The Gut-Vagina axis

Did you know your gut plays a huge role in how your periods flow and your vagina feels too?
Adam Hamdi
Written by

Coni Longden-Jefferson


When we talk about gut health you probably immediately think of what you eat or how you go to the toilet. But did you know your gut plays a huge role in how your periods flow and your vagina feels too? 


Key Takeaways


  • Your gut has millions of bacteria inside it - good and bad - known as the microbiome  
  • When the bad bacteria outweighs the good it can cause gut health issues, but it can also directly impact your menstrual and vaginal health too
  • Your gut microbiome is also linked to your vaginal microbiome - and when that becomes imbalanced it can make you more vulnerable to thrush and STIs 
  • An imbalanced gut microbiome can lead to an excess of oestrogen - and too much oestrogen can mean painful periods and general hormonal havoc! 



What is gut microbiome and what does it have to do with gut health?

Let’s start with the gut health basics. Inside the gut are millions of good and bad bacteria that make up your gut microbiome - or as some people like to call it, your gut flora (which admittedly sounds a lot nicer). The gut loves to have a really diverse mix of bacteria going on in there, which is why we must feed our gut flora with fruit and vegetables, as well as natural probiotics like yoghurt and kombucha. However, if the bad bacteria in the gut start to outweigh the good, this is when problems can arise. 

Your gut is the powerhouse of your entire body. When your gut health is off it can impact everything from your digestive system to your mental health, your immunity to your hormones - and even the health of your vagina.  



Let’s talk vaginal microbiome

Just like the gut, the vagina has its own microbiome ecosystem of good and bad bacteria - and some of these bacteria even overlap between the gut and the vagina.

However, unlike the gut, your vagina isn’t keen on having lots of bacterial diversity. In a healthy vagina, the Lactobacillus species of bacteria tend to run the show, with a small number of fungi (mostly Candida albicans) playing a supporting role. When other bacteria or fungi overgrow - it's bad news for your vaginal health.  


Why we love lactobacilli

Lactobacilli keep your vagina healthy in numerous ways -  from reducing your risk of thrush to keeping bacterial vaginosis at bay. The main way they achieve this is by producing lactic acid. This keeps the pH balance of your vagina down and makes the environment pretty acidic, which makes it harder for infections to thrive. These good bacteria also help to stimulate mucus production which acts as a protective barrier against unwanted microorganisms that might throw your vaginal balance off kilter. 

What happens when the vaginal microbiome is imbalanced?


So, we love lactobacilli and want it to be the most prominent bacterial species in our vagina. When the balance is altered for some reason, the vagina can become more alkaline than acidic. At this point, the bad bacteria can take over and encourage more bad bacteria to join the party, causing an imbalance - also known as dysbiosis. 

Whilst almost half of the people with vaginal dysbiosis will experience no symptoms, some people will experience itchiness and irritation, alongside an unusual vaginal discharge that can smell off or be unusually thick. 

An imbalance in vaginal bacteria has also been linked to bacterial vaginosis, thrush, urinary tract infections and even fertility issues. On the flip side, a healthy vaginal microbiome has been associated with a lower risk of contracting STIs, a reduced risk of gynaecological cancer and even a reduced risk of miscarriage and preterm birth. 

Everyone’s vaginal microbiome is unique, and it can be impacted by factors like your menstrual cycle, your diet and your stress levels. It can also be altered by unprotected sex and not staying on top of our intimate hygiene. Your gut health can also play a surprisingly key role in the balance of your vagina, but how are they connected? 


How does your gut health impact your vaginal health?

There are a few different ways your gut health and vaginal health are connected.


Gut bacteria ending up in the vagina

Firstly there’s the fact that your vagina and your anus are pretty close! Obviously, there are three separate holes down there (something some people who don’t have a vagina are still worryingly surprised by) but bacteria from the gut can occasionally come out of the rectum/anus area and make their way into your vagina. Even if it’s good bacteria, if it’s foreign to the vagina it can cause problems. This is why intimate hygiene is pretty important, especially cleaning up after sex when things can get a bit messy! 


Gut dysbiosis connected to vaginal dysbiosis

Our gut and vagina are also connected in less direct ways - through the gut-vagina axis. This relates to the fact that our gut health can be reflected in our vaginal health. For example, a healthy gut can reduce whole-body inflammation which can have an impact on our vaginal health, as well as our period health symptoms, including pain. 

On the flip side, if there is an imbalance of bacteria in the gut, this might be reflected in vaginal dysbiosis as well. Some studies support this theory including one that found taking oral probiotic bacteria actually lead to the migration of healthy probiotic organisms from the intestine to the vagina! 

The gut and oestrogen


Lastly, and an area we still need more research into, is the connection between your gut health and oestrogen. Your gut health and the way your body produces and metabolises oestrogen is intrinsically linked. It’s probably why many people with endometriosis - and oestrogen dependent condition - also suffer with poor gut health. 

In the gut, oestrogen is processed and metabolised by a collection of bacteria and enzymes known as estrobolome. If your gut bacteria is imbalanced this can make it harder for the estrobolome to do its job and we may see too much or too little oestrogen being pumped around the body. 

When our oestrogen levels are too low we might struggle with symptoms like irregular periods or vaginal dryness and if we become oestrogen dominant we could begin to have more severe PMS symptoms including pain and mood swings. 



What can you do to keep your gut and vagina healthy?


When it comes to supporting the gut-vagina axis, there are a few things you can do to support both!

  • Avoid overloading on sugary foods - Excess sugar can encourage growth of yeast and harmful bacteria in the gut 
  • Fermented Foods - Foods that contain natural good bacteria like yoghurt, sourdough bread, kombucha and kimchi are all going to make your gut and vagina very happy. 
  • Eat a diet rich in fibre - Try to include wholegrains and fruit in your diet as they are rich in probiotics 
  • Cranberry - Cranberries are often recommended for UTIS and there is a good reason why! Cranberries contain proanthocyanidins, which work in the gut to prevent E.coli bacteria from affecting the tissues in your vagina and urinary tract. Pro tip: Go for fresh cranberries over cranberry juice as juice often contains a lot of sugar!
  • Find a good probiotics: It’s great to get probiotics from whole foods, but it’s a good idea to have a supplement to - for an extra gut-vagina health boost.