Vaginal flora – EVERYTHING about pH levels, imbalance & restoring your flora

We're used to associating the word bacteria with something we'd rather not have in our bodies – but the reality is rather different: there are indeed bacteria that can harm us, but there are also so-called good bacteria, and these are precisely the ones we want when we talk about vaginal flora.

Your vagina needs these good bacteria to protect you from vaginal and urinary tract infections. The trouble is that the delicate balance of these microorganisms is very easily disrupted. So let's take a look at how the vaginal flora works, what it consists of and how you can restore and maintain its balance.

What does vaginal flora mean and why does it matter?

Let's start by clarifying what the microflora actually is. In short, it comprises all the types of bacteria found in the vaginal tract.

Depending on its composition, the flora can be healthy or thrown off balance – whether by a urinary tract infection, a genital infection or a sexually transmitted disease. So let's look at what a normal vaginal flora looks like, one that maintains the bacterial balance in your vagina.

What is the vaginal microflora made up of?

Numerous different microorganisms live in the vagina, and together they form the microflora. Studies have identified up to 250 species of bacteria in the vaginal tract, including fungal species such as Candida. As long as they don't multiply excessively, the microflora remains in balance.

Predominantly, however, lactobacilli dominate – the bacteria that make up a healthy vaginal microbiome, including:

• Lactobacillus crispatus;
• Lactobacillus gasseri;
• Lactobacillus iners;
• Lactobacillus jensenii;

So when we speak of a normal vaginal flora, we automatically mean lactobacilli. They help to maintain a healthy vaginal pH (between roughly 3.8 and 4.5, slightly acidic, to protect against infection). Lactobacilli also produce lactic acid and hydrogen peroxide, which prevent harmful bacteria from multiplying.

An imbalance in the vaginal flora

This brings us to the topic we opened this article with: the balance between lactobacilli and bad bacteria, i.e. germs from the environment, is extremely delicate. And the latter can multiply very quickly in your vagina.

If the lactobacilli flora changes, the production of hydrogen peroxide is no longer sufficient to prevent infection, and the risk of inflammation or urogenital conditions increases. A Candida infection or bacterial vaginosis may develop, for example. It's precisely this imbalance between lactobacilli and other microorganisms in the vagina that we really mean when we talk about disrupted vaginal flora.

Symptoms & conditions associated with disrupted vaginal flora

When lactobacilli no longer predominate in the bacterial flora of the vagina, you become susceptible to various infections, which in turn can cause further unpleasant complaints. Here are the main signs and conditions associated with such an imbalance:

• Inflammation: itching, irritation, burning;
• Unusual discharge;
• Pain;
• Unpleasant odour: which becomes stronger particularly after unprotected intercourse, when the higher pH of semen makes the smell more intense;
• Candidiasis: caused by the proliferation of the fungus known as Candida;
• Bacterial vaginosis: caused by the rapid and unusual proliferation of germs from the environment;

In addition, there are studies linking bacterial vaginosis to an increased risk of further conditions and health problems:

• Sexually transmitted diseases;
• Pelvic inflammatory disease;
• Premature labour and preterm birth;
• Problems with in vitro fertilisation and miscarriage due to low lactobacilli levels.

Risk factors for vaginal flora imbalance

Now we'll also explain why we keep emphasising how easily the bacterial flora is thrown off balance: the risk factors are extremely varied – both physical and psychological. What does that mean? Quite simply: a great many of your habits in your hygiene routine, your lifestyle, or even your emotional and mental state can become risk factors.

How you look after your body and your mental health can affect your vaginal pH and upset the balance of your flora. So let's take a look at these risk factors, so you know what to watch out for in future in order to maintain a healthy urogenital flora.

Incorrect use of tampons

Or … using the "wrong" tampons. But let's take things one at a time:

First: what does it mean to use a tampon incorrectly, and how can that throw your vaginal flora off balance? Well, bacteria can build up on the tampon and multiply rapidly – especially if you don't change it often enough.

Equally, a super tampon with high absorbency designed for heavy bleeding, used during a light period, can cause tiny injuries in the vagina because the environment becomes too dry. This allows bacteria to enter the bloodstream and trigger new infections. All of this can disrupt the microflora in your vagina.

And second: when is a tampon considered "wrong"? What we mean here are conventional tampons, which may contain plastic, dioxins, fragrances and other harmful chemicals. In women with sensitive skin in particular, these chemicals can cause irritation and allergies. On top of that, the vagina is highly absorbent and will automatically take some of these chemicals into your body, month after month, for as long as you use such tampons.

That's why it's always better to use hypoallergenic organic cotton tampons with a neutral pH, which won't throw your vaginal flora off balance or cause allergies or inflammation. Enroush organic tampons are made from 100% organic cotton and are gynaecologically and dermatologically tested and approved. That's how we make sure we're here for you with healthy period products that protect your vaginal bacterial flora.
 

A weakened immune system 

A weakened immune system makes it easier for pathogens to accumulate and multiply. For the vaginal microbiome, this means germs can multiply to the point where they outnumber the lactobacilli, leading to infections of the vaginal flora. So look after your immune system by meeting your daily requirement for vitamins and minerals.

Hormonal fluctuations 

Fluctuations in oestrogen levels in the body can also alter the vaginal flora. During pregnancy, for instance, studies show a decrease in the number and diversity of bacterial species in the vaginal tract, particularly towards the uterus.

The contraceptive pill and the menopause are two further factors that can cause hormonal fluctuations. During the menopause, oestrogen levels drop dramatically, making vaginal tissue thinner and drier – which increases your susceptibility to imbalances and infections of the flora.
 

An unhealthy diet 

The specialist literature of recent years shows that the flora of the genital tract and the gut flora are in constant communication with one another, influencing your mental state, your immune defences and your metabolism. In turn, they also interact with other organs and affect your health and your internal balance.

A diet with an excess of fat and sugar, lacking in important nutrients, has a negative effect on general health – and this is also reflected in the health of the vagina and its flora. A diet rich in vitamins and minerals, on the other hand, is associated in studies with a balanced state of the vaginal flora and a lower risk of bacterial vaginosis and HPV.

So it's important to look after both the vaginal flora and the gut flora.  Some studies even show that a balanced intake of probiotics containing Lactobacillus strains helps to restore and maintain a healthy vaginal flora. However, further research is needed to determine exactly what quantity of probiotics is genuinely beneficial.

Vaginal douching 

We tell you at every opportunity and take every chance to remind you: unless your gynaecologist has specifically recommended it, do NOT use vaginal douches.

Specialists in gynaecology and women's health advise against vaginal douching – neither with water nor with any other substance. Just like incorrect or excessive hygiene, douching can alter the vagina's natural acidic pH, disrupt the balance of the flora and thus increase your susceptibility to infections, irritation and PID (pelvic inflammatory disease).

The vagina's self-cleaning function is entirely sufficient, so you don't need anything else. Water only, externally only (around the vulva), once a day – that's correct intimate hygiene.

If you'd also like to use products that give you a feeling of freshness, make sure you choose a natural intimate gel without fragrances or harmful chemicals. Enroush intimate gel is antibacterial, made from 95% natural ingredients, free from fragrances and parabens, and developed together with gynaecologists and dermatologists – so that we can care for your vulva and your vagina the way you deserve.

Certain medicines 

Antibiotics are used to treat bacterial infections in the human body. In the vagina, however, antibiotics can destroy both the bad and the good bacteria (lactobacilli). A course of medication such as antibiotic therapy can therefore alter your flora and the pH balance of the vagina, leaving you more vulnerable to infection.

High stress levels 

At first glance, you might think there's no connection between the vaginal flora (something physical) and stress (something psychological). But there certainly is, because cortisol – a stress hormone – rises when you're tense or exhausted. And high cortisol levels can lower lactobacilli levels and thereby damage your vaginal flora.

That's why, in difficult periods especially, it's important to keep up activities or habits that help you keep your stress levels under control. You can use breathing, relaxation or meditation techniques, prioritise rest and exercise, and also seek professional support if things become overwhelming.

Smoking

Studies suggest that lactobacilli are also sensitive to the level of tobacco in the body. Researchers point out that in women who smoke, tobacco can increase the proportion of pathogenic bacteria and reduce that of lactobacilli. In addition, compounds produced by smoking have been detected in cervical mucus. So yes: smoking is a risk factor and has a negative effect on the microflora.

Sexual activity 

There is also a growing body of studies suggesting a link between sexual activity and bacterial vaginosis or an imbalance in the vaginal flora. Particularly after unprotected intercourse or with several new partners – and not just because of sexually transmitted diseases.

Bacteria from outside enter the vagina, while the vaginal pH can naturally shift away from its slightly acidic state because semen is alkaline – all of which disrupts the normal flora and increases the risk of infection. The simplest way to prevent all these problems is to use a barrier method (a condom).

Other factors that can cause vaginal imbalance 

Above we've listed only the main risk factors, but there are many other things in your daily life that can affect the balance of your flora. So keep an eye on the following as well:

• Sweating: It's perfectly normal to sweat in the intimate area, especially in warm weather. What matters, though, is changing your clothes and underwear and spending as little time as possible with damp fabric against your skin. After exercise or swimming, too, you shouldn't stay in wet clothing for too long, because a moist environment encourages bacteria to build up and throws the natural flora off balance.
• Your clothing: If your clothes or underwear are too tight and made of synthetic fibres, your skin can't breathe – which encourages and sustains sweating, bringing us back to what we've just discussed.
• Damp environments: Saunas and swimming pools are two further examples of environments that can increase the risk of disrupting your vaginal microbiome. Pool water usually contains chlorine, which can destroy the good bacteria in the vagina.
• Chemicals your skin comes into contact with: What we mean here are fabric softeners and detergents, fragrances and other harmful chemicals in intimate care products. Avoid artificial substances as far as possible and opt for natural ingredients.
• Contraceptive methods: The coil is another well-known risk factor for the vaginal flora.

Rebuilding the vaginal flora – treatment options: 

With so many risks of it being damaged – how can the vaginal flora be restored after such an imbalance? Essentially, your doctor will recommend a treatment after which the types and numbers of bacteria may return to normal – or may not.

What's clear is that the aim of treatment is to restore a flora made up predominantly of lactobacilli. There are two main options that specialists may recommend for this:

• Probiotics for the vaginal flora: usually taken as food supplements in tablet form;
• Vaginal pessaries for the vaginal flora: these contain Lactobacillus strains intended to multiply and restore a healthy vaginal flora.

Whatever the treatment, the most important thing is to follow your gynaecologist's instructions, because only specialists can give you the right advice based on your medical history and your diagnosis.

Complications of disrupted vaginal flora 

There aren't a great many complications that can arise as a result of a vaginal flora imbalance, but even the symptoms are unpleasant, as they come with considerable discomfort. When we speak of an unhealthy flora, however, we automatically also mean bacterial vaginosis or other infections and conditions, which in turn can lead to further complications. Ultimately, this can even result in:

• Preterm birth;
• Miscarriage;
• Difficulties with in vitro fertilisation;
• Worsening of other urogenital infections or conditions.

Tips for maintaining your vaginal flora 

By keeping your vaginal flora in balance and your vaginal pH within the normal range, you ensure that your body can protect you effectively against infection. So you have every reason to take good care of your vaginal health – and we'll end this article with a few tips on how to do just that:

• Avoid harsh soaps, scented wipes and vaginal douches: Anything that involves excessive washing and introducing foreign bacteria into your vagina gets a clear NO. Prevent harmful chemicals such as fragrances or parabens from coming into contact with your intimate area and disturbing its delicate balance. Use only water and, if you wish, a natural intimate gel.
• Choose your tampons carefully and change them in good time: If you use tampons during your period, opt for natural tampons made from 100% organic cotton, free from dioxins, chlorine, pesticides, plastic, fragrances, synthetic fibres and so on. Also make sure you change them in good time so that the lactobacilli aren't outnumbered by other types of bacteria;
• Wear clothing made from natural materials and check the detergents you use: Choose clothing made from cotton or other lightweight materials that let your skin breathe, with no synthetic fibres – all the more so with underwear. Also make sure the detergents you use don't contain ingredients that could be problematic for your intimate health;
• Lead as healthy a lifestyle as possible: As mentioned, the gut and vaginal microbiomes are in constant communication, and everything that forms part of your diet also affects your intimate health. Try to eat foods as rich as possible in vitamins and minerals, manage your exercise, stress and rest well, and avoid excess fat, sugar and tobacco. This strengthens your immune system, protects your reproductive health and does you and your body good at the same time.
• Don't put off visits to your gynaecologist: Whether it's an examination for particular symptoms or a routine check-up, seeing your doctor and following the advice you're given is hugely important for preventing imbalances, restoring your normal vaginal flora and preserving your intimate health.