Maintaining good vaginal health is every woman’s priority. One of the critical factors that influence vaginal health is the vaginal flora — the microorganisms in your vagina. Learn all you need to know about the bacteria that live in your vagina, their importance to good vaginal health, and how to protect these microorganisms and care for your vagina.

What Is Vaginal Flora?

Similar to your gut, your vagina has many different types of microorganisms, especially bacteria. These are collectively referred to as the vaginal flora or vaginal microbiome. Among the more than 250 identified bacterial species, lactobacillus comprises the main group of vaginal bacteria [1]. In fact, it’s estimated that more than 70% of the vaginal flora is made up of lactobacillus.

The predominant types include Lactobacillus reuteri, Lactobacillus rhamnosus, Lactobacillus crispatus, Lactobacillus jensenii, Lactobacillus iners, and Lactobacillus gasseri. However, not all strains of lactobacillus like to stay in the vagina. Some lactobacillus rhamnosus and reuteri may stay in the gut, whereas Lactobacillus rhamnosus gr-1 prefers the vagina.

These bacteria play a critical role in maintaining vaginal health by providing the ideal environment for normal vaginal functions to occur. One of the most common factors that influence the vaginal environment is the pH (or acid-base balance) level. The normal pH of adult female vaginas is maintained between 3.8 and 5, which means that vaginas usually have an acidic environment.

The vaginal flora doesn’t remain constant but changes with a woman’s age. Before birth, vaginas are sterile, and female babies usually take on some bacteria from their mothers during the birthing process. In childhood, the vagina usually has a neutral or alkaline pH.

Puberty brings about many changes in the vaginal microbiome. The rise in estrogen levels causes an increase in the amount of glycogen stored in the vaginal lining. This glycogen is fermented by vaginal lactobacilli to produce lactic acid, thus giving the vagina its acidic pH. This acidic pH is a critical indicator of optimal vaginal health.

What Is the Role of Vaginal Flora?

The vaginal flora can contain good, bad, and even neutral organisms. Good bacteria like lactobacilli produce useful substances like lactic acid, which help in maintaining the vaginal pH. An acidic pH is important because it prevents the growth of harmful microorganisms and protects against infection.

The vaginal flora also produces a chemical called hydrogen peroxide, which prevents the growth of pathogenic bacteria and yeast. Bacterial vaginosis is a condition where there is a disruption in the normal balance of vaginal flora and an overgrowth of bacteria that are usually present only in small amounts in the vagina.

This imbalance can affect lactobacillus population levels, which, in turn, affects vaginal pH levels, making the vagina susceptible to more serious conditions like yeast infections (e.g., candidiasis or thrush), pelvic inflammatory disease, and sexually transmitted diseases. Bacterial vaginosis can even lead to preterm labor or birth in some cases.

Bacterial vaginosis is characterized by a typical fishy odor and usually occurs among women of reproductive age. Some home remedies you could try for bacterial vaginosis include vaginal pH balance pills and probiotic suppositories. However, don’t delay in seeking medical advice if you’re experiencing pain or any other serious symptoms or suspecting any other condition.

In case of vaginal infections, doctors will usually take vaginal swabs to assess the vaginal flora and determine which types of harmful microorganisms are growing in the vagina. This can help in rapid and targeted treatment. Thus, healthy vaginal flora is the foundation of a healthy vagina.

What Are the Factors That Affect Vaginal Flora?

The vaginal flora can be affected by a variety of external and internal factors as well as lifestyle changes. These include:

1. Menstruation: Hormonal changes and blood flow during menses decrease lactobacilli growth and increase the vaginal pH.
2. Sexual activity: It can damage the vaginal lining, and body fluids like semen, which has an alkaline pH, can promote the growth of harmful organisms.
3. Pregnancy: There is increased growth of lactobacilli and bifidobacterium to prevent harmful bacteria from entering the uterus and causing infections.
4. Menopause: The decrease in estrogen levels affects lactobacilli growth, increases the pH, and causes vaginal dryness.
5. Stress: Prolonged stress leads to increased cortisol production in the body, which affects the glycogen levels in the vagina [2]. The lack of glycogen hampers the lactobacilli population and affects the vaginal pH.
6. Medications: Medications like antibiotics can accidentally kill good bacteria, causing an imbalance in the vaginal flora.
7. Poor hygiene: Harsh chemicals, lack of regular washing, hair removal procedures, and intimate piercings can adversely affect the growth of vaginal flora.

‍