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The vaginal microbiome: how to look after it – and what to avoid

Probiotic supplements claimed to ‘support the vaginal flora’ are being promoted online. But is there even a problem to be fixed?

‘Us girls, we have a lot of problems down there and it’s an absolute nightmare,” one influencer says on TikTok, like a seasoned teleshopping host. She reels off a list that includes thrush, bacterial vaginosis (BV) and urinary tract infections – common issues that many women are too shy, insecure or squeamish to talk about. But she has an answer to these woes: vaginal probiotic pills. These are being touted on the social media site as magical new supplements that can improve the health of your vaginal microbiome.

But what is the vaginal microbiome? And does it need to be fixed? According to Ina Schuppe Koistinen, an associate professor at the Karolinska Institutet in Sweden and an expert in the subject, the term refers to the gene content of the microbes in that area of the body. “You can also call it the vaginal microbiota – or vaginal flora – and it means all the microbes that are present. That’s bacteria, but also viruses, fungi and all kinds of single-cell organisms.” We all have microbiota in other parts of the body, too, including on the skin and in the gut. The health of the microbiome is determined by the delicate balance of microbes.

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