How the Gut Microbiome Affects Your Vaginal Health

By Jessica Horwitz FNP-C
Chief Clinical Officer – Tia

The human body is home to trillions of microorganisms. And these microorganisms make up the human body microbiome. You can’t scroll instagram or even have dinner with friends without hearing about the microbiome. What exactly is it though? 

What is a Microbiome?

You can think of the microbiome as an invisible ecosystem that influences your health – and in some ways you can imagine it as a busy city inside your body, made up of trillions of tiny living organisms like bacteria, viruses, fungi, and other microbes. These little residents live in different parts of your body, especially in places like your gut, skin, mouth, and vagina.

Most of these microbes are friendly and do helpful things, like break down food in your stomach, produce vitamins, protect against harmful bugs, and support your immune system. They work together in harmony to keep you healthy, almost like a team of workers in a city, each with a specific job.

However, just like in a city, the balance of the microbiome is critical. If too many of the wrong types of microbes move in, or if the good ones decrease, it can cause problems, like infections or digestive issues. When this happens – the microbiome is considered “out of balance” or “dysbiotic.”

The gut microbiome is the most critical to overall health. And while much focus has been placed on the gut microbiome’s impact on digestion, immunity, and mental health, emerging research suggests that the gut microbiome may also play a significant role in vaginal health. 

Gut Composition and the Gut’s Influence on Vaginal Health

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How does the composition of the gut microbiome influence vaginal microbiota and overall vaginal health?

The gut microbiome and the vaginal microbiota are interconnected through a complex, bidirectional relationship known as the “gut-vaginal axis.” Both ecosystems are composed of diverse communities of microorganisms, and maintaining a balanced microbiome in the gut is crucial for the overall balance of the vaginal flora.

The gut and the vagina share similar types of microorganisms, including Lactobacillus species, which are essential for maintaining a healthy vaginal environment. In the gut, beneficial bacteria like Lactobacillus help maintain a healthy balance of microorganisms, prevent pathogenic overgrowth, and support immune function. This same protective role of Lactobacillus is evident in the vagina, where these bacteria dominate and produce lactic acid, keeping the vaginal pH acidic and preventing the growth of harmful bacteria.

When the gut microbiome is imbalanced, the vaginal flora can also become disrupted, potentially leading to an increased risk of infections.

The Gut and Bacterial Vaginosis and Yeast Infections

What role does imbalance in the gut microbiome play in conditions such as bacterial vaginosis or yeast infections?

An imbalanced gut microbiome, particularly when there is an overgrowth of pathogenic bacteria directly contributes to conditions like bacterial vaginosis (BV) and yeast infections.

Bacterial Vaginosis (BV) is a common cause of vaginal discomfort and abnormal vaginal discharge. It occurs when the normally protective Lactobacillus bacteria in the vagina are outnumbered by harmful bacteria, leading to an overgrowth of anaerobes like Gardnerella vaginalis. While BV is typically thought to originate in the vaginal microbiome, emerging research suggests that an imbalance in the gut microbiome can promote the development of BV. Studies have found that women with BV, especially recurrent BV, often exhibit an altered gut microbiota, characterized by lower diversity of bacteria and an overrepresentation of pro-inflammatory bacteria. These gut imbalances can influence the vaginal microbiome, increasing susceptibility to BV by disturbing the immune system and local vaginal pH.

Yeast infections, typically caused by Candida species, are another common condition that may be influenced by gut microbiome imbalances. Candida is naturally present in the gut, but when the gut microbiome is disrupted—often due to factors like antibiotic use, high sugar intake, or stress—Candida can overgrow. This overgrowth can lead to a systemic imbalance that favors the overgrowth of Candida in the vaginal tract, resulting in a yeast infection. The gut’s ability to regulate fungal populations is crucial, and an imbalance in the gut microbiome can impair this regulation, making individuals more prone to vaginal yeast infections.

Gut Health and The Impact of Probiotics on Vaginal Health

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Can improving gut health through diet, probiotics, or lifestyle changes have a positive impact on vaginal health?

Yes!! Improving gut health through diet, probiotics, and lifestyle changes can have a positive impact on vaginal health. Several approaches have been shown to support the gut-vaginal axis and help maintain a balanced vaginal microbiome.

Diet: A healthy, fiber-rich diet can encourage the growth of beneficial bacteria in the gut, which supports the maintenance of a balanced vaginal microbiome. Foods high in prebiotics, such as garlic, onions, bananas, and whole grains, nourish beneficial gut bacteria. Additionally, polyphenol-rich foods, like berries, green tea, and dark chocolate, can enhance gut microbiota diversity and promote a healthy immune response, which is essential for preventing infections.

Probiotics: Probiotics are another powerful tool in supporting both gut and vaginal health. Probiotic strains such as Lactobacillus and Bifidobacterium can help restore balance to the gut microbiome and inhibit the growth of pathogenic organisms that could potentially affect the vagina. Some studies suggest that probiotics, particularly Lactobacillus strains, can be beneficial for those prone to BV, yeast infections, and urinary tract infections (UTIs) by promoting a healthy vaginal microbiota.

Lifestyle Changes: Regular exercise, sufficient sleep, stress management, and avoiding smoking are all factors that can influence gut health and, consequently, vaginal health. Chronic stress can disrupt the gut microbiome by increasing the abundance of harmful bacteria, which may lead to immune dysregulation and increased vulnerability to infections. Taking steps to reduce stress and ensure overall wellness can thus help maintain the health of both the gut and the vagina.

Vaginal Health FAQs

Is there a direct relationship between gut inflammation and vaginal discomfort or infections?

Yes! Inflammation in the gut, often a result of dysbiosis, can lead to systemic inflammation that affects the entire body, including the vaginal area. When the gut is inflamed, it can trigger an immune response that leads to changes in vaginal pH and microbial composition, potentially increasing the risk of infections like BV and yeast infections.

Additionally, inflammation in the gut can weaken the intestinal barrier, allowing harmful bacteria or toxins to enter the bloodstream (a condition sometimes referred to as “leaky gut”). These harmful substances can travel to other areas of the body, including the vagina, where they can disrupt the delicate balance of the vaginal microbiome, contributing to infections and discomfort.

How do hormonal changes, such as those during pregnancy or menopause, affect the gut microbiome and its subsequent impact on vaginal health?

During pregnancy, hormonal fluctuations, particularly increases in estrogen and progesterone, can alter the composition of both the gut and vaginal microbiomes. Research suggests that the gut microbiome during pregnancy tends to become less diverse, with an increase in Firmicutes and a decrease in Bacteroidetes. These changes may help support the increased energy demands of pregnancy but can also impact the vaginal microbiota. For instance, increased estrogen levels during pregnancy promote the growth of Lactobacillus in the vagina, which helps protect against infections. However, an imbalanced gut microbiome may still contribute to pregnancy-related vaginal issues, including yeast infections.

The hormonal changes of menopause results in a drop in estrogen levels, which can affect both the gut and vaginal microbiomes. Estrogen plays a key role in maintaining a healthy vaginal flora by promoting the growth of Lactobacillus and maintaining vaginal acidity. A decrease in estrogen during menopause can lead to vaginal atrophy (thinning and drying of the vaginal walls) and an increased risk of infections, including BV and yeast infections. The gut microbiome may also shift during menopause, with some studies showing a decrease in beneficial bacteria such as Bifidobacterium and an increase in pro-inflammatory bacteria. This imbalance can further contribute to vaginal discomfort and infections.

Are there specific strains of probiotics that are particularly beneficial for both gut and vaginal health?

Yes, there are specific strains of probiotics that are particularly beneficial for both gut and vaginal health. Lactobacillus strains are the most studied and widely recommended for supporting both microbiomes.

Lactobacillus rhamnosus and Lactobacillus reuteri are two strains that have shown potential in promoting a healthy vaginal microbiota by preventing the overgrowth of harmful bacteria like Gardnerella vaginalis and Candida albicans. These strains have been found to help restore balance to both the gut and vaginal ecosystems, supporting overall immunity and preventing infections.

Additionally, Bifidobacterium strains, such as Bifidobacterium bifidum, can also play a role in supporting gut health by enhancing the gut barrier function and modulating the immune system, which can indirectly help maintain vaginal health.

Takeaways

The gut microbiome plays a crucial role in maintaining vaginal health through the gut-vaginal axis. Improving gut health through diet, probiotics, and lifestyle changes are key to promoting improvements to both vaginal and gut health. 

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