I’ll never forget when I worked for Dr. Oz back in 2005 and he got a question on his radio show from a caller on douching (which, I would realize years later, was really a question about the vaginal microbiome). What he said would bring him attention for decades to come. Don’t douche! The vagina is a self-cleaning oven.
He was right. Don’t douche. But what we didn’t fully understand then is the role the microbiome plays in overall vaginal health, defining exactly why the vagina is in fact a self-cleaning oven. The medical community has spent a ton of time talking about the gut microbiome but lately I’ve been super interested in how our health is impacted and supported by the other microbiomes that get less airtime. Think: the skin microbiome (which I’ll cover in a future newsletter) and yes, the vaginal microbiome.
I thought of this self-cleaning oven moment recently when I attended a launch event for my friends at Seed (who I’m partnering with on content this fall, including this newsletter) which just launched a new probiotic designed to support the vaginal microbiome.
If you have a vagina—Or care about someone who does!—you may find it as fascinating as I have to dive into the bacterial ecosystem important for everything from supporting vaginal immunity, to odor, to lubrication.
Read on for the research and what I’m personally doing to make sure all my microbiomes are as healthy, vibrant, and resilient as possible.
The research says
The vaginal microbiome is a dynamic ecosystem and a key driver of gynecological, urogenital, and reproductive health. Activities like douching disrupt that ecosystem, causing an overgrowth of potentially harmful bacteria that can lead to all kinds of uro-gynecological health issues. Yet—despite Dr. Oz’s self-cleaning PSAs—nearly 20% of women still do it, according to the U.S. Office on Women’s Health.
The optimal vaginal ecosystem
A healthy vaginal pH level is between 3.8 and 5 (slightly acidic, like a tomato), according to a 2021 study.
The optimal vaginal microbiome is also dominated by a superabundance of one type of bacteria—Lactobacillus Crispatus—which is associated with favorable health outcomes. Put another way, bacterial diversity here is bad. Ideally, L. crispatus runs the show.
As far as good bacteria go, L. crispatus is a super-defender. It produces lactic acid to keep vaginal pH in balance and limit the growth of potentially harmful organisms.
The vaginal microbiome out of balance
Just like your gut microbiome, the vaginal microbiome is malleable and easily influenced—lots of seemingly innocuous things can alter the balance. Beyond douching—any product that comes into contact with the vagina can impact the microbiome.
Take lube, for example. Lubricant can not only impact the pH balance of the vagina (which is why it’s important to choose a lube that matches vaginal pH), but have antimicrobial effects. (Which is bad for a microbiome.) Lube containing chlorhexidine gluconate is particularly bad for the growth of healthy lactobacillus, according to a 2021 in vitro study.
A lot of normal daily activities can impede the ability of L. crispatus to thrive. Recent research shows:
- Sexual activity including oral sex and using sex toys can increase the presence of non-optimal vaginal bacteria L. iners and Gardnerella vaginalis
- Intense exercise can increase diversity of bacteria in the vaginal microbiome
- A vegetarian diet can lead to a loss of lactobacillus
- Menstruation can cause imbalances in the vaginal microbiome
- Menstrual pads can negatively impact L. crispatus levels (while menstrual cups have been positively associated with the presence of L. crispatus)
What I’m doing for my own body
This doesn’t mean you should stop doing cardio or having sex. For optimal vaginal health, I employ a one-two punch of avoiding behaviors that are detrimental (within reason) and making choices that help boost my beneficial bacteria.
- Follow a low-sugar diet. Sugar feeds yeast. I aim for less than 25g of sugar per day.
- Take a probiotic. Recent research suggests taking a regular oral probiotic likely doesn’t benefit the vaginal microbiome. I personally take Parsley’s probiotic every night for optimal gut health. For patients struggling with uro-gynecological issues, I sometimes recommend Fem-dophilus.
- Never douche! Dr. Oz had it right. Hopefully we all know this by now.
- Avoid scented soaps and tampons. You may have seen the headlines about heavy metals in tampons. Consider this another reason to consider what products you put into your vagina.
- Choose the right lubricant. The World Health Organization recommends using a lubricant with a pH of 4.5. I recommend water-based lubricants—they won’t damage the vaginal microbiome over time, according to a small study of postmenopausal women.
What I recommend for you
Given the delicacy of the vaginal microbiome and its importance to health, I was genuinely excited when I learned about the VS-01™ Vaginal Synbiotic from our friends and partners at Seed.
VS-01™ is the first clinically validated vaginal probiotic suppository formulated with three proprietary L. crispatus strains. It was developed from over 15 years of breakthrough vaginal microbiome research to restore a healthy vaginal microbiome, maintain vaginal pH, and is safe and well tolerated. Use my personal code DRROBIN25 for 25% off your order!
Looking for a personalized plan to address imbalances in your microbiome? Come talk to one of our experts at Parsley. Use my personal code RBMDCREW for $100 off your membership.