Vaginal Microbiome and Fertility

Following a recent post about my experience with vaginal microbiome screening, I have had some questions about the importance of microbiome in fertility, and the impact of nutrition and life stage. 

Firstly, what is the vaginal microbiome? The vagina is host to a range of bacteria, yeast and other microbes, that exist in varying quantities and, when in good proportion to one another, help maintain good vaginal health and function. Most of the ‘good’ bacteria in the vagina are from the Lactobacillus family, and they work together to make the vagina a less hospitable place for the unhelpful microbes. New evidence is showing that having plenty of lactobacillus could also be helpful in reducing inflammation. When compared to a microbiome which is out of kilter, emerging research is pointing towards a healthy vaginal microbiome being associated with improved chances of pregnancy and reduced likelihood of miscarriage. 

Where are the imperfections?
From time to time, and more so for some women than others, the vaginal microbiome can be put off balance. This might occur when exposed to different bacteria, such as with sexual partners, when the acidity of the vagina is changed, or potentially even when the woman is under a great deal of emotional stress. It is common for the vaginal microbiome to be altered during menopause too, when the drop in oestrogen leads to reduced lactobacillus levels. 

What can be done about it?
Undeniably, more research is needed into this area to fully understand the role that the microbiome plays. However, current research suggests that some women may benefit from probiotic supplements to improve their vaginal microbiome. In fact, some studies have shown that women suffering from Bacterial Vaginosis (BV) had better treatment outcomes and lower recurrence rates when treated with probiotics, rather than the traditional method of using antibiotic treatment alone. This is important, as recurring BV can lead to inflammation which could hinder healthy pregnancy. That said, probiotics may not be useful for all women with dysbiosis, and with approximately 50% of women with dysbiosis being asymptomatic, it can be difficult to identify who may or may not benefit. There is also debate about the administration of probiotics for vaginal health: the train of thought be that even though a vaginal delivery may be better able to colonise, an oral probiotic is more acceptable and so comes with better adherence rates. So, there is a lot that we still need to learn, but the science looks promising! 

For more information about vaginal health, you can ask your Gynaecologist, or check out the info at Daye and The Eve Appeal. 

References:
doi:  10.1111/1471-0528.14390
doi: 10.1080/1040841X.2017.1306688
doi: 10.3389/fcimb.2022.963868
doi: 10.1007/s00404-015-3810-2.