Vaginal flora refers to the microecosystem of different species of bacteria that are present in the vagina. These bacteria help maintain the ideal environment to keep the vagina healthy and avoid infections. Sustaining an ideal pH and promoting Lactobacilli — a type of good bacteria — are essential in gynecological health.
This article discusses the delicate balance of bacteria in the vagina, its importance to a person’s health, and what someone can do to maintain or restore it.
Vaginal flora refers to the different species of bacteria that live in the vaginal tract.
According to a 2016 article, although scientists have identified over 250 bacterial species, a healthy vaginal microbiome consists mostly of Lactobacillus.
Lactobacilli help to maintain the vagina’s healthy pH.
In addition, these bacteria also produce lactic acid, which can help prevent less beneficial species from growing and colonizing the vagina.
A newborn starts to colonize bacteria from the birth parent’s vagina if they have a vaginal birth. Afterward, breastmilk provides more bacterial species to the infant.
During the reproductive phases of a female’s life, hormones promote the growth of over 120 species of Lactobacilli in the vagina.
In females who have not started menstruating and those who are postmenopausal, a lack of estrogen means the vaginal flora mainly consists of skin and gut flora. However, the Lactobacilli can be present in the vagina.
Vaginal flora and pH can vary based on a person’s race and genetics.
A 2021 review article suggests that the differences in vaginal microbiomes could occur due to:
- genetic factors, such as the immune system
- receptors on the epithelial cell surfaces
- the quantity and components of vaginal discharge
More research is required to understand the differences in vaginal microbiomes.
The 2016 article notes that obstetrician and gynecologist Albert Döderlein was the first to explain the importance of bacteria in the vagina. In 1892, he described the vaginal bacillus as a long, gram-positive bacillus occurring in vaginal secretions.
Döderlein and his colleagues explained how vaginal bacteria produce lactic acid, which inhibits other pathogenic species, thereby maintaining the health of the vagina.
Since then, the article states that more scientists have proposed different ways to classify the different types of flora:
- 1914: Manu af Heurlin characterized the vaginal flora between those who were pregnant and not pregnant and between children and adults. He also attempted a grading system that ranged from healthy flora to disturbed flora.
- 1921: Robert Shröder distinguished between three different vaginal flora types. Gynecologists still use these types when determining between normal flora, bacterial vaginosis (BV), and other types of flora.
- 1930: Ludwig Nürnberger agreed with Döderlein that there were only two types of vaginal flora — normal and abnormal.
- 1948: Otto Jirovec presented six classifications of vaginal flora:
- abnormal with leucocytes — white blood cells
- 1955: Herman Gardner and Charles Dukes noted the importance of the microscopy vaginal fluids. They defined a diagnostic criteria called clue cells. They thought that BV was a sexually transmitted infection (STI).
- 1984: Per-Anders Marfh realized that BV was “a replacement of lactobacilli by characteristic groups of bacteria, accompanied by changed properties of the vaginal fluid.”
Using technological advances such as genomic sequencing, scientists now understand the different species of bacteria that live in the vagina.
The delicate balance of bacterial diversity can determine the health of someone’s vagina.
According to a 2018 review, there is an association between BV and an increased risk of STIs and other infections, such as pelvic inflammatory disease. Additionally, for someone who is pregnant, BV can cause preterm labor or birth.
Furthermore, the review suggests a link between diminished Lactobacillus dominance and the failure of in vitro fertilization (IVF) and pregnancy loss.
As well as bacteria, the vaginal flora includes yeasts.
In a healthy vagina, the Candida species exists as a yeast form. If this type of fungus multiplies, it
Ensuring a healthy bacterial diversity in the vagina is key to its health, and there are several factors to consider to prevent dysbiosis, or unbalanced flora.
Diet and nutrition
For this reason, supporting flora in both the gut and vagina is beneficial to vaginal health.
For example, a
Conversely, diets deficient in these nutrients and too much fat and sugar have negative consequences on vaginal health.
A 2018 review suggests that stress can have adverse effects on vaginal health.
The review explains that stress hormones, such as cortisol, decrease the abundance of beneficial Lactobacilli, causing inflammation and worsening symptoms of vaginal infection.
A person can consider the following to help reduce stress:
- trying relaxation techniques
- taking time to meditate
- participating in physical activity
- following a healthy, balanced diet
- seeking support from a mental health professional
A person who smokes may wish to quit to help maintain their vaginal flora.
Sexual intercourse or other sexual activity can introduce bacteria that can interrupt the balance of vaginal flora,
A person may be
Sexual activity can also trigger vulvovaginal candidiasis.
It is important to note that BV and vulvovaginal candidiasis are not STIs.
To help prevent disrupting the vaginal flora during sexual activity, a person may wish to use barrier methods of protection, such as condoms or dental dams.
Medical treatment is available to restore the balance of vaginal flora. Antibiotics can treat BV and a person can use over-the-counter medications, such as pessaries, to treat vulvovaginal candidiasis.
Douching is washing or cleaning out the vagina with water or other fluids.
OWH explains there is a link with douching and some health problems, including BV, vaginal irritation, and pelvic inflammatory disease.
The vagina is self-cleaning and does not require any cleaning products. However, some people may wish to clean the vulva using warm water and mild, unscented soap.
Flora, including Lactobacillus, protect the vagina from infections.
BV and vulvovaginal candidiasis are common conditions that have unbalanced flora as their root cause. Following a healthy diet, safe sexual practices, and avoiding stress and smoking are strategies a person can use to reduce the risk of developing these conditions.
Additionally, it is essential that people do not perform vaginal douching as this upsets the balance of healthy bacteria.