Many women don’t realize the health significance of keeping the vaginal environment balanced. All of medicine should be personalized and vaginal health is no exception. The best way to balance the vaginal pH is to maintain health lactobacillus in the vagina. The best way to have healthy levels is to have normal estrogen levels. This can be accomplished by vaginal treatment with estrogen in menopausal women, Osphena will move the pH in the right direction and help symptoms, but the pH is not as good as with estrogen. A healthy vaginal pH is low, meaning acidic. Using vaginal moisturizers do not change the balance of the vaginal pH or restore normal lactobacillus counts to the vagina. Menstrual periods can alter colony counts, but they quickly return after menses.
The Balance of your bacteria may be in your genes.
The field of genomic medicine, what your genes and what genes the bugs we have living with us, have has begun to make it’s way into personalized disease management, and interestingly enough, this applies to vaginal health too. Individualizing your gyno care based on either the unique genes or the unique function of the genes in our system apparently also applies to the genes of the bacteria we harbor in our vaginas. In reality we have more bacteria, by far, than cells in our body. The behavior of the bacteria in our body is critical to our good health, as well as being critical to curing many diseases. Vaginal health is one example of an organ system that is only healthy if the right balance of bacteria is present.
Poor vaginal balance leads to increased symptoms of infection
Bacterial Vaginoisis (BV) is an infection gets started when you lose the normal, healthy, vaginal lactobacilli. There are actually at least 100,000 bacterial colonies in the vagina, and we won’t be able to cover all of them in a short discussion, but even 1% imbalance can be an issue. Lactobacilli species produce by metabolizing the sugars in the cells of the vagina and through this metabolism emit a small amount of hydrogen peroxide which then keeps the vagina very acidic. If the lactobacilli colonies decrease due to being over grown by other species the vaginal pH changes, becomes too basic (less acidic, the pH rises), and other bacteria, that are more hostile to vaginal health will flourish.
Here are some simple strategies that you can follow to keep your vaginal health in balance. At Women’s Health Practice we have been a leader in clinical studies, the adaption of new medical technology, and testing that can help you answer questions important to your individual concerns. Here’s a list of things you can discuss with your gyno to see if these will help you.
1. Lactobacillus acidophilus and other lactobacillus probiotics can help both pre and post menopausal women, but studies show greater effects in post menopausal women. You can use them vaginally or orally.
2. Boric Acid tablets, work primarily as a treatment for infection. They do lower vaginal pH but work mostly like an antibiotic directly against bacteria. In post menopausal women they can successfully treat both yeast and BV with these. No actual guidelines recommend boric acid as first line therapy, but ACOG does recommend it for treatment of recurrent infections. Dosage is 600 mg daily or twice daily for 1-5 months. Avoid in pregnancy because of lack of safety data.
3. Avoiding antibiotics. Symptomatic yeast occurs in about one third of women after use of a round of antibiotics.
4. Using condoms for sex especially in premenopausal women appears to lower pH and help increase the colonization of healthy lactobacilli.
5. Douching? Or No Douching? The data varies, some studies show that the pH lowers, some formulas claim to restore pH, most studies show no really harm or benefit.
6. Gut balance. By taking in probiotics the natural, healthy, bacteria Lactobacillus, increases in numbers which is the ultimate way to normalize the health of the vagina and, in a study reported in BMC conducted by a group of researchers lead by PB Heczko, lengthen out the time until there is a recurrence. Probiotics are not right for every women nor every case.
7. Latic acid gel, this is what is in most moisturizers and it’s not effective like estrogen is.
8. Hydrogen peroxide, a single treatment can work, but not recommended nor safe for long term use.
9. Povidone-iodine vaginal douches work against both good and bad bacteria and do not establish a healthy good bacteria balance.
10. Ascorbic acid, typically about 650 mg, can restore a good pH and promote healthy bacteria. About 1/4 women find the OTC formulations a bit strong and irritating.
