Reproductive Microbiome Health and Gynaecological Issues

Written By: Melissa Rivard, Registered Clinical Naturopath, Nutritionist, & Health Coach

If you are an AFAB (assigned female at birth) and have been experiencing issues such as recurrent thrush, bacterial vaginosis, UTIs your reproductive microbiome will likely need some support. We now have research that shows that are reproductive microbiome may also be involved with other conditions such as uterine polyps, endometriosis, PCOS, and infertility.

 We are learning more about the reproductive microbiome, particularly the vaginal microbiome and its relationship with our reproductive health. The female reproductive tract harbours a unique microbiome that accounts for apron 9% of the body’s total microbial population ( Moreno and Simon, 2019).

Our vaginal microbiome is a low diversity environment with a lot of lactobacillus strains, which release lactic acid. Lactic acid keeps the PH of this environment more acidic, which is protective against pathogenic bacteria.

Up to 50 % of women with vaginal dysbiosis (microbial imbalance) may be asymptomatic.

What can impact our vaginal microbiome:

• low estrogen - we see a reduction in lactobacillus strains and changes in PH

  NOTE - low dose vaginal estrogen cream can be beneficial with perimenopausal/postmenopausal women experiencing recurrent infection.

• Poor gut health - dysbiosis in the gut will often lead to dysbiosis in the reproductive microbiome

• Poor nutrient status (e.g. vitamin D)

• Systemic inflammation

• Poor immune function

• Oral health issues (oral microbiome concerns)

• Chronic stress

• antibiotic use

• sexual partners

• STIs

• smoking and alcohol

Whilst antibiotic treatment will be a useful strategy that is necessary in many cases to eradicate pathogenic bacteria, it is common for many AFABs to have another infection within 6 months. This suggests that more upstream issues need to be addressed in addition to antibiotic treatment.

If you have been experiences recurrent infections, talk to a health care practitioner about how you can support your reproductive health.

Vaginal microbiome testing may be useful to understand what exactly is going on. If you would like to find out more about this type of testing, you can message me for more information.

Addressing upstream contributing factors as well as working to improve microbiome health by removing pathogenic bacteria/fungi/viruses and improving beneficial bacteria strains will not only address current infection but increase protection against future infections.

References:

PMID: 40041148

PMID: 40454473

PMID: 36421397

PMID: 36590579

 PMID: 38396443

DOI: 10.3389/fcimb.2021.686167