How healthy is your vagina?

Most of us women are unaware of our vaginas, except during sex or childbirth, or when we feel that ‘something is not right’. To know what is ‘not right’, we must first understand what is regarded as ‘right’ or normal.

The vagina is a hollow, tube-like muscular organ that is lined with special skin cells. The scaffold or supports are created by what we call connective tissue. It is naturally home to many different bacteria and micro-organisms that all live together quite happily.

The environment in the vagina is maintained by an acidic pH of between 3,5 and 4,5. This allows for the organisms, called lactobacilli, to function at their peak.

Lactobacilli produce beneficial products for the vagina, like lactic acid and hydrogen peroxide, that have protective effects. These substances inactivate herpes viruses, prevent overgrowth of fungi that cause thrush and keep a check on the bacteria that cause bacterial vaginosis.

An added bonus is protection from sexually transmitted diseases like gonorrhoea. Lactobacilli’s real superpower lies in its ability to aid the cervical mucus in trapping and slowing down the HIV virus.

It is when this finely-tuned system gets disrupted that problems or symptoms arise. Women can complain of a discharge (different to the normal), an odour, itchiness, dryness or even just discomfort.

What factors disrupt vaginal pH?

1. Hormonal fluctuations

Situations like pregnancy, using oral contraceptive pills and menopause will affect the pH. Vaginal pH is also sensitive to the normal hormonal fluctuations of the menstrual cycle. When oestrogen levels are low – during menopause and when on breast cancer drugs like tamoxifen or aromatase inhibitors (Arimidex or Femara) – the lactobacilli concentrations fall to a low level. This can then compromise the natural protective immunity of the vagina.

2. Antibiotic usage

Taking antibiotics to treat an infection anywhere in the body can have the unwanted side effect of killing off the lactobacilli in the vagina. The resulting alteration in the pH may then lead to an infection in this sensitive area.

3. Menstruation

During your period the vaginal pH can fluctuate massively from 8 on day 2 to 4 on day 4. This change is temporary and usually fixes itself. When it does not re-balance, then symptoms of a discharge or odour may be noticed during this time.

4. Semen

Sperm is alkaline, with a pH of 7,1 to 8. After sex without a condom and ejaculation into the vagina, the pH will undergo a temporary change. When this has not fixed itself naturally, an odour or discomfort arises.

5. Feminine hygiene products

Use of scented bath products or even overzealous use of vaginal wipes or douches can affect the delicate balance of vaginal bacteria.

How to maintain a healthy vagina?

1. Wear the correct underwear

Cotton or other natural fibre panties, like bamboo, allow for better control of perspiration moisture. They absorb sweat better than synthetic fibres, such as nylon or lycra.

Save the sexy non-cotton lingerie for special occasions and limit wearing them to short periods of time.

Change out of wet swimwear or gym clothes as soon as possible. Wet garments against the vulva (entrance of vagina) can breed bacteria.

2.Change pads and tampons frequently

Blood close to the skin can lead to the growth of unwanted bacteria.


Binging on alcohol and diets high  in refined sugars promote growth of harmful bacteria. Try to maintain a good balance of raw and whole foods. Read food labels. Cut out preservatives and unnecessary additives. Take ownership of what  you eat.

4. Probiotics

The best way to use them will be directly inserted into the vagina. Ask your doctor or pharmacist for their recommendations.

Oral probiotics have also shown to be of benefit (lesser so); they have a natural ability to migrate to the vaginal region from the intestine via the skin surrounding the vagina and anus.

Probiotics high in lactobacilli concentrations can restore and maintain a disturbed vaginal environment. They can be used preventatively or as part of a treatment plan for infection that includes other medications.

Dr Sumayya Ebrahim is a gynaecologist in private practice in Johannesburg. She is also a blogger. Check out her blog Vaginations by Dr E on

MEET OUR EXPERT – Dr Sumayya Ebrahim

Dr Sumayya Ebrahim is a gynaecologist in private practice in Johannesburg. She is also a blogger. Check out her blog Vaginations by Dr E on