Practices that put your vaginal microbiota at risk
Drinking parties, multiple partners, antibiotics, intimate hygiene products... What are the risk factors for female students’ vaginal microbiota, and which vaginal flora are most at risk?
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About this article
A woman’s vaginal microbiota undergoes changes over the course of her life, sometimes to the point of shifting type, as shown by a study 1 including 125 sexually active women aged 18 to 25 in the south of France (Montpellier).
There are five types of vaginal community 2 (Community State Types, or CSTs), which can be divided into three groups in terms of vaginal health, as in this study:
- Three optimal types dominated by lactobacilli: CST I dominated by Lactobacillus crispatus, CST II by L. gasseri, and CST V by L. jensenii
- One suboptimal type, CST III, dominated by another lactobacillus (L. iners), which is much more vulnerable to dysbiosis
- One non-optimal type, characterized by its low lactobacillus content (CST IV)
Lactobacilli, guarantors of stability
The study’s first finding was that bacterial communities dominated by lactobacilli — rod-shaped bacteria known to be most beneficial to women’s intimate health — are more stable over time. In other words, vaginal microbiota rich in lactobacilli such as L. crispatus, L. gasseri, L. jensenii, or L. iners are more difficult to disrupt.
A balanced vaginal microbiota dominated by these lactobacilli will limit the proliferation of pathogens, but if too much stress is put on the microbiota, pathogens can proliferate anyway.
Have you heard of dysbiosis?
Drinking parties, disrupted vaginal flora
The second finding was the list of factors that can wreak havoc on our vaginal flora.
In the 125 students studied, alcohol was identified as the factor with the strongest and most consistent effect, promoting suboptimal flora and increasing vagina’s vulnerability to infections, particularly by facilitating proliferation of pathogenic bacteria.
Partners, hygiene, and antibiotics
Other factors may also influence the transition from one vaginal bacterial community to another:
- A higher number of sexual partners may increase the risk of maintaining (or switching to) non-optimal flora, thereby promoting the development of vaginal infections that can progress to bacterial vaginosis.
Studies have shown that genital microbiota can be transferred between sexual partners, potentially destabilizing the resident microbial community.
- The effects of intimate hygiene products (creams, tablets, capsules, gels, and wipes) on women’s health appear to vary from one woman to the next, with possible circular changes from one type of flora to another.
The study indicates that probiotics can cause temporary disturbances in the vaginal microbiota. However, they are not among the covariates analyzed in this study.
Intimate hygiene products, for their part, are associated with varying effects on bacterial communities, depending on the type of microbiota present.
- As for antibiotic use — whether local treatments for bacterial vaginosis (genital application of metronidazole) or systemic treatments (oral antibiotics) — it appeared to be only loosely associated with transition to a different type of vaginal flora. This absence of an effect surprised the researchers: were the samples taken too far apart to “capture” any short-lived change in flora linked to antibiotics?
