There’s something living in your vagina. Several billion ‘somethings', in fact. It’s an interconnected community of bacteria, fungi, viruses, and other microbes in your vagina that are—believe it or not—supposed to be there.
What is the vaginal microbiome?
A microbiome is a community of microbes. You may have heard of your gut microbiome, which is the diverse group of microbes living in your digestive tract that help you get nutrients out of your food. But your gut microbiome is not the only microscopic, mutually-beneficial, hub in your body. Almost all of your external and internal surfaces are home to unique communities of microbes. The microbe family living on your hands, for example, is completely different from the one inside your ears, the one in between your toes, and yes...the one in and on your genitals. All humans have a genital microbiome, and the vaginal microbiome is incredibly important to your overall health and wellbeing.
Why is the vaginal microbiome important?
1. It is your personal security guard:
We may often think of bacteria, fungi, and viruses as causes of disease or 'pathogens'. But our body’s various microbiomes are actually there to help us. In the case of your vagina, bacteria make up the bulk of the community. In a healthy, balanced vagina, there’s typically a high proportion of Lactobacillus species—organisms with names like Lactobacillus crispatus, Lactobacillus iners, Lactobacillus gasseri, and hundreds more. Lactobacillus bacteria produce acidic compounds, like lactic acid, as part of their day-to-day routine. These keep the pH of your vagina relatively low, meaning your vagina is acidic. This acidity provides one of your first lines of defence against invading microbes that could cause infection and inflammation: microbes like Staphylococcus aureus (commonly known as ‘staph’), E. coli, and group B strep. The same goes for fending off bacteria and viruses that can cause sexually transmitted infections (STIs) like chlamydia, gonorrhoea, and more. Research even shows that a balanced and acidic vaginal microbiome decreases your chances of contracting or transmitting HIV.
2. It keeps the ecosystem in balance:
Most of the bacteria found in the vagina are where they’re supposed to be...most of the time. But the population makeup can sometimes get thrown off-kilter. When a vaginal microbiome starts to go off track, we see fewer Lactobacillus bacteria and more of other kinds of bacteria, species like Prevotella and Gardnerella. This is what’s called ‘dysbiosis’: essentially, the community has gotten out of balance. A dysbiotic vaginal microbiome is often characterised by an increase in the number of species present (that’s called species diversity) and a higher pH, which results in a loss of some of that protective capability. This can mean that other organisms that naturally live in the vagina, like a yeast called Candida albicans, get the opportunity to grow too much. An overgrowth of yeast is what’s behind the itching, burning, and redness of a classic yeast infection (also known as thrush). The same goes for bacterial vaginosis, or BV—it’s the most common vaginal infection for premenopausal people with vaginas, and is caused by an overgrowth of a certain kind of bacteria along with a reduction in lactobacilli. It can cause itching, discharge that isn’t typical for you, and a hallmark fishy smell. The wild thing is, many people can have BV—essentially, a dysbiotic vaginal microbiome—and not have any symptoms. And that’s problematic because…
3. It shapes its environment:
The bacteria in the vagina are living organisms, meaning they’re eating and replicating and producing waste. These waste compounds are different depending on the species of bacteria, and some (like the ones produced by our friendly lactobacilli) are good for us, keeping the environment protected against bad microbes. But some bacteria produce compounds that are inflammatory, may have a negative effect on the tissue of the vagina and the cervix, and can go on to influence all kinds of wider health concerns: things like the birth of your baby, your overall immune system, and even your risk of developing certain cancers.
Why am I just hearing about the vaginal microbiome?
At this point you may be asking, “Well then how do I make sure mine stays healthy?!”. Research into the complex ecosystem of the vagina is really just starting to get detailed, thanks in part to increases in the availability and accuracy of genomic sequencing. This is a scientific tool that can help us understand exactly what organisms are in the vagina, what they’re doing there, and how they’re interacting with each other.
Topics in what has historically been termed ‘women’s health’ have most often focused around reproductive health—and while that’s important, it’s certainly not the whole story. Health topics associated with female health and pleasure that don’t necessarily directly impact our ability to bear children have been shrouded in shame, a lack of education, and a big gap when it comes to funding and research. The medical world has centuries of inequity to rectify when it comes to female anatomy and health concerns, so we don’t have a lot of specific answers just yet. But our understanding of the vaginal microbiome is rapidly evolving every year, and it remains to be seen whether the norms that are mentioned above still hold true as we discover more and more.
How do I take care of my vaginal microbiome?
Here’s what we do know: Keeping your vaginal microbiome happy and in balance means not throwing off its rhythm with too many disturbances. It’s KEY to let your vagina’s natural bacteria thrive, and that means avoiding douching, scented soaps and menstrual products, and other scented or flavored items that spend a lot of up close and personal time with your vagina. Practicing safe sex with condoms, dental dams, etc. is also essential to reducing microbiome disturbance, as is using sex products (like lube, toys, and more) that are gentle, body safe, and easy on your personal ecosystem. There’s no one-size fits all solution, because everybody’s microbiome is unique to them!
How do I find out what’s in my vaginal microbiome?
If you want to find out more about the balance of your ecosystem, how it’s helping you, or how it may be contributing to a recurring problem you’re struggling with, information is power. Juno Bio’s at-home test kit allows you to investigate your personal vaginal microbiome makeup, and our resources equip you with the information you need to take action if necessary. Closing the gender health gap—which originates in historical biases in medicine as well as cultural shame around female anatomy, sexual and reproductive health—starts with more open and honest conversations, more questions, and more research. You never know, starting a conversation with a friend about what your vagina’s been up to lately could make a bigger difference than you ever thought possible.
References
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8. Alcalde-Rubio L, Hernández-Aguado I, Parker LA, Bueno-Vergara E, Chilet-Rosell E. Gender disparities in clinical practice: are there any solutions? Scoping review of interventions to overcome or reduce gender bias in clinical practice. Int J Equity Health. 2020;19(1):166.
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