Even though millions of our planet’s inhabitants have vaginas, we’re rarely given the right information to understand how they work. So we say it’s time to decode some research and share clear, tangible information about the vaginal microbiome that can help you stay informed about your body and health. 

What Is the Vaginal Microbiome?

Sometimes called vaginal flora or vaginal microbiota, the vaginal microbiome is a complex ecosystem of bacteria, fungi, and yeast that live throughout the vulva and vagina. Their job? To protect the body and reproductive system from harmful pathogens and infections. The bacteria that make up the vaginal microbiome are small but mighty, finding their power in numbers. In fact, the average vulva hosts around 300 different types of bacteria, with billions of individual microbes. Let’s get to know a few of the major players in the vaginal ecosystem. 

‍Lactobacillus makes up the vast majority of bacteria found in the vaginal microbiome. Depending on which species of ‍lactobacillus is most abundant, a vagina’s microbiome can be categorized under five major types. These categories are also known as "Community State Types” (CSTs) and can change over the course of a person’s life. 

• Type 1: ‍Lactobacillus crispatus 
• Type 2: ‍Lactobacillus gasseri 
• Type 3: Lactobacillus iners 
• Type 5: Lactobacillus jensenii

CSTs 1, 2, and 5 are typically considered to be the healthiest. Type 3 microbiomes can still be healthy, but the prevalence of lactobacillus iners may be a sign of an unstable vaginal ecosystem. Wondering what happened to type 4? Vaginal microbiomes with low levels of lactobacilli (or those experiencing an infection) usually fall under type 4.

It may surprise you to know that the vaginal microbiome is anything but static. In fact, your vaginal microbiome CST can change as a result of a number of different factors. In addition to medications, supplements, smoking, sex partners, birth control, pregnancy, childbirth, and menopause, the health of your vaginal microbiome is also greatly influenced by the health of your vulvar skin. The many folds and crevices of the vulva—such as the labia minora (inner lips)—offer plenty of places for microbes to collect and thrive. This means factors like excessive hair removal and wearing tight or non-breathable underwear can disturb the microenvironment of intimate skin. With microbiome imbalance comes an increased risk of infection, so making sure your intimate skin is well taken care of is crucial. 

The Vaginal Microbiome and pH

Think of the vaginal microbiome as the guardian of your vaginal ecosystem. In the never-ending war against infection, the good microbes in your vagina work around the clock to keep bad bacteria at bay. As you sweat, have sex, stress, and change lifestyle habits, infection-causing bacteria have many chances to grow. Luckily, a thriving vaginal microbiome and balanced pH levels work together to maintain vaginal health. 

The friendly bacteria of the vaginal microbiome produce lactic acid, which helps create a slightly acidic environment and a healthy pH balance. Vaginal pH levels of around 4.0 - 4.5 help prevent infection because pathogens, yeast, and bad bacteria tend to grow in more alkaline (less acidic) conditions. The vaginal microbiome also produces hydrogen peroxide, which makes it difficult for bacteria and yeast to grow.  

Caring for Your Vaginal Ecosystem

Luckily, you have more power to influence the health of your vaginal microbiome than you may realize. Since your vaginal ecosystem can change over time, it’s important to consider three main lifestyle categories when trying to optimize the health of your vaginal flora. 

Down There Care

It all starts with caring for your intimate skin. Changes in moisture, sweat, menstruation, and hormones can influence the balance of your microbiome. That’s why habits like using non-breathable underwear, applying irritating intimate skin care products, douching, and sitting in wet or sweaty panties for too long can upset your microbial ecosystem.

Our advice? Avoid using harsh cleaners, chemicals, and douches to clean your vulva. Warm water or a mild, gentle wash used around your vulva should be enough to keep yourself clean while not disrupting your vaginal microbiome. You should also make it a habit to pee immediately after sex. While this may not be the sexiest post-climax ritual, going to the bathroom after sex helps flush infection-causing bacteria out of your urethra. 

If you experience frequent vaginal infections, reach out to your doctor for help. Many effective treatments are available for supporting the health of your vaginal microbiome, including over-the-counter and prescription probiotics.

Consider Your Diet

Your diet can also impact the health of your vaginal microbiome. For example, high-sugar diets can decrease the number of good bacteria present in your vaginal flora. This imbalance in the vaginal ecosystem can lead to an overgrowth of yeast and bad bacteria, causing infections. Research also suggests that a low-sugar, nutrient-rich, and low-fat diet can decrease the chances of developing bacterial vaginosis (BV). 

Life Stages

The hormonal shifts that happen through childhood, puberty, menstruation, pregnancy, and menopause can have a huge impact on your vaginal microbiome. And that’s okay! Your vaginal flora fluctuates naturally as your body changes over time. When it comes to your body, knowledge is power. That’s why understanding how hormonal levels fluctuate over time can help you make informed decisions about caring for your vaginal microbiome. 

Childhood

From the time you’re born to mid-childhood, your vaginal pH is mostly neutral and you have fewer lactobacillus bacteria. This means it’s especially important for parents to avoid bath products that are highly scented or overly harsh. 

Puberty

With puberty comes a bunch of hormonal changes. Rising estrogen levels cause glycogen (the stored form of glucose) to develop on the vaginal walls. Vaginal bacteria then ferment this stored glycogen and produce lactic acid. This lactic acid helps protect the vaginal microbiome by promoting balanced pH levels. 

Pregnancy and Menstruation

When pregnant, the number of lactobacilli in the vaginal ecosystem spikes. This acts as extra security against infection during pregnancy. On the other hand, people with periods may notice that the likelihood of getting a vaginal infection spikes around the time of menstruation. This is commonly caused by fluctuating hormone levels. 

Menopause 

During menopause, estrogen and glycogen levels drop. Lower levels of stored glycogen (which helped balance your pH during puberty) lead to smaller amounts of lactobacilli in the vaginal ecosystem. This means that the risk of vaginal infection increases after menopause. 

Much like the other parts of the body, the vaginal ecosystem is dynamic and ever-changing. Rather than being seen as a mysterious enigma, the inner workings of the vagina and its microbiome should be common knowledge. We know that changing the conversation can take multiple lifetimes, but each step in the right direction gives people more and more autonomy over their bodies and health.