Hippocrates coined the phrase ‘all disease begins in the gut’ many centuries ago[i], and while he may not have been entirely accurate, the recent discovery of the ‘gut-organ axis’ suggests he wasn’t too far off the mark! The gut-vagina axis is one of many gut-organ axes in which gut health can influence the health of a distant organ.[ii][iii] And one of the ways this influence can occur, is via the microbiome.  Let’s explore…

 

It seems that each day we learn more about the marvels of the gut microbiome and its influential role over the health of the human body. The ways in which the gut can communicate to local and distant organs never ceases to amaze.[iv] So, given the relatively close proximity of the gastrointestinal tract (GIT) to the female vaginal tract, it makes sense that a communication pathway between the two systems exists. This pathway is referred to as the gut-vagina axis.[ii]

 

What is the gut-vagina axis?

Many of us were unknowingly introduced to the gut-vagina axis during high school health class, that is, if you were one of the few still paying attention! Remember the message of wiping front to back? This lesson in vagina hygiene 101 was designed to help females prevent the transmission of not so healthy bugs from the GIT to the vagina and urinary tract when going to the loo.[iv]  What we didn’t get taught, however, was about the important role of good bugs in gut and vagina health.

These good bugs, or microbes, belong to a larger community of bacteria, viruses and fungi that are collectively referred to as the microbiome, and both the gut and vagina are home to their own unique microbial communities.[v]  Interestingly, research has discovered ways in which gut health can affect our vaginal microbiome! [vi]

 

How does the gut-vagina axis work?

While there is still much to be learned, there are several ways in which recent research has demonstrated a connection between the gut and vagina microbiome health. 

Some of the findings include:

  • Diet –Diet is well recognised as an important influence over the health and balance of the gut microbiome, but did you know that diet also affects the vaginal microbiome? Research has shown that deficiencies in certain nutrients, in addition to diets high in fat and sugar, can affect the balance of microbiome communities living within the vagina, and therefore impact vaginal health.[vi]
  • Probiotic supplementation – Have you ever wondered how taking a probiotic by mouth can affect the balance of probiotics in the vagina?  Well, you are not alone!  Researchers have been investigating this phenomenon and have found that certain probiotic strains, once ingested, are able to journey through the gut and into the vagina via the gut-vagina axis.[ii] Emerging evidence also suggests that special immune cells may also be able to carry probiotic bacteria to distant sites, such as in the case of the gut-breast axis.[vii]

 

These fascinating discoveries highlight the inter-connectiveness of the human body, where the gut really does seem to be at the centre of it all.  An important reminder to care for gut (and microbiome) health when caring for your vagina!

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[i] Wallace RK. The microbiome in health and disease from the perspective of modern medicine and Ayurveda. Medicina. 2020 Sep 11;56(9):462.  No conflict of interest declared.  Research was not funded, however the Wege Foundation covered publication costs.

[ii] Amabebe E, Anumba DO. Female gut and genital tract microbiota-induced crosstalk and differential effects of short-chain fatty acids on immune sequelae. Frontiers in Immunology. 2020 Sep 10;11:2184. No conflict of interest declared.  Authors funded by National Institue for Health Research

[iii] Ahlawat S, Sharma KK. Gut–organ axis: a microbial outreach and networking. Letters in applied microbiology. 2021 Jun;72(6):636-68.  No conflict of interest declared.  Research funded by Indian Council of Medical Research

[iv] Santos-Longhurst, A., et al.  How to wipe properly, even if you can’t reach.  Healthline.  USA

[v] Meštrović T, Matijašić M, Perić M, Čipčić Paljetak H, Barešić A, Verbanac D. The role of gut, vaginal, and urinary microbiome in urinary tract infections: from bench to bedside. Diagnostics. 2020 Dec 22;11(1):7.  No conflict of interest declared.  Research funded by the Croation Science Foundation

[vi] Saraf VS, Sheikh SA, Ahmad A, Gillevet PM, Bokhari H, Javed S. Vaginal microbiome: Normalcy vs dysbiosis. Archives of Microbiology. 2021 Sep;203(7):3793-802.  No conflict of interest cited.  Authors affiliations include COMSATS University, Pakistan, George Mason University, USA and Kohsar University, Pakistan

[vii] Hurtado JA, Maldonado-Lobón JA, Díaz-Ropero MP, Flores-Rojas K, Uberos J, Leante JL, Affumicato L, Couce ML, Garrido JM, Olivares M, Fonollá J. Oral administration to nursing women of Lactobacillus fermentum CECT5716 prevents lactational mastitis development: A randomized controlled trial. Breastfeeding Medicine. 2017 May 1;12(4):202-9.  Authors of the article are workers of Biosearch Life, owners of patent for the probiotic strain Lactobacillus fermentum CECT5716

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