Are Thrush and BV actually “infections”?
Bacterial Vaginosis (BV) and Thrush (Candida yeast) are two of the most common issues faced by women. These conditions affect most women, with some 75% of women having Thrush at some time in their lives and BV affecting approximately 10% of women at any one time (NICE CKS).
These conditions are generally treated as infections with antibiotics or antifungal medicines.
The UK National Health Service (NHS) definition of an infection is:
“The invasion of the body by a harmful organism or infectious agent such as a virus, parasite, bacterium or fungus.”
But what if the cause of the problem is already there?
The bacteria and yeasts that cause BV and Thrush are a natural part of a woman’s vaginal microbiome. They are present in most women all of the time and generally do not cause a problem. If the conditions are right in the vagina, these microbes grow and reproduce and cause the conditions which we call Thrush and BV. It is more correct to call these ‘infections’ an imbalance, where the bad bacteria or yeast overgrow and cause symptoms.
What causes the bad bacteria and yeast to ‘take-over’?
The vagina is kept healthy by a harmonious ecosystem called the vaginal microbiome. It is collection of microbes that live in the vagina, mostly working to keep it clean, healthy and free from problems. Ideally, it should have a majority of good bacteria called Lactobacillus, specifically three species:
These good bacteria thrive in the lining of the vagina called the vaginal mucosa and produce a number of natural anti-microbial compounds which stop the bad bacteria and yeast which cause Thrush and BV from growing out of control. The most common antimicrobial is Lactic acid which keeps the vaginal acidity at a pH level of 3.8-4.5. This acidity stops the bad microbes from multiplying and causing symptoms. If there is an imbalance reducing Lactobacillus populations, BV or Thrush can dominate You can test your vaginal pH with a simple at home pH test like the one from VJJ Health.
What causes an imbalance in the vaginal microbiome?
The vaginal microbiome is quite sensitive. There are several common things that can affect the good bacteria in the vaginal microbiome:
Periods – Menstruation happens every month when the level of progesterone and oestrogen drop and the uterus sheds its lining as blood. The combination of reduced oestrogen and blood which is less acidic than the vagina can alter the delicate balance of the good Lactobacilli. This is the reason why many women get Thrush or BV around their period.
Unprotected sex – Spermatic fluid is one of the most alkaline fluids in the body. It can affect the acidity (pH) of the vagina which in turn can encourage the growth of the microbes that cause BV. Recurrent BV is common with increased sex. This is mostly a consequence of a more alkaline vagina which affects the good Lactobacillus. If this happens, using a non-spermicidal condom will stop sperm affecting the vaginal pH
Using soaps and washes in the vagina - Most soaps and washes both affect the acidity of the vagina and kill good bacteria. The vagina is self-cleaning and should not be washed with soap. Try washing the vulva with water or with a gentle moisturising emollient like Cetraben, but never the vagina.
Wearing tight sweaty underwear - Tight sportswear, artificial underwear and wet swimsuits can be a problem if they are worn for too long. They don’t allow the vagina to breathe and this hot environment is perfect for Thrush to multiply. Try to change out of tight-fitting sports clothes as soon as you can, and wear underwear made from natural breathable fabrics like cotton or Tencel.
During the menopause, the reducing level of oestrogen in the body causes significant changes in the vagina. The vaginal wall becomes slightly less elastic and the layer of cells which produce moisture and lubrication, the vaginal mucosa, begins to thin. This thinning of the vaginal mucosa is important because this is where the good bacteria live. Without HRT or vaginal oestrogen, the vaginal pH rises and women are much more likely to suffer from Urinary Tract Infections (UTIs).
BV is a bigger problem than just a bad smelling discharge
Bacterial vaginosis causes an unpleasant smelling discharge, often described as ‘fishy’, but they are also responsible for a range of other health issues. The main bacteria that causes BV is called Gardnerella vaginosis, it can also contribute to infertility and to early pregnancy loss (miscarriage). Bacterial Vaginosis can be asymptomatic, meaning that there are no signs that you have it. A simple pH test will tell you if you have an asymptomatic infection.
What can I do to balance my intimate health?
The first line treatment for Bacterial Vaginosis is antibiotics. These medicines kill the bacteria that cause BV….. but they also kill the good bacteria that protect you from BV and Thrush. This is one of the reasons why women get Thrush after a course of antibiotics – the good bacteria have been killed and there is nothing to stop the thrush yeast from taking over.
There is now considerable clinical evidence showing that supporting your important Vaginal Microbiome with the right strains of vaginal Lactobacilli can not only treat thrush and BV infections but can reduce the likelihood of them coming back.
Ultimate V, a specific oral women’s vaginal probiotic from VJJ Health contains the four most common healthy Lactobacilli and has been clinically validated to reach the vagina and to improve the pH and to be effective against Thrush and BV. In menopause, there is evidence that taking the lactobacilli contained in Ultimate V maintains a healthy pH and can relieve some of the symptoms of vaginal atrophy.
