Vaginal Flora – A Key Guardian of Women’s Intimate Health

Why is vaginal flora important?

For a woman’s normal functioning and intimate health, maintaining a balanced vaginal flora is essential.
Just like the gut microbiota, the vaginal microbiota represents a system of natural microorganisms that protect women from infections.

The majority of healthy vaginal flora consists of lactobacilli (Lactobacillus) — beneficial bacteria responsible for maintaining vaginal acidity.

Role of lactobacilli

Lactobacilli produce:
• Lactic acid – keeps vaginal pH acidic
• Hydrogen peroxide – inhibits harmful bacteria

A drop in lactobacilli leads to reduced acidity and creates favorable conditions for pathogens.

Due to anatomical proximity to the colon, vaginal flora is continuously exposed to bacterial migration.

Symptoms of disrupted vaginal flora

• Itching
• Burning
• Increased discharge

These symptoms often indicate infection and imbalance.
Women prone to repeated infections can restore flora using lactic acid and lactobacillus–based products.

Causes of imbalance in vaginal flora

1. Antibiotic therapy

Destroys protective lactobacilli → allows bacteria and fungi (Candida) to overgrow.

2. Hormonal changes

Oral contraceptives, pregnancy, breastfeeding, menopause.
Low estrogen levels (especially in menopause) increase infection risk.

3. Stress and infections

Weakens immune protection in the intimate area.

4. Excessive vaginal douching

Disturbs natural pH and irritates mucosa.

5. Alkaline body fluids

• Menstrual blood
• Semen
• Amniotic fluid

These fluids temporarily reduce vaginal acidity.

6. Mechanical factors

• Tight clothing
• Nylon stockings
• Gynecological exams
• Frequent intercourse

Can cause irritation and increase risk of infection.

Normal vaginal discharge

Healthy vaginal discharge is:
• Clear
• Odorless
• Viscous

Any change in color, smell, or texture may indicate infection.

Most common vaginal infections

1. Bacterial vaginosis

Caused by disturbed vaginal flora.

Symptoms:
• White discharge with “fishy” odor
• Mild or no itching
• Possible burning during urination
• Often confused with candidiasis or trichomoniasis
• 50% of women are asymptomatic

Treatment: antibiotics + lactic acid preparations to restore flora.

2. Trichomoniasis

Symptoms:
• Frothy yellow–green discharge
• Strong fishy odor
• Itching

Treatment: by gynecologist; partner treatment mandatory.

3. Candidiasis

Symptoms:
• Thick, white, cottage cheese–like discharge
• Intense itching and burning
• Redness and irritation
• Pain during intercourse

Causes include: pregnancy, diabetes, antibiotics, high estrogen, immunosuppression, poor hygiene, tight clothing, stress, frequent intercourse…

Treatment: antifungal therapy after confirmation; partner therapy required.

Many women self-medicate with vaginal creams or suppositories — this may worsen the condition.
Always consult a gynecologist or pharmacist.

Products with lactobacilli and lactic acid

Forms:
• Oral capsules
• Vaginal suppositories

Recommended use:
• Preventively: 1–2× weekly
• For women prone to infections: 2–3× weekly
• After menstruation: 1–2 days if symptoms appear
• After intercourse: as needed
• During pregnancy: 1–2× weekly

Prevention of vaginal imbalance and infection

• Occasional use of lactic acid & lactobacillus supplements
• Proper rinsing of underwear
• Reduced sugar intake
• Intimate hygiene
• Choosing safe sanitary pads
• Wearing appropriate clothing
• Regular gynecological check-ups

If symptoms persist despite all measures, consult your gynecologist.

mr ph. spec. Vesna Stanković – Kojić
Specialist in pharmaceutical healthcare