For most of us, we entered this crazy world through someone’s vagina.
That moment in our lives played a very important role in the future of our health.
Not only does the vagina serve as a birth canal- the vagina is our first external exposure to bacteria – and that exposure to vaginal bacteria is a really good thing.
The intestine of the healthy newborn infant can be considered to be sterile – or- bacteria free.
The healthy, diverse vaginal bacteria is what colonizes the baby’s digestive tract and becomes their gut flora or microbiome.
Their microbiome informs their developing immune system.
C-section babies have a slightly different initial exposure to microbes- that of the skin and hospital microflora, which is less beneficial.
However, we are able to mitigate that.
Today, prior to a planned c-section, a sterile piece of gauze is incubated in the mother’s vaginas for one hour and then placed into a sterile container.
Within two minutes of the birth, the baby delivered by C-section is swabbed with the gauze starting with the mouth, then the face and the rest of the body.
The diversity in the gut flora of these c-sections babies is the same as babies from vaginal births!
The vagina has its own very important ecosystem.
You’ve probably heard of Lactobacillus acidophilus (yogurtor probiotics probably come to mind).
The Lactobacillus species are the predominant bacteria type in the vagina.
Aptly named, these bacteria produce lactic acid as a byproduct of metabolism which acidifies the vagina.
The vaginal ecosystem is most happy and healthy at an acidic pH of about 3.8 to 4.2.
The higher the pH ( the greater the number) the more alkaline the substance is.
Lower pH indicates a more acidic environment.
We need certain areas of our body to remain robustly acidic- like the stomach at a ph of 2, and the vagina at a pH of about 4.
Different substances that enter of leave the vagina can pose a threat to that acidic pH:
Blood, via monthly periods in menstruating women.
Fluids exchanged during sex – ejaculatory fluid, saliva and/or lubricants.
These fluids are typically more pH balanced sitting around a pH of 7.
However, in the relatively acidic vagina, lined with ample lactobacillus species, periodic exposure to alkaline substances does not disrupt the ecosystem.
The vagina is like a self-cleaning oven and is able remain healthy and balanced.
However, douching or washing with soap and water internally is not a good idea and can disrupt the vagina’s delicate balance.
Soap is very alkaline- ph of about 9, and can be a causative factor for bacterial vaginosis (BV).
BV occurs when the ratio of lactobacilli species is reduced relative to other species of bacteria- and causes the vaginal ecosystem to become relatively more alkaline at a pH of 5.5
Yeast infections, although they don’t alter pH, are also a result of an imbalance in vaginal flora.
The candida albicans species, in small amounts, is a normal part of the vaginal flora. However, it is an “opportunistic” organism.
This means that if the conditions are hospitable for it to take over, it will try to.
Often this happens when our immune system is weak, our blood sugar is chronically elevated, and most notably when the Lactobacillus species are outnumbered by the Candida species.
This can occur after recent rounds of antibiotics that can kill off some of the lactobacilli.
How do we treat BV and Candida?
My approach involves completing a vaginal swab to determine the status of the vaginal flora.
I then recommend treatment that encourages balanced vaginal flora (killing off the offending organisms while reinoculating with beneficial bacteria) and supports immune function.