The importance of looking after our intimate health

Our intimate health is very important, but as with much of our health we take it for granted until something isn’t right!  Implications of imbalance in this area can range from annoying to serious, yet it is rarely openly discussed, and until recently has been lagging behind in research, testing and treatment options.  

A little bit of biology to begin….

By intimate health, I refer to the vagina, vulva, and urinary tract (urethra and bladder).  The main determinant of health for these areas lies with the mix of microbes (bacteria, fungi etc) present, called the microbiome.

Research has been limited in both areas, in fact, for many years science believed the bladder was sterile, but now we are gaining insight into what these microbes mean for our health - and it can be significant. 

At a basic level, the vagina and bladder are ‘healthy’ when teeming with beneficial bacteria such as lactobacillus, but when compromised, pathogenic bacteria can take hold and cause an infection.  In the vagina this may cause burning, discharge, a fishy smell and painful sex, and in the bladder, UTI symptoms.  Sound familiar? 

What are the implications of imbalance in the vagina and bladder microbiomes? 

Imbalances in these areas is very common.  

• 3 in 4 of all women will experience vaginal thrush at some point.  
• 1 in 3 women will experience bacterial vaginosis (a bacterial infection in the vagina).
• 1 in 4 pregnant women will have a vaginal microbial imbalance.
• 1 in 2 women will have a UTI at some point in their life.
• 1 in 10 postmenopausal women have had a UTI in the past year. 
  

Symptoms can range from fleeting and annoying to severe and chronic, impacting a woman’s mental and physical health enormously.   

Implications can be wide ranging too: 

• an imbalance of the vaginal microbiome can increase the risk of STIs and UTIs ⁽¹⁾
• vaginal imbalance can carry pregnancy complications including pre-term labour ^(2), premature rupture of membranes ⁽³⁾ and may contribute to second trimester miscarriage ^(4).
• vaginal imbalance has also been linked to lower success rates in IVF ^(5). 
• imbalance in the vagina has been linked to some cervical abnormalities and cancers ⁽⁶⁾

So what disrupts this balance and how can we mitigate these? 

Various factors can impact the health of the intimate areas, and the good news is we can control many of these in our everyday life. 

The impact of hormones

The vaginal microbiome is very much influenced by oestrogen. Oestrogen promotes a healthy, stable microbiome with plenty of favourable lactobacillus bacteria, whilst a low oestrogen state (think peri-menopause & menopause) increases the chance of infection.

Ways to support hormone health include consuming healthy fats, eating plenty of fibre and including phytoestrogenic foods (flaxseeds, soy products, chickpeas) in your diet.  Get your hormone levels checked.  Local oestrogen cream may be an option as you approach menopause and oestrogen levels fall - speak to your GP.

The impact of medications

Medications, particularly antibiotics, can drastically change our vaginal and bladder microbiomes, killing friendly bacteria and leaving the area exposed to pathogenic bacteria. 

If you take antibiotics, repopulate some of the good bacteria afterwards by eating probiotics and prebiotic rich food e.g. sauerkraut, kefir, live yogurt, oats, a wide range of fruit and veg.  Consider a course of probiotics too. 

Lifestyle factors

Consider what goes on, in or near the vagina when considering its health.  It is self cleaning, meaning it doesn’t need anything other than a splash of water in the shower to keep it healthy.  It maintains a slightly acidic environment which is very protective; certain products containing chemicals and fragrances can disrupt this. 

• Avoid douching, scented soaps and perfumed washes.  
• Choose non fragranced toilet roll 
• Choose a PH balanced lube to minimise disruption (Yes or Into the Wylde), and flavour free condoms. 
• Wee after sex to avoid bacteria entering the urethra. 
• If you exercise or swim, change out of your lycra quickly and shower.  Pathogens thrive in warm, moist environments so don’t give them a chance to grow! 
• Choose cotton or bamboo undies;  these allow the area to breathe and friendly bacteria to thrive.
  

Immune function & nutrient status 

Our immune system is first in line to fight pathogens.  If this is compromised, we may be at increased risk of infections.  Similarly, nutrient levels can support hormones and immunity, as well as tissue integrity which is important in the vaginal canal.  

Having good levels of vitamin D, A, C and E and zinc is ideal; include pumpkin seeds and almonds in your diet regularly, eat beef once a week, supplement with vitamin D in the winter months, and eat a variety of coloured fruits and vegetables. 

What to do if you have symptoms? 

• If you have new, irritating symptoms around the vagina area always see a GP; they can carry out basic swab testing to rule out serious infections like STIs.  
• Similarly, always see a GP with a UTI; these can become serious if left untreated. 
• If symptoms persist after treatment, or re-occur again, there may be an underlying cause which isn’t being addressed.  Consider my points above and consult a specialist.  I see clients with persisting symptoms in the vagina and bladder and carry out private testing (including vaginal and bladder microbiome) to understand the root cause. 

This blog was written for the Mum Hub. The Mum Hub was founded by mum of three, Safia, after struggling to find her own identity when becoming a mum. She faced significant struggles with the constant feeling of not doing enough, feeling judged and burning herself out. In response to this, she created The Mum Hub in 2021. TMH host brunches with a twist – specifically tailored to mums and to support their mental health. What makes TMH unique is that each event has a guest speaker discussing a topic that affects mums every day, even where they carry a social stigma or are difficult to discuss. From perimenopause, returning to work, Mum Guilt & working with Anna Mathur to deliver a brunch on Anxiety as a Modern Day Mother, Safia hopes to give mums confidence when facing testing times, by equipping them with knowledge, knowing that there are always choices available for them by empowering them with knowledge to pass onto their children. Be sure to follow her on Instagram @the_mumhub

References

1. ^{https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840952/} 
2. ^{https://www.nichd.nih.gov/health/topics/vaginitis/conditioninfo/pregnancy} 
3. ^{https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345902/}
4. ^{https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995870/}
5. ^{https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719507/}
6. _{https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648063/}

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