Flora vaginala

Vaginal flora

How to take care of your vaginal flora?

The vagina is home to hundreds of bacteria. Let's see how they work and what we need to watch out for flora/microbiota our vaginal.

  • What exactly is the vaginal microbiota?
  • How does the vaginal microbiota evolve throughout life?
  • Why does the vaginal microbiota play an important role in health?
  • What are the diseases associated with an imbalance of the vaginal microbiota?
  • Knowing the factors that can directly affect it, how can we take care of our vaginal microbiota

What exactly is the microbiota/vaginal flora?

The vaginal microbiota (or vaginal flora) consists of hundreds of bacteria and a smaller number of fungi (Candida) that live in the vagina.

In the vast majority of women (unlike what happens with the gut microbiota), the vaginal microbiota is balanced when it has a low diversity (about 200 bacterial species) and when lactobacilli predominate, i.e. the rod-shaped bacteria.

Although all women have a vaginal microbiota, this one is different. So far, they have been described five main types of vaginal bacterial communities:

Four dominated by lactobacilli (Lactobacillus crispatus, L. gasseri, L. iners or L. jensenii)

One characterized by a reduced amount of lactobacilli or even their complete absence

The vaginal microbiota is a dynamic community influenced by various factors such as ethnicity, sex hormones, hormonal contraceptives, sexual behavior, showering, diet, smoking, social environment (eg housing) and genes.

However, vaginal flora do not live in isolation. The entrance to the vagina is located very close to the anus, so intestinal bacteria can eventually colonize the vagina. Thus, the intestine is a natural reservoir of lactobacilli for the vagina, which is important for the balance of the vaginal flora.

How does the vaginal microbiota evolve throughout life?

Our body changes throughout life, and the vaginal microbiota is no exception. The composition of the vaginal microbiota varies considerably from childhood to menopause and into adulthood.

Hormonal changes alter the rhythm of our lives and also have an impact on the vaginal microbiota. For example, menstruation temporarily alters the microbial diversity of the vagina.

The microbiota is also involved at birth. During pregnancy, physiological changes occur that facilitate the adaptation of the mother's body to the fetus and vice versa. In pregnant women, the vaginal microbiota is more stable, less rich and less diverse, while high concentrations of estrogen guarantee the absolute predominance of lactobacilli. At menopause, the vaginal microbiota finds a new balance.

Why does the vaginal microbiota play an important role in health?

Vaginal microbiota bacteria contribute to maintaining a healthy vaginal environment. Some of these bacteria, especially lactobacilli, prevent the formation of pathogenic microorganisms in the vagina. Various mechanisms have been proposed to explain this phenomenon:

Due to the production of lactic acid, the microbiota favors an acidic environment (pH ≤ 4.5) that is hostile to many pathogens.

Certain defensive compounds produced by the microbiota, such as hydrogen peroxide (H2O2) or antibacterial substances (bacteriocins), attack bacteria, viruses and fungi considered intruders.

The microbiota acts as a barrier, preventing pathogens from easily adhering to the vaginal walls. The presence of lactobacilli accelerates the renewal of the epithelium to which pathogens may try to adhere.

The microbiota facilitates the production of protective mucus by the vaginal epithelium that keeps pathogens at bay.

By stimulating the woman's immune system, the microbiota improves its ability to repel pathogen attacks.

What are the diseases associated with an imbalance of the vaginal microbiota?

Many factors can affect the composition of the vaginal microbiota: stress, disease, excessive hygiene (vaginal douches), certain drugs (antibiotics, etc.), alcohol, tobacco, etc. An imbalance in the composition of the microbiota is called "dysbiosis".

Vaginal dysbiosis is characterized by loss of predominance of lactobacilli in the vaginal flora, opening the way for colonization of the vagina by opportunistic microorganisms. Its presence is frequently accompanied by vaginal secretions, itching and burning, or a bad smell, although it can also be asymptomatic.

A vaginal dysbiosis is associated with:

  • Bacterial vaginosis, due to colonization by pathogenic bacteria
  • Candidiasis, due to the proliferation of a fungus
  • Decreased fertility
  • Increased risk of premature birth

It must be remembered that…

…women with bacterial vaginosis are more likely to contract sexually transmitted infections (STIs) such as herpes, papillomavirus, AIDS (HIV), or bacterial infections (gonorrhea, chlamydia, trichomoniasis).

How do we detect these imbalances and possible sexually transmitted diseases?

Complete evaluation can be done through a test of vaginal discharge which is processed with state-of-the-art RT-PCR technologies, one of the most reliable technologies at the moment. This test is processed at the Teletest laboratory in Barcelona.


Greenbaum S, Greenbaum G, Moran-Gilad J, et al. Ecological dynamics of the vaginal microbiome in relation to health and disease. Am J Obstet Gynecol . 2019 Apr;220(4):324-335 .

Petrova MI, Lievens E, Malik S, et al. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. 2015 Front. Physiol . 6:81.

Lewis FM, Bernstein KT, Aral SO. Vaginal Microbiome and Its Relationship to Behavior, Sexual Health, and Sexually Transmitted Diseases. Obstet Gynecol. 2017;129(4):643-654 .

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