How Menopause can change your Vaginal Microbiome
Your vaginal microbiome is strongly influenced by your ethnicity and is mostly comprised of the bacteria genus, Lactobacillus. Research demonstrates that if you are an African-American or Hispanic decent, that you might have other species that are dominate other than Lactobacillus (Ravel et. al. 2011).
Lactobacillus produce an acidic environment in your vagina. Most pathogens won’t exist in an acid environment and therefore, it is very beneficial to have a dominance of Lactobacillus species. Lactobacillus species feed off a carbohydrate called glycogen. Where does glycogen come from? Glycogen is expressed from oestrogen!
During menopause your oestrogen and progesterone levels naturally decline. This means LESS fuel to FEED the Lactobacillus species. Lactobacillus numbers decline and vaginal dysbiosis can occur. This where there is an imbalance in the vaginal microbiome and pathogens can have a party!
What type of pathogens?
Vaginal dysbiosis can create an environment for Bacterial Vaginosis (BV), Vulvovaginal candidiasis (also known as thrush. Thrush is not common during menopause because thrush is influenced by times of high oestrogen within a menstrual cycle), there is also more of a risk in developing an STI (sexually transmitted infection). This can also be because your pH balance may shift to a more alkaline balance. Healthy vaginal pH levels are between 3.6-4.5.
With the decrease in oestrogen levels and a risk in having lower Lactobacillus species in your vaginal cavity, this also makes the lining of your vagina thin (causing vaginal atrophy) and can lead to irritation, painful intercourse, and tearing. These symptoms are also associated with Genito-urinary Syndrome of Menopause (more on that in another post!)
Other factors to consider..
Menopause comes with a lot of changes; mentally, stress levels are generally high, physically, metabolically, and neurologically (plus if you have any other comorbid conditions to add into the mix).
Natural ways to feed your Lactobacillus species
Fortunately, there are natural ways that you can increase your Lactobacillus species and support irritation (yay!):
Diet: Eat foods that are high in polyphenols or contain phyto-estrogens (as long as there in no history of oestrogen dominant cancers).
Create an acidic environment: There are pessaries that are high in lactic acid and can be inserted into your vagina to increase acid levels. Probiotics can either be taken orally or vaginally to increase Lactobaciluus species (probiotic needs to be strain specific for your vaginal microbiome) and with the rise in Lactobacillus species, this will create a more acidic pH.
Green tea taken in a capsule (or in a herbal tincture) orally and vaginally to recolonise Lactobacillus species (Tuzil. J., 2020) and has anti-microbial properties (Kim, YW., 2013) for treating vaginal dysbiosis. Also drinking green tea will help too. Green tea is also a polyphenol, which is also another reason why it is beneficial.
Lactulose is a carbohydrate that can be used as a fuel for your healthy vaginal microbes and increase your Lactobacillus species due to its prebiotic activities (Collins et. al. 2018) . This can be taken as a pessary and inserted into your vagina or used as an irrigation. There is a green tea and lactulose capsule that is also available that can be taken orally or vaginally, or you can take it as a liquid. For some people, lactulose can cause unwanted tummy symptoms such as bloating, abdominal pain or loose stools. Another option is to dip a tampon in 6ml of liquid lactulose and insert into your vaginal canal (the tampon needs to have absorbed the liquid, but not too much where you can’t insert).
Alternative options for other symptoms:
Vaginal atrophy can be soothed with oil based lubricants such as sea buckthorn (Larmo, P.S., 2014) and Vitamin D (Riazi, H. 2019) used topically and taken orally. Other oil based lubricants that can be purchased online are: Olive and Bee Intimate Cream (used to soothe vulva and vaginal tissue) or can be used as a personal lubricant during intercourse, Sea Buckthorn oil by Byron Bay Love Oils soothes and regenerates vaginal tissue integrity, YES OB lubricant is an oil based lubricant used as a massage oil or a personal lubricant during intercourse or try Vitamin E capsules (Porterfield, L. et. al. 2022) that can either be inserted internally into the vagina or a capsule can be broken and used to heal and soothe your vulva and labia majora.
Fennel oil can be used to reduce inflammation and support vaginal atrophy. Fennel oil can used as a personal lubricant, topically with olive oil, as a moisturiser, or in a pessary (Yaralizadeh, M. et. al. 2016)
Vitamin D is a promotor of the proliferation of the vaginal epithelium (Gilbert, 2023) and can be used as a capsule inserted into the vagina.
What next?
Perhaps you are able to self administer some of your symptoms or you can go one step further and complete of Vaginal Microbiome test and discover what microbes are living in your vagina! Everyone is individual and there are many external (and internal) factors that can influence the health of your vagina. The benefits of visiting a naturopath is that they can also include other aspects that might be influencing your vaginal microbiome.
As I mentioned above, these symptoms are part of Genito-Urinary Syndrome of Menopause. You can read more on this here.
References:
Collins, S. L., McMillan, A., Seney, S., van der Veer, C., Kort, R., Sumarah, M. W., & Reid, G. (2018). Promising Prebiotic Candidate Established by Evaluation of Lactitol, Lactulose, Raffinose, and Oligofructose for Maintenance of a Lactobacillus-Dominated Vaginal Microbiota. Applied and environmental microbiology, 84(5), e02200-17. https://doi.org/10.1128/AEM.02200-17
Gilbert G.G. Donders & Francesca H.W.V. Donders (2023) New developments in the management of vulvovaginal atrophy: a comprehensive overview, Expert Opinion on Pharmacotherapy, 24:5, 599-616, DOI: 10.1080/14656566.2023.2194017
Kim, YW., Chun, H.J., Kim, IW. et al. RETRACTED ARTICLE: Antimicrobial and antifungal effects of green tea extracts against microorganisms causing vaginitis. Food Sci Biotechnol 22, 713–719 (2013). https://doi.org/10.1007/s10068-013-0136-3
Larmo, P. S., Yang, B., Hyssälä, J., Kallio, H. P., & Erkkola, R. (2014). Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: A randomized, double-blind, placebo-controlled study. Maturitas, 79(3), 316–321. https://doi.org/10.1016/j.maturitas.2014.07.010
Porterfield L, Wur N, Delgado ZS, Syed F, Song A, Weller SC. Vaginal Vitamin E for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review of Randomized Controlled Trials. J Menopausal Med. 2022 Apr;28(1):9-16. https://doi.org/10.6118/jmm.21028
Ravel, J., Gajer, P., Abdo, Z., Schneider, G. M., Koenig, S. S. K., McCulle, S. L., Karlebach, S., Gorle, R., Russell, J., Tacket, C. O., Brotman, R. M., Davis, C. C., Ault, K., Peralta, L., & Forney, L. J. (2011). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences - PNAS, 108(Supplement 1), 4680–4687. https://doi.org/10.1073/pnas.1002611107
Riazi H, Ghazanfarpour M, Taebi M, Abdolahian S. Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review. J Menopausal Med. 2019 Dec;25(3):109-116. https://doi.org/10.6118/jmm.19194
Tuzil J, Filkova B, Jircikova J, et al. Tea Extract Vaginal Ovule for Intermediate Flora: Randomized Blinded Vehicle-Controlled Multicenter Pilot Clinical Trial with Microbiome Analysis. Journal of Biologically Active Products from Nature. 2020;10:357-372.
Yaralizadeh, M., Abedi, P., Najar, S., Namjoyan, F., & Saki, A. (2016). Effect of Foeniculum vulgare (fennel) vaginal cream on vaginal atrophy in postmenopausal women: A double-blind randomized placebo-controlled trial. Maturitas, 84, 75–80. https://doi.org/10.1016/j.maturitas.2015.11.005
Best Recipe Websites for Inspo!
If you are seeking me out to hand over endless customised meal plans, you have come to the wrong person. A few years back I dabbled with starting a recipe blog. At the time there weren’t as many options as there are now. But it all ended very quickly when I started feeding the chickens too many times with my failed recipe attempts. I just couldn’t handle throwing my creations into the chook pen anymore (coconut flour is a real pain in the arse to work with).
I LOVE cooking and I also enjoy eating too! But with so many recipe websites available now, it can get a little overwhelming to know what is right for you and what also tastes good too.
Over the years I have noticed that I generally recommend the same websites over and over. So now is the time to share these websites with you!
If you are anything like me, I often go to a recipe and adjusted it if I don’t have the ingredients or I would rather choose a different ingredient.
The list you have been waiting for!
The Healthy Chef- Teresa Cutter
You might notice that many are Australian and a few that live in Perth, Western Australia…
If I have forgotten any, I will update this again (or if I discover new ones!)
Enjoy!
Supporting Your Mental Health
As things start to return to normal for us folk in Perth , Western Australia, there are other places in Australia and the rest of the world that are still feeling the pinch of Coronavirus.
Today I visited my local beauticians. I am not generally one for waxing and spending money on such things, but I guess it is the usual feeling of when things are suddenly taken away from you- you miss them!
There have been many a funny meme on social media of image of (mostly women) people that had regrowth, broken nails and hairy legs and eyelashes falling of their faces. You honestly have to laugh of the first world problems that we live in.
While many businesses have their staff working from home, I am back at taking face to face clients. It was so lovely to step back into the space that I know and love - EarthPoint Energy Centre in East Perth. It is a combination of the smell, the amazing women that I work along side with and the atmosphere that does something supportive to your nervous system.
I hindsight, I hope this pandemic has made more people aware about the importance of mental health during these times. Fortunately for me I have been one of the lucky ones. But for many, the home environment can be volatile and unsafe. Or the workplace can be for some people their only interaction with others and gives them a sense of belonging.
Has this time been a positive or negative experience for you?
The amount of online services supporting people’s wellbeing has increased greatly from free mediation sessions, online yoga classes and Zoom meetings.
My 3 pillars to health: MIND, MOVEMENT & MICROBIOME are always at the forefront of my mind for creating an ideal life for my clients. For if we don’t have a balance of all of these components, then we can become out of balance and experience low mood or digestive upsets.
I know living or even attempting to live a healthy lifestyle can be daunting and overwhelming. Knowing where to start can be off putting and can often lead to no action at all.
My approach is always taking one step at a time and focus on what is the easiest for you. No use in setting you up for failure before you have even started!
If you feel you need support with your mood or your tummy troubles….fill out my online enquiry form and see if I can help you.
Celebrating International Yoga Day!
Friday the 21st of June celebrates Yoga in all its forms, internationally. It's a day that we can share our love of yoga through connecting with the community.
Friday the 21st of June celebrates Yoga in all its forms, internationally.
It's a day that we can share our love of yoga through connecting with the community. Many yoga teachers and yoga studios usually provide special events or practices to recognise the day. This year I decided to share a little of my morning meditation and yoga practice by a LIVE Facebook event on my FB business page.
For those that have missed the event or would like to watch the replay, I have provided the LIVE stream by clicking HERE.