Estrogen, Vaginas & BV

There is so much to know about how estrogen supports genitourinary health. For this blog entry my focus is on one of my favourite topics – estrogen and the vaginal microbiome (also known as the vaginal flora).

During pre-menopause (your active reproductive years) estrogen causes the outer layer of vaginal cells to shed naturally. When they die off they release glycogen which converts to glucose (sugar). Lactobacillus (the “good” bacteria) coverts the glucose to lactic acid. This acid keeps pH levels in the healthy pre-menopause levels of 3.5 and 5.

When estrogen starts to diminish this vaginal cell shedding process slows down and the lactobacillus starves. The bacterial balance is disrupted and the “bad” bacteria takes over. The vaginal pH subsequently rises and can cause something called Bacterial Vaginosis (BV). This is the most common vaginal infection and is often symptomless. When left untreated BV can raise the risk of Sexually Transmitted Infections (STIs). When there are symptoms they include thin, grey, white or green vaginal discharge, fishy vaginal odour, vaginal itching and burning during urination.

Recently, over-the-counter vaginal gels and suppositories to treat BV have hit the market. They contain various acids with the aim of keeping the good bacteria fed. I wrote about some of them here. There is also the vaginal moisturizer Mae by Damiva that contains topical sucrose that might help with the prevention but not treatment.

If you suffer from recurrent BV they may be something you’d like to consider.


If you think you have BV, I highly recommend you see your GP or gynaecologist to confirm this. There are a number of different vaginal infections as well as STIs that cause similar symptoms. Best to get an accurate diagnosis.

Keep in my mind vaginas don’t smell like flowers or spring fields. Dryer sheets do. Vaginas and vulvas have a slightly sweet or musky scent. BV can cause a very different scent – fishy.

Do not douche. This remedy is superficial, temporary and ultimately harmful. Treat the cause. Don’t camouflage the symptoms. Again, your vagina shouldn’t smell like Febreeze or strawberries.

If you find you regularly have BV – for example, after your period or after being exposed to male ejaculate – you may want to consider post period or post sex use of the gels or suppositories.  Again, check with your doctor.

In my case, I have had BV so often over the years that even without major symptoms I just know when my vaginal microbiome balance is off. I got an IUD last July * and had spotting near daily for 6 months. BV seemed like my constant companion even though I tried to manage things with the gels and suppositories (as per my doctor’s recommendation). Once the spotting stopped I was treated with antibiotics. If it happens again, I will likely go that route. Ultimately, I have the best, long lasting and more affordable results with antibiotics. It’s what brought me some relief and, pardon the expression, some a feeling of balance.

If you suffer with bacterial vaginosis, I hope you find some relief too.


Centers For Disease Control & Prevention

This post is not sponsored. Links are for information purposes only. Please consult your health care provider to help you decide what is the right course of action for *you*.

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