Wellness Wisdom: Vaginal Microbiome and Menopause

Season 1, Episode 23

Dr. Briana Sinatra

Dr. Briana Sinatra


In this week’s Be HEALTHistic Extra, Dr. Briana Sinatra explains some key information all women should know about their vaginal (urogenital) microbiome and how to keep it in balance — which is especially important for women as they age and experience menopause. Dr. Briana points out the various symptoms and infections to be aware of, and shares lots of natural solutions for maintaining the health of your urogenital microbiome. You won’t want to miss this special Wellness Wisdom, with essential women’s health advice.



Dr. Briana Sinatra: In today's Wellness Wisdom segment, I wanted to share with you some interesting research I've been reading about on all of the different and unique microbiomes that exist within our bodies. Specifically, the bacteria and flora that make up the microbiome within our vagina and urinary tract.

Similar to the good and bad yeasts, bacteria and viruses that make up our gut microbiome — our urogenital microbiome is also made up of countless microorganisms, and researchers are just beginning to understand the impact it has on women's health.

One thing we do know, however, is that infections like bacterial vaginosis, a bacterial overgrowth in the vagina, can happen when the delicate environment of our vaginal microbiome gets out of balance. It can cause symptoms like itching, discomfort, and a "fishy” odor. It's usually treated easily with antibiotics, but many people who get it don't have symptoms, making it hard to detect.

Urinary tract infections, or UTIs, are also common types of bacterial infections that can be the result of an out-of-balance urogenital microbiome. Millions of women are diagnosed with UTIs every year — and approximately 10% of menopausal women, especially, will report having a UTI within the past year.

So why does this pesky health issue get more pervasive as women age? As women enter into the mid-life, the main cause behind recurring UTIs are physical changes, including: thinning of the vaginal tissue, pelvic floor prolapse, incontinence, and trouble completely emptying the bladder. Low levels of estrogen after menopause are also a contributing factor. These are all reasons why we want to do all we can to tip the scales in our favor, and keep this particular microbiome in equilibrium.

So what can you do to maintain the health of your urogenital microbiome? I wanted to provide some natural solutions that can help you keep it all in balance. Minimize sugar, processed foods and refined carbohydrates. Not only do these foods have low nutritional value, they can decrease your immune system, negatively impact your microbiome, and make you more vulnerable to infection.

Stay hydrated. Drinking plenty of water helps to moisten your tissues, and flush out harmful microbes that can ascend from your perineal area. Research has shown that drinking an extra six cups of water per day can help reduce recurrent UTIs — so drink up.

Don't hold your urine for long periods of time, and remember to urinate before and after sex to help flush out unwanted bacteria. Your urogenital microbiome is wise, so be careful with things that can change it. Avoid vaginal douches and be mindful of bubble baths, bath oils, vaginal creams and lotions, deodorant sprays or harsh soaps, as they can alter your vaginal flora and this may ultimately result in a UTI.

Avoid scented wipes and scented sanitary products that may irritate your tissue, and can increase your susceptibility to UTIs. If your tissues are dry and you want to use something to support your vaginal tissue health, like a personal lubricant or vaginal moisturizer, I recommend ensuring that it is water-based, paraben-free, and is as similar as possible to your natural vaginal secretions.

Probiotics are a great choice to support the microbiome of your gut, and can also positively impact your urogenital microbiome. For more localized support, many of my patients have benefited from vaginal probiotic suppositories.

Cranberry proanthocyanidins — found in capsules or liquid extracts — can help to inhibit urinary bacteria, such as e-coli, from attaching to the inner wall of your urinary tract, which can help reduce infection. To reduce the symptoms of atrophy from menopause, vaginally-inserted estriol helps to improve urogenital tissue health. Repleting the estrogen to this area helps to increase the good, acidic producing lactobacillus species, which reduces the vaginal pH and helps to keep the bad bacteria within the vagina and urethra in check.

And most importantly, make sure to have any symptoms evaluated by a professional, to ensure you have the correct diagnosis and can be supported on the correct treatment. Don't self-diagnose or treat, and please don't grin and bear the discomfort alone. You deserve the relief and comfort, so find a practitioner to be your health ally to guide you through this process.

I hope these suggestions help all you ladies out there to maintain a healthy, vaginal microbiome — especially as we age and become more susceptible to infections, like UTIs.

Narrator: Thank you for joining us for today's special Be HEALTHistic. Join us next week, when the Doctors Sinatra return with Season 2 and brand new, full episodes of Be HEALTHistic.


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Dr. Briana Sinatra

Meet Dr. Briana Sinatra

Dr. Briana Sinatra is a board-certified naturopathic doctor with a vibrant practice in the Pacific Northwest. There she focuses on women’s and family health, taking a holistic approach to healthcare by empowering women with the knowledge and tools they need to live their best life now and protect their future wellness by looking at how all the systems in the body work together and how diet, lifestyle, and environment all influence health.

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