Vaginal dysbiosis refers to an imbalance in the vaginal microbiome—the community of bacteria and other microorganisms that reside in the vagina. A healthy vaginal microbiome is typically dominated by Lactobacillus species, which maintain an acidic environment (pH 3.8–4.5), helping to protect against infections by harmful organisms. However, when this balance is disrupted, it can lead to an increased risk of infections, including more frequent bacterial and yeast infections, and even a greater susceptibility to sexually transmitted infections (STIs) .
Recognising why this imbalance occurs and identifying its signs are crucial steps in maintaining vaginal health. As a women’s health naturopath, I often see women dealing with recurring issues related to vaginal dysbiosis, such as bacterial vaginosis (BV) and candidiasis (thrush). In this blog, I’ll explain why vaginal dysbiosis happens and explore some of the conditions that arise as a result, such as BV and thrush. I’ll also cover lesser-known conditions like aerobic vaginitis (AV) and cytolytic vaginosis (CV), which may offer further insight into how your vaginal health can be impacted by different imbalances
Why Does Vaginal Dysbiosis Happen?
A healthy vaginal microbiome is predominantly made up of Lactobacillus species, which are beneficial bacteria that help maintain an acidic environment (pH of 3.8-4.5). This slightly acidic pH prevents harmful bacteria and yeast from thriving. However, certain factors can disrupt this balance and create an environment where pathogenic organisms can overgrow.
Hormonal Shifts: Fluctuations in oestrogen levels play a significant role in maintaining a healthy vaginal environment. During different phases of life—such as puberty, pregnancy, perimenopause, and menopause—oestrogen levels naturally rise and fall, impacting vaginal pH and the stability of Lactobacillus populations.
Menstruation: The menstrual cycle causes hormonal fluctuations that can temporarily alter vaginal pH. During the luteal phase (after ovulation), progesterone is dominant, which can reduce oestrogen levels and lower the presence of beneficial bacteria. This is one reason why many women experience increased susceptibility to infections like thrush or bacterial vaginosis just before their period.
Pregnancy: Elevated oestrogen levels during pregnancy generally encourage the growth of Lactobacillus and help maintain a protective vaginal environment. However, these same hormonal changes can sometimes lead to yeast infections, as higher oestrogen levels can promote the growth of Candida.
Menopause: As oestrogen declines during perimenopause and menopause, the vaginal lining becomes thinner, and the natural acidic environment weakens, making the vagina more susceptible to infections like BV and atrophic vaginitis.
Medications: The use of antibiotics, while helpful for treating infections, can wipe out both harmful and beneficial bacteria, leading to an imbalance. Without sufficient Lactobacillus to keep harmful bacteria in check, conditions like BV or yeast infections can emerge.
Diet & Lifestyle: High sugar intake, processed foods, and poor nutrition can feed harmful bacteria and yeast, worsening dysbiosis. Additionally, stress, harsh soaps, and douching can strip the vagina of its natural protective bacteria.
Sexual Activity: Semen has a higher pH than the vaginal environment, which can temporarily alter the vaginal pH and affect the balance of the microbiome. Frequent intercourse or unprotected sex may introduce bacteria that further disrupt this balance.
Weakened Immune System: When your immune system is compromised, it becomes more challenging for your body to maintain a healthy bacterial balance. This can happen due to stress, illness, or chronic conditions.
By recognising the factors that contribute to vaginal dysbiosis, you can better understand why recurring infections occur and take steps to maintain optimal vaginal health.
Vaginal Microbiome Testing: Why It Matters
Vaginal microbiome testing, such as vaginal microbiome mapping, provides detailed insights into the balance of beneficial bacteria and the presence of harmful organisms. By understanding your specific microbiome composition, you can identify the root causes of recurrent infections, such as low Lactobacillus populations or overgrowths of harmful bacteria like Gardnerella or Candida. Knowing this information allows for a more personalised approach to treatment, focusing on restoring balance rather than just treating symptoms.
Common Conditions Related to Vaginal Dysbiosis
Below is a table highlighting common conditions linked to vaginal dysbiosis, their characteristics, and typical causes.
Condition | Type of Discharge | pH Level | Cause | What It Is |
Bacterial Vaginosis (BV) | Thin, greyish discharge with a fishy odour | >4.5 | Overgrowth of anaerobic bacteria (Gardnerella) | An imbalance where harmful bacteria outnumber beneficial ones |
Aerobic Vaginitis (AV) | Yellowish, foul-smelling discharge | >5 | Overgrowth of aerobic bacteria (E. coli, Staph.) | Inflammation caused by aerobic bacteria |
Thrush (Candidiasis) | Thick, white, cottage-cheese-like discharge | <4.5 | Overgrowth of Candida yeast | A fungal infection caused by an overgrowth of yeast |
Cytolytic Vaginosis (CV) | Watery, excessive discharge, vaginal itching | <4 | Excessive Lactobacillus | A condition where Lactobacillus overgrows, leading to irritation |
If you're experiencing recurring thrush or bacterial vaginosis (BV), understanding the root cause is key to long-term relief. Instead of focusing solely on symptomatic relief, vaginal microbiome testing offers valuable insights into why these infections keep returning. Book a free intro call today to learn how microbiome mapping can identify imbalances in your vaginal health and guide you towards fixing your vagina problems for good!
ReferencesÂ
Lehtoranta, L., Ala-Jaakkola, R., Laitila, A., & Maukonen, J. (2022). Healthy vaginal microbiota and influence of probiotics across the female life span. Frontiers in microbiology, 13, 819958. https://doi.org/10.3389/fmicb.2022.819958
Saraf, V.S., Sheikh, S.A., Ahmad, A. et al. Vaginal microbiome: normalcy vs dysbiosis. Arch Microbiol 203, 3793–3802 (2021). https://doi.org/10.1007/s00203-021-02414-3
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