Sadly, the female body tends to come under an endless amount of scrutiny.
If it’s not the insensitive comments we hear when we’re growing up, it’s there to see, hear and read about in the media too.
It’s no surprise that so many women are conscious of their bodies – and particularly when it comes to their vagina.
Many girls and women worry about how their labia looks, how their vagina feels and if their personal odour if offensive. They may also be concerned about discharge too, which is a normal vaginal function.
As you’re probably well aware, it can be terribly embarassing experiencing any number of those things, denting your confidence and self esteem.
The problem is, if women don’t seek help with reproductive issues, it can become a more serious problem. Poor vaginal health is a risk factor for miscarriage as well as infertility.
The great news is there are plenty of ways you can promote optimal vaginal health, all from the privacy of your own home.
Tips For Vaginal Health
BellyBelly asked Doctor Andrew Orr, a highly experienced women’s health and reproductive specialist, if he could share his very best tips for optimal vaginal health. Doctor Orr has helped thousands of women (and men) overcome reproductive problems in order for them to conceive a baby. Here are his 10 best tips.
#1: Don’t Douche!
Never ever douche with any preparations, unless it’s with a doctor-prescribed medication to treat an infection.
Douching increases your risk of vaginal irritation and upsets the healthy bacterial balance of the vagina.
Triggers for the development of thrush (yeast infections) include the disruption of the vagina’s protective barrier by douching, contact allergens or minor abrasions occurring during intercourse.
A healthy vagina does not need a vaginal deodorant or douching, because a healthy vagina should not have bad odour.
A bad odour is caused from build up of bad bacteria or an infection. Both need to be tended to, or treated.
#2: To Wash or Not To Wash?
Many women are told or believe the vagina is self cleaning, and they shouldn’t use soap in case of irritation or infection.
But contrary to popular belief, the vaginal area still needs cleaning, just as any other part of the body. Heathy hygiene habits are important, and the vaginal area is no exception.
Just like we wash our hands to remove bad bacteria, women need to wash the outer vaginal area (labia, mons pubis, clitoris etc).
Bad bacteria feed on built up oil, sweat and other secretions, and need moisture and heat to multiply. The vagina and its associated parts are the perfect place for this to happen. Water alone will not get rid of built up of salts, oils and other secretions which bad bacteria feed on.
This is why soap is also needed. Harsh soaps can cause irritations, so opt for pH neutral soap to help keep the bad bacteria under control. Bad bacteria build up can not only cause odours and bad smells, but they can also cause irritation to the vagina and surrounding area. This can lead to infections, such as thrush and bacterial vaginosis.
Bacteria from the gut can also escape from the anus, which is also in close proximity to the vagina. This is why there is easy transmission of candida to the vagina, which then can cause thrush. It’s also why it’s important to wipe from front to back when going to the toilet.
Good gut health is also important – if your gut is in balance, the less likely you are to have thrush.
#3: Dress For The Occassion
As previously mentioned, bacteria needs heat, moisture and a food source to survive.
Materials that do not breathe promote excess heat and moisture, and also provide a breeding ground for these bacteria to grow.
Certain materials can hold bacteria too, allowing for further reinfection. Women should wear underwear and clothing that can breathe, for example, 100% cotton.
Synthetic materials do not breathe as well and are best avoided.
#4: Take Probiotics Designed For Vaginal Health
An estimated three out of every four women will experience at least one episode of thrush during her lifetime.
Candida albicans is the organism found in 85% of vaginal infections.
The most likely source of candida is the women’s own intestinal reserve. It can be introduced into the vagina possibly during intercourse, by a partner or from the almost inevitable lapses in personal hygiene. This is why washing with a low irritant or pH neutral soap, along with personal hygiene, is so important.
To begin a candida infection, the circulating candida must adhere effectively to the vaginal lining. It does this by recognizing a receptor on a cell membrane, to which they attempt to adhere tightly, by producing a specific protein.
Once the candida has penetrated below the surface membrane, its spores punch holes in the cellular membrane, causing a release of inflammatory substances, such as prostaglandins. Once established, the yeasts convert local sugars into alcohol, which then acts as an irritant when it makes contact with the vaginal and vulval skin.
Remember that any bacteria or yeast needs heat, food (sugars) and moisture to grow and survive. I’ll talk about the importance of avoiding of sugars later.
Triggers for the development of thrush include the disruption of the vagina’s protective barrier due to douching, contact allergens or minor abrasions occurring during intercourse.
The use of broad-spectrum antibiotics (which reduces the numbers of normally protective vaginal flora) is usually included as a likely trigger, and there are certainly studies which appear to support this.
The best probiotic to use when thrush or an infection is present is Saccharomyces cerevisiae (boulardii). S. boulardii exerts its affects throughout the gastrointestinal tract, to reduce the symptoms of microbial imbalance, which includes thrush and yeast overgrowth. It also helps to maintain healthy bacterial populations and to restore normal gut functionality.
Lactobacillus acidophilus (NCFM), Bifidobacterium lactis (Bi-07) and Lactobacillus rhamnosus (LGGR) are scientifically proven strains to restore healthy gut bacteria, reduce bad bacterial overgrowth and reduce the incidence of yeast overgrowth. They have also been shown to assist in maintaining healthy gut flora during and after antibiotic use.
All probiotics should be used with a prebiotic, to help them grow and colonise in the gut. Prebiotics are the food source for good bacteria and are needed to help them grow.
#5: Considering A Vaginal Steam Or Herbal Bomb?
Some ‘treatments’ growing in popularity in some circles are vaginal steams and herbal bombs (which are inserted into the vagina).
Just like douching, vaginal steam baths disrupt the healthy vaginal flora, and inevitably kill off beneficial bacteria. It can also lead to overgrowth of bad bacteria once the good bacteria is killed off.
Steam can cause irritation to the mucosa and the lining of the vagina and surrounding areas, further leading to bacteria and yeast being inoculated into the damaged area. There has also been reports of steam causing burns to the vaginal area.
The vagina does not need steam baths.
Nor does it need to be bombed.
There have been reports of severe reactions from home made vaginal herbal bombs. Done under the supervision of a qualified practitioner this practice may be okay, but many of these bombs are not done under supervision, and many times the wrong herbs are used, causing permanent damage to the vaginal area. This can even cause toxic shock.
There are specific herbs, such as naturopathic and chinese herbal medicine formulas, which have been proven to eradicate bad bacteria and vaginal infections, as well as promote a healthy vagina and gut environment. You should consult a properly qualified healthcare practitioner to find out which ones are best for you. These are taken orally, not intravaginally.
#6: Avoid Sugars and Grains
As mentioned previously, the most likely source of candida, bad bacteria and vaginal infections is the women’s own intestinal reserve. This is then inoculated into the vagina, possibly during intercourse or the almost inevitable lapses in personal hygiene.
All bacteria need the right environment to feed and grow. All bacteria need heat, moisture and food to grow. Bad bacteria have one particular food source that they enjoy: sugar.
FACT: All refined grains (which can be found in foods like bread, cereals and pasta) are high glycaemic carbohydrates which convert to sugar. This then leads to high blood sugar levels and high insulin response. Grains also contain other inflammatory agents, such as gluten, leptins and lectins.
High insulin levels lead to inflammation, but they also interfere with hormone regulation too, namely higher amounts of oestrogens — or obestrogens as we now call them too. High oestogen levels increase the amount of glycogen in cell linings of the vagina. This provides the right environment for candida growth and germination to flourish, as well as other bad bacteria and vaginal infections. This is why thrush is more common during pregnancy, when oestrogen levels are higher.
For those wishing to maintain a healthy vaginal flora, or to get rid of vaginal infections and bad bacteria, strict adherence to a grain free and sugar free (no refined/processed food) diet is a must. The fact is, all bad bacteria need sugar to survive. Take away the food source, and then these bacteria cannot survive, or multiply.
Choose whole foods that are either grown or caught in the wild, without processing: protein (meat or non-meat), veggies in an array of colours, nuts (especially almonds and walnuts), leafy greens, seeds and good fats (avocado, eggs, fish, chia seeds).
#7: Address Stress
Stress is one of the major players in the disruption of the vaginal flora and vaginal health. Ask any woman what goes first when she is stressed, and it’s usually her immune system, closely followed by her vaginal health, and even menstrual health.
As with most fungal infections, the ability of candida to initiate an infection is also dependent on its host’s (i.e. your!) defence system.
Local T cell-mediated immunity is probably the most important factor in the protection against vaginal infection. Cell mediated immunity will be affected by stress, diet, lifestyle choices, diabetes mellitus, cytotoxic drugs, alcohol, smoking, corticosteroids and pregnancy. Interestingly, evidence suggests that the incidence of vaginal infections are higher in people who are stressed and have compromised immunity because of it.
#8: Avoid Unhealthy Lubricants
Use of unhealthy oils such as baby oil has been recommended on the basis that it’s an effective lubricant, or in the case of coconut oil, it can kill unhealthy bacteria and yeasts.
However, lubricants such and baby oil are petroleum based, and preparations vary enormously in potency and in the extraction process used in their manufacturing. Skin reactions to these products are common, with about 5% of women developing a significant sensitisation reaction after use, and 2% end up with a true allergy.
Similarly, this can happen with oils such as coconut oils, and severe reactions have been reported. The potential for skin reaction increases with the age of the product, since oxidation within the oil increases over time.
For this reason, users should be warned to dispose of the product if it’s more than a few weeks old, or not use them at all.
Only water based lubricants should be used. A decent water based lubricant should be licensed by the TGA or FDA for use internally.
#9: Make Sure Your Partner Is Healthy Too
Partners can also share their bacteria if their hygiene is not adequate too.
Uncircumcised men have a higher risk of transmission of bacteria and STI’s, and research has now proven this. Thrush and other infections are often passed on by a partner, then recurrent transmission to each other continues. Pelvic inflammatory disease (PID) is sometimes referred to as Penis Injected Disease. The use of condoms and barrier methods can also help you to keep a healthy vagina too. Make sure your partner has good hygiene habits in order to keep your vagina healthy too.
Other Things To Consider
Minerals and vitamins such as Vitamin D, zinc, Omega 3 oils, antioxidants and Vitamin C also assist in vaginal health and reducing the risk of vaginal infections.
Smoking is a habit which creates an unhealthy vagina, and can even lead to cancers of the cervix, endometrium and other parts of the body. Smoking of cigarettes and use of recreational drugs leads to disruption of the healthy vaginal environment, kills off good bacteria and promotes bad bacteria overgrowth. It’s now known that the by-products of chemicals in cigarettes can be found in the vaginal secretions and cervical mucus of women. While smoking can cause bad breath in someone that smokes, it can also cause bad odours, similar to that of a smokers mouth due to these toxic chemical built in the vaginal mucus.
It’s important to teach vaginal health to our daughters, and even seeing a specialist when your daughter gets her first period can help prevent fertility problems in future! See our article for more information about that here.
For more information or for treatment advice on a vaginal health problem, visit Dr Orr’s website.
References:
1. Krivan HC. Microbial Adhesion: Glycolipds As Possible Receptors For Vaginal Pathogens. Orlando, Fl: Second International Conference on Vaginitis. March 1999; Abstract 29: P3.
2. Geiger AM, Foxman B. Risk Factors for Vulvovaginal Candidiasis: A Case Control Study Among University Students. Epidemiology 1996; 7(2), 182-187.
3. Spinillo A, Capuzzo E,Assiano S, De Santolo A, Zara F. Effect Of Antibiotic Use On The Prevalence Of Symptomatic Vulvovaginal Candidiasis. Am J Obstet Gyne 1999; 180(1):14-17.
4. Tooley PJ. Patients and doctor preferences in the treatment of vaginal candidiasis. Practitioner 1990; 71:73-76.
5. Holland J, Young ML, Lee O. Vulvovaginal carriage of yeasts other than Candida albicans. Sex Trans Inf 2003;79: 249-50.
6. Sobel JD. Treatment of vaginal candida infections. Expert Opin. Pharmacother. 2002; 3(8): 1059-1065.
7. Falagas ME, Betsi GI, Athanasiou S, Probiotics for prevention of recurrent vulvovaginal Candidiasis: a review, J Antimicrob Chemother 58 (2006), pp. 266-272.
8. Andreu A, Stapleton AE, Fennell CL et al. Haemagglutination, adherence and surface properties of vaginal Lactobacillus species.J Infect Dis 1995; 171:1237-43.
9. Ferris DG, Nyirjesyp, Sobel JD, Soper D et al. Over-the-Counter Antifungal Drug Misuse Associated With Patient-Diagnosed Vulvovaginal Candidiasis. Obstet Gynecol 2002; 99(3):419-425.
10. Bodnar et al. Maternal Vitamin D Deficiency Is Associated with Bacterial Vaginosis in the First Trimester of Pregnancy. Journal of Nutrition, June 2009; DOI: 10.3945/jn.108.103168.
11. Gray RH, Kigozi G, Serwadda D, et al. The effects of male circumcision on female partners’ genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda. Am J Obstet Gynecol. 2009; 200:42.e1-42.e7.
12. Petersen EE, Magnani P. Efficacy and Safety of Vit C vaginal tablets in the treatment of non-specific vaginitis. A randomised, double-blind placebo controlled study. Eur J Obstet Gynecol & Rep Biol 2004;117:70-75.
13. McCann MF, Irwin DE, Watson LA et al. Nicotine and cotinine in the cervical mucus of smokers, passive smokers and non smokers. Cancer Epidemiol Biomarkers Prevent 1992:1:125.
14. Szarwski A Cuzick J. Smoking and cervical neoplasia:a review of evidence. J Epidemiol Biostat 1998:3:229.