Menopause

Vaginal microbiome in menopause

According to Jessica Lloyd, head of MyVagina and a vaginal microbiome expert: “A menopausal vagina typically has low levels of all bacteria, not just lactobacilli. This lack of protective healthy flora may result in the overgrowth of pathogens that can cause bacterial vaginosis or aerobic vaginitis, along with sometimes an increase in urinary tract infections.”

She says the pH of a menopausal vagina will also increase, and the actual number may vary depending on which microbes are present. The pH tends to be around 5.5. This can be problematic because a healthy vaginal microbiome sits at around 3.5-4.5 on the pH scale. Those above 4.5 are at risk of contracting bacterial vaginosis.

The changes in the vaginal microbiome during menopause are driven by hormonal fluctuations, specifically low estrogen levels. Imagine the vagina as a thriving garden, with estrogen playing the role of the gardener - watering, nurturing and sustaining its delicate ecosystem. The plants, representing vaginal wall cells, when healthy, produce blossoms rich in sweet nectar—glycogen, a complex sugar. This nectar nourishes the friendly bees, Lactobacillus bacteria, ensuring the garden remains balanced and healthy.

However, when the gardener disappears, the plants are left untended. Without water, they dry out, wilt, and become damaged. Without nectar, the beneficial bees struggle to survive, their numbers dwindle, and the once-harmonious garden ecosystem falls out of balance.

Healthy women of reproductive age typically have an abundance of Lactobacillus bacteria, which decreases slightly during menstruation but is on a rise during pregnancy. During menopause, women often experience unpleasant symptoms such as vaginal dryness and itchiness due to low estrogen levels, depleted Lactobacillus colonies, and reduced mucus production.

We recommend consulting your health practitioner to explore suitable options for supporting the vaginal microbiome during menopause.