Menopause and Vaginal Microbiome
A microbiome is a collection of microbes that interface between the body and the environment and affect the body’s health. Microbes are bacteria that act to buffer the body from harmful substances. Throughout life, a person’s vaginal microbiome constantly fluctuates in response to factors such as hormone fluctuations, medication, diet, and environmental exposure.
A healthy vaginal microbiome is dominated by strains of the bacterial species Lactobacillus. As estrogen hormones shift during perimenopause and menopause, a lower level of vaginal lactobacillus can make the vagina susceptible to infections like yeast and bacterial vaginosis (BV). This imbalance can alter the vagina’s healthy pH. Symptoms associated with this include odor, itching, and discharge.
How does one keep their vagina healthy after menopause when estrogen levels naturally decline?
If you are not experiencing symptoms, your vagina is probably managing its ecosystem just fine! There is no need to “clean” the vagina. Water and occasional mild soap to the genitals are the safest ways to maintain vaginal health.
Stay away from vaginal douches, heavily fragranced soaps, body washes or wipes, scented detergents, fabric softeners, fragranced panty liners, and powders. Avoid oil-based lubricants during sexual activity, which can breed pathogens. All these products can disrupt the natural balance of vaginal bacteria.
Be proactive by engaging in consistent healthy lifestyle habits to maintain vaginal health.
Eat a variety of nutritious whole foods, manage stress, use water-based or silicone-based lubricants during sexual activity, and avoid smoking. In addition to exacerbating hot flashes in menopause, cigarette smokers are more likely to have low lactobacillus levels and are at higher risk of bacterial vaginosis and damage to their cervical cells. If using a vaginal lubricant during sexual activity, your best option is a water-based lubricant that lowers the risk of irritation or cellular damage. Lubricants with a pH of 4-5 help keep the vaginal microbiome in balance. Some women find relief of vaginal symptoms such as itching and dryness from a quality, non-prescription, water-based, vaginal moisturizer designed to balance the vaginal microbiome.
Fortunately for most, the vagina manages its environment with the right balance of good bacteria to ward off issues. However, hormonal changes during perimenopause and menopause can sometimes upset the vagina’s microbiome. Anyone experiencing vulvar or vaginal discomfort or unusual symptoms should check in with their doctor to rule out infection first. If cleared but still having symptoms such as dryness, itching, or discharge, discuss with your provider how to best manage the symptoms and promote optimal vaginal health.