Disturbed vaginal flora

Why many women have problems in their intimate area

An intact vaginal flora protects against harmful germs and infections in the intimate area.

(Bild: stock.adobe.com/SENTELLO - stock.adobe.com)

The vaginal flora consists of numerous different microorganisms that colonize the mucous membrane. They protect against harmful germs and infections in the intimate area. A gynecologist explains why the optimal composition of the vaginal microbiome is so important.

The vagina is lined with a mucous membrane from the entrance to the cervix, which fulfills a number of functions. Of particular importance is protection against intruders such as fungi and harmful bacteria that lead to infections. This requires an intact vaginal flora (vaginal microbiome), i.e. a balanced composition of the microorganisms that live there.

"The majority of women are often very concerned about the healthy and natural vaginal environment. Patients are increasingly coming to the doctor's consultation because they notice that the smell or color of the discharge has changed," reports Prof. MR. Dr. Friedrich Gill, gynaecologist in Vienna.

There is a lot of ignorance about what may be behind this and there are a few myths circulating. For example, a new partner is sometimes accused of something that does not correspond to the medical facts. But even doctors are often unclear, as the gynecologist explains.

However, the vagina is not a sterile organ and bacteria of various types are always found - even if they are removed using a cotton swab within a few days - but these often do not require antibiotics!

Prof. MR Dr. Friedrich Gill, Frauenarzt in Wien

Bild: Gill

Dr. Gill: "For example, general practitioners very often immediately administer an antibiotic with a more or less recent secretion finding, without any knowledge of the normal vaginal environment. However, the vagina is not a sterile organ and bacteria of various types can always be found - even if a cotton swab is used within a few days - which often do not require antibiotics!

The constant request for a referral to a fungal laboratory to re-determine the colonization is also very often misleading and unfortunately misinterpreted even by doctors."

What does the vaginal microbiome mean?
The microbiome ensures that infections of the urinary and reproductive organs caused by bacteria or fungi, including sexually transmitted diseases, do not occur again and again and severely restrict the quality of life of the women affected.

However, it is also important to maintain a healthy vaginal environment in view of a possible pregnancy and the potentially increased risk of premature birth.

However, according to Dr. Gill, disorders of the vaginal flora (vaginal dysbiosis) are on the rise. This can not only lead to premature births, but also to a dysfunction of the placenta during pregnancy, growth retardation of the unborn child and even an increased incidence of endometriosis.

Composition of the vaginal flora
Lactobacilli (a type of bacteria that produces lactic acid) make up around 70 percent of the vaginal microbiome. Of the approximately 120 strains of these bacteria found in healthy vaginal flora, studies have shown that four are particularly important for ensuring the health of the female urogenital tract. They ensure that the pH value of the vagina remains in the correct range, thus creating an acidic environment.

The optimal composition of the microbes that colonize the vaginal mucosa is important.

(Bild: stock.adobe.com/TeraVector - stock.adobe.com)

"If there is a lack of lactobacilli, patients repeatedly come to the gynecologist's consultation with complaints at short intervals. If the environment is brought back into balance, the recurring problems are very often eliminated," says the gynecologist.

No self-treatment for complaints 
If symptoms occur, they should definitely be clarified by a specialist instead of self-treatment based on assumptions, as Dr. Gill emphasizes. He also strongly advises against the use of fungicides without prior clarification. The same applies to the use of tampons soaked in yoghurt or tea tree oil, etc., as they do more harm than good.

If, for example, no doctor is available at the weekend, Dr. Gill has the following tip: "Apple cider vinegar rinses with two tablespoons of apple cider vinegar in one liter of lukewarm water once a day to alleviate acute symptoms. Then seek medical advice as soon as possible!"

The gynecologist continues: "In the case of recurring fungal infections and a pH value that is within the normal range, the so-called fungal vaccination with lactobacilli (3 times at 14-day intervals and annual refreshment) and regular heat treatment of the vagina helps very well. In addition, the repeated intake of probiotic preparations, which are available in pharmacies or from gynecologists."