The superhero in your vagina

While it’s healthy to have a variety of bacteria in our guts, there’s one place where a single dominant type is best: the vagina. Kendall Powell meets the researchers trying to make the world healthier, one vagina at a time.

The aisle is marked with a little red sign that says “Feminine Treatments”. Squeezed between the urinary incontinence pads and treatments for yeast infections, there is a wall of bottles and packages in every pastel shade imaginable. Feminine deodorant sprays, freshening wipes, washes for your “intimate area”.

Vaginal odour might be the last taboo for the modern woman. I’ve actually driven to the SuperTarget two towns away from where I live so as to not run into anyone I know while scrutinising the various products that exist for cleansing, deodorising and re-balancing the pH of your vagina (I still bumped into another PTA mom in a neighbouring aisle).

The companies behind these products know that many women are looking for ways to counter embarrassing and debilitating symptoms such as vaginal odour and discharge. The culprit is often bacterial vaginosis, the most common vaginal infection you’ve probably never heard of. Nearly one-third of US women of reproductive age have it at any given time. The sad truth is that these sprays, soaps and wipes will not fix the problem. They will – in many cases – actually make it worse.

But while women try to mask embarrassing smells, a more sinister truth also remains under cover: the bacteria responsible are putting millions of women, and their unborn babies, at risk from serious health problems. All of which is making researchers look anew at the most private part of a woman’s body, to understand what it means to have a healthy – some prefer “optimal” – vagina and why that is so important for wider health.

Reference:

• This 1978 study by Terrence Pheifer and King Holmes found that metronidazole was an effective treatment for bacterial vaginosis, then called non-specific vaginitis.
• In 2007, epidemiologists calculated that bacterial vaginosis affects 29 per cent of women in the US at any given time.
• By sequencing samples from nearly 400 North American women, Jacques Ravel and Larry Forney defined the communities of bacteria that make up the microbiota in healthy vaginas.
• Samuel Lai and his colleagues found that women with microbiota dominated by Lactobacillus crispatus had vaginal mucus that could block HIV particles in the laboratory dish.
• In a 2014 study of Rwandan sex workers, women with Lactobacillus crispatus as their dominant vaginal bacteria had a lower prevalence of HIV and other STIs.
• The US Centers for Disease Control and Prevention has a fact sheet on bacterial vaginosis.
• LACTIN-V, the vaginal probiotic containing Lactobacillus crispatus, is currently being tested in a clinical trial in the US.