Vaginal microbiome is a big buzzword now. As the scientific and medical communities learn more about it, it’s being talked about more in health media. And it’s also being talked about more with products too.
There is still so much we don’t understand, but the research and emphasis on maintaining and optimizing the microbiome of all parts of our bodies – skin, intestines, vagina – is very promising.
As an OBGYN, most of the questions I get are about the vaginal microbiome.
It’s can be hard to find time during a quick OBGYN visit to get detailed information about the vaginal microbiome though! Questions like “is bubble bath bad for my vaginal microbiome?” don’t get asked!
So here are the top facts that, as an OBGYN, I want you to know about the vaginal microbiome.
Different terms for the microbiome are used interchangeably.
Microbiome, microbiota, vaginal flora, “good bacteria”. While there are differences in the precise definitions of these terms, I don’t want you to fixate on that. For example, microbiota means the organisms themselves – the bacteria, virus, fungus. Microbiome is the organism AND their genome – the parts that make up the organism. Do you need to know that difference when you want to know why douching can be harmful? Nope! But just FYI, I default to “microbiome”.
The ideal vaginal pH is 3.5 – 4.5 and the vaginal microbiome helps keep it that way.
Lactobacillus is the dominant organism in the vaginal microbiome. What is its primary task? It breaks down glycogen (which is produced by the vaginal lining), and that produces lactic acid. Lactic acid helps maintain the vaginal pH at this optimal acidic level
Why is this pH the optimal level? It helps prevent other bacteria from colonizing and taking over. When these other bacteria do take over, symptoms include bad smelling vaginal discharge, an increase in amount of vaginal discharge, abnormal bleeding from inflamed tissue, or irritation and itching. Not good, right?
In terms of feminine hygiene products, here are some things to remember:
- When products are “pH balanced”, it means they have the same pH as the skin, which is around 5.5. The idea is that these soaps don’t alter the pH balance of the skin since they ARE the same pH as the skin! This is important when washing the skin of the vulva (the area where hair grows!).
- Remember, the skin and vagina do NOT have the same pH, so these products can still disrupt the pH of the vagina. This is one reason putting soaps inside the vagina can be harmful. Don’t douche!!
- Products like soap and fragrance that get inside the vaginal also prevent Lactobacillus from doing its job. That disrupts the optimal vaginal pH, increasing the chances of those symptoms above.
So, back to that question – is bubble bath bad for the vaginal microbiome?
It certainly can be. When someone sits in a bathtub, some of that water does get inside the vagina. If that bubble bath water has a huge amount of soap, or that soap has a high pH, or has a lot of chemicals, those are all risk factors for disrupting the vaginal microbiome. And, everyone is different, so some people are just more likely to be affected than others.
I am a board certified OBGYN at Cedars Sinai in Los Angeles.
I am co-founder of Female Health Education, a platform offering digital courses, striving to empower females through health education.
My passion is promoting and demystifying health information to the public. My blog, Dr. Sara Twogood’s LadyParts Blog, provides comprehensive information about fertility, pregnancy, and gynecology topics. I am on the medical board for the period tracker app Flo; contribute as a medical expert for pregnancy app and website The Bump; and serve on the Byrdie Beauty and Wellness Review Board (Byrdie.com). I have been featured as an expert for the podcasts The Dream and Her body, Her Story and quoted in numerous online and print publications.
I am honored to be named “Top Doctor” in Los Angeles magazine for years.