vaginal microbiome, which is referred to as dysbiosis. In a state of dysbiosis, there is a higher diversity of bacteria, which can allow disruptive microbes like Gardnerella, E.coli, or Ureaplasma to flourish. These bacteria can cause unwanted symptoms like itching, burning, irritation, or pain, as well as catalyze vaginal infections like bacterial vaginosis, yeast infections, and urinary tract infections (UTIs).
The most common vaginal infection is bacterial vaginosis (BV),which is defined by high bacterial diversity and an abundance of disruptive bacteria. Research shows that over 30% of women will have this condition every year, and up to 84% of these cases can be asymptomatic. You can read more about BV in our article here.
Dysbiosis of the vaginal microbiome can catalyze other types of infections as well, such as aerobic vaginitis, yeast infections, cytolytic vaginosis (CV), UTIs, all of which can have frustrating (and confusingly similar) side effects, such as itchiness, abnormal discharge, and burning.
One important thing to note: research shows that dysbiosis is more prevalent in Black and Hispanic women, but there is a disappointing lack of research explaining why that is or how we can change it. More broadly, it’s incredibly frustrating that research on this topic has not been more highly prioritized in medicine overall, given the prevalence of vaginal dysbiosis and its impact on our quality of life.
Considering the larger picture
To add to the many reasons the vaginal microbiome deserves more attention: on top of being the primary actor in the prevalent and often debilitating conditions listed above, recent research is starting to uncover groundbreaking insights on the vaginal microbiome’s critical role in female health far beyond the vagina.
When the vaginal microbiome is in an optimal state, it can do amazing things. It turns out that having protective bacteria like Lactobacillus in your vaginal microbiome can protect you from a variety of other potential health outcomes.
On the flip side, disruptive microbes can create a favorable environment for other infectious microorganisms, increase inflammation, and inhibit your immune response.
Research has shown that the composition of your vaginal microbiome is associated with your risk for the following conditions:
- STIs such as chlamydia, gonorrhea, trich, herpes, HPV, and HIV
- Pelvic inflammatory disease
- Fertility issues or failed IVF cycles
- Pregnancy complications such as miscarriage, preterm birth, neonatal problems, and preeclampsia
- Gynecological cancers such as ovarian, cervical, or endometrial cancer
- Toxic shock syndrome
An evolving ecosystem
While the vaginal microbiome is critically important to female health, it is also always changing. Unlike genetic results, which are static, microbiomes are dynamic and can reflect progression towards or away from disease. They can shift not only across years, but even from one week to the next.
There are multiple reasons that the vaginal microbiome changes over time. Your day to day behaviors -- such as trying new birth control, medications, supplements, sexual partners, smoking, or vaginal products -- can influence its composition. The vaginal microbiome is also affected by hormones, shifting when someone gets their first period, pregnancy, and menopause.
Given its dynamic nature, if your vaginal microbiome isn’t in an ideal state, it might be cause for consideration -- and possible care -- but not concern.
Decoding your vaginal defense
When it comes to the vaginal microbiome, knowledge is power. By keeping tabs on its composition, you can catch potential imbalances early, giving you the chance to proactively take action to promote the protective bacteria and prevent the disruptive bacteria from taking hold.
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