The vaginal microbiome – all you need to know!

Chances are that you have probably heard about the bacteria in your gut and how it’s linked to overall health, but the likelihood is that you’re less well acquainted with the bacteria living in your vagina.

Known as the vaginal microbiome, it is a very different environment to the gut, but, critically, research suggests that it plays an important role in maintaining a women’s overall health. While the gut is home to trillions of bacteria from several different species and a diverse gut microbiome is an indicator of good gut health, the vaginal microbiome is dominated by the Lactobacillus genus (with L. crispatus being the most dominant) and the diversity is much lower. Lactobacillus are producers of lactic that helps preserve vaginal acidic pH, acting as a defence against pathogens. 

Research has shown that the dominance of Lactobacillus in the vaginal microbiome plays a vital role in fertility outcomes. Women with a dominant Lactobacillus vaginal microbiota (≥ 90%) have a higher success rate in both term pregnancy and live birth rate. Whereas, non-predominance (<90%) of the genus Lactobacillus has a direct correlation with miscarriage.

Additionally, women with an unfavourable vaginal microbiota profile were 7 times less likely to achieve a pregnancy in IVF and the degree of dominance of Lactobacillus crispatus was an important factor in predicting pregnancy. Women who had a favourable profile, as well as <60% L. crispatus, had a high chance of pregnancy.

Women who may have an unbalanced vaginal microbiome:

• Patients with recurrent infections
• Endometriosis patients
• After and during a course of antibiotics

Keeping your vaginal microbiome healthy

There are strategies to improve the health of your microbiome – the best way is by eating well, drinking lots of water, exercising regularly and refraining from smoking and alcohol. Minimising stress and maintaining good general hygiene are also essential.

In addition, a number of studies have shown that administration of Lactobacillus probiotics has the capability of restoration of vaginal microbiome to improve fertility, pregnancy outcome, and menopausal infection.

Oral administration of Lactobacillus rhamnosus and Lactobacillus fermentum has been shown to restore healthy vaginal microbiota in up to 82% of women with previous vaginal dysbiosis, specifically an increase in Lactobacillus species. 

The gut microbiome and probiotics have been extensively researched and their use in the vaginal microbiome and fertility is presenting a promising field.