Vaginal flora is the balance of bacteria and yeasts in our reproductive ecosystem. It plays an important role in conception, for comfort during pregnancy and a healthy bacterial start for the baby entering the world.
It is commonly accepted that when planning a pregnancy, certain nutrients like iodine and folic acid are important. However, the healthy balance of vaginal flora also has an important part to play in conception and throughout pregnancy.
Let's take a look at the general importance of vaginal flora around pregnancy.
How important is vaginal health for conception?
Trying to solve infertility issues has led to an increase in research and this includes the part that vaginal flora plays. Many of these studies are useful as they are in controlled settings where women are receiving IVF treatment. A pilot study published in The Australian and New Zealand Journal of Obstetrics and Gynaecology showed how vaginal flora health may affect pregnancy outcomes. The study took 2 groups of women, those undergoing IVF and others with a history of fertility. It was found that women in the IVF group had some less desirable bacteria populations. This led to the conclusion that vaginal flora health could have an effect on fertility¹.
How is healthy vaginal flora maintained?
The vagina has a variety of different types of bacteria and yeasts – some less beneficial than others. The beneficial bacteria, most commonly Lactobacillus, need to dominate in numbers to maintain vaginal health. To discourage less desirable populations the Lactobacillus produces hydrogen peroxide and lactic acid, which create an acidic environment (around pH 4). Yeast and bad bacteria struggle to thrive in this acidity.
Also, the cells in the vagina produce mucous which:
- Provides nutrients for the Lactobacillus bacteria
- Provides vaginal lubrication
- Helps to flush away dead bacteria and yeasts
Why are flora imbalances common in pregnancy?
It is thought that as hormone levels change in pregnancy, this leads to pH changes in the vagina and bladder. It makes the environment less acidic, which can alter the balance of bad bacteria and yeasts.
What problems can flora imbalances cause in pregnancy?
There are several yeasts and bacteria that can start to take over when pH levels change in the vagina. Here are the most common issues and the challenges they cause.
Yeast imbalances
These are caused by the yeast Candida albicans and lead to discomfort and itching. Vaginal discharge may be thicker than normal or there may be a change in the normal clear/white colour. These are not harmful but can be persistent and unpleasant.
Bacterial vaginosis (BV)
This is often caused by the bacteria species Gardnerella vaginalis. It has similar symptoms to yeast vaginitis, but vaginal discharge sometimes has an unpleasant fishy odour. However, it can also be asymptomatic (without symptoms so you don't know you have it), which is a concern in pregnancy as BV has been associated with preterm pregnancy. Also, according to studies BV is three times as common in infertile women than fertile women.
Group B Streptococcus
This is a bacteria tested for in the weeks before women give birth. Group B Streptococcus (GBS) is mostly asymptomatic in pregnant women but can be transferred at birth to infants increasing the risk of serious infection.
Ideally, the baby should be born into healthy vaginal flora as this gives a head start in immune health.
What can we do to support healthy flora through pregnancy?
Cut the perfumed products
Perfumes and chemicals can change the pH in the area around the bladder and vagina. Try to avoid perfumed shower gels, bath oils or soaps around this area. Just wash with water.
Good hygiene habits
To avoid moving bacteria towards the bladder, get into the habit after going to the bathroom of wiping from front to back.
Stay Hydrated
To make our protective mucosa in the vagina we need water. Keeping the vaginal tissues hydrated helps feed good bacteria and flushes away less desirable bacteria and yeasts.
Dietary influences on flora
Bacteria and yeasts love sugar to feed on and although you would not expect it to affect "down there" studies have shown a link between diet and vaginal flora². Long term increase of high glycemic index foods were linked with increased levels of BV. Examples of high GI foods include sugar, fizzy drinks, cakes, biscuits, processed foods, white bread and pasta. Make sure these food are not eaten in excess, as they are also linked to blood sugar issues in pregnancy.
Boost beneficial bacteria
As we have learnt, when our vaginal Lactobacillus bacteria are in abundance, they help to maintain the balance of less beneficial bacteria and yeasts. Therefore boosting these numbers will help to deter less beneficial species. It is great to take them in preparation for pregnancy to create an ideal environment and through pregnancy to maintain flora balance.
There are well researched strains that have been shown to provide support in this area. In a 2004 study probiotic strains Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14® used by 64 women for 60 days reduced the colonization of less beneficial bacteria and yeasts³.
Also, a clinical study published in the International Obstetrics and Gynecological journal, showed the use of Lactobacillus strains GR-1 and RC-14 can reduce the infection of beta streptococcus in pregnant women⁴.
If you are planning a pregnancy or have already conceived, consider the balance of vaginal flora for your good health and your baby's. If you would like to know more about our products that are suitable for use at this special time, please feel free to talk to our Clinicians Naturopaths.
References:
¹https://www.sciencedirect.com/science/article/pii/S1472648317301876
²https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159055/
³Reid, et al. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS
⁴Ho, et al. Oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 to reduce Group B Streptococcus colonization in pregnant women: A randomized controlled trial. Taiwan.J.Obstet.Gynecol. 2016;55(4):515-518
