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Bacterial Vaginosis and Diet

A more plant-based diet may help prevent vaginal infections, one of the most common gynecological problems of young women.

June 7, 2013 |
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Supplementary Info

Sources Cited

A. Drewnowski, V. Fulgoni III. Nutrient profiling of foods: Creating a nutrient-rich food index. Nutr. Rev. 2008 66(1):23 - 39

E. Kennedy. Food rating systems, diet quality, and health. Nutr. Rev. 2008 66(1):21 - 22

E. H. Koumans, M. Sternberg, C. Bruce, G. McQuillan, J. Kendrick, M. Sutton, L. E. Markowitz. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis 2007 34(11):864 - 869

M. E. Thoma, M. A. Klebanoff, A. J. Rovner, T. R. Nansel, Y. Neggers, W. W. Andrews, J. R. Schwebke. Bacterial vaginosis is associated with variation in dietary indices. J. Nutr. 2011 141(9):1698 - 1704

R. M. Brotman, M. A. Klebanoff, T. R. Nansel, W. W. Andrews, J. R. Schwebke, J. Zhang, K. F. Yu, J. M. Zenilman, D. O. Scharfstein. A longitudinal study of vaginal douching and bacterial vaginosis--a marginal structural modeling analysis. Am. J. Epidemiol. 2008 168(2):188 - 196

J. L. Martino, S. H. Vermund. Vaginal Douching: Evidence for Risks or Benefits to Women's Health. Epidemiologic Reviews 2002 24(2):109 - 124

B. H. Cottrell. Discourage Douching. MCN Am J Matern Child Nurs 2010 35(2):102-107

N. Ahluwalia, H. Grandjean. Nutrition, an under-recognized factor in bacterial vaginosis. J. Nutr. 2007 137(9):1997 - 1998

B. C. Tohill, C. M. Heilig, R. S. Klein, A. Rompalo, S. Cu-Uvin, E. G. Piwoz, D. J. Jamieson, A. Duerr. Nutritional biomarkers associated with gynecological conditions among US women with or at risk of HIV infection. Am J Clin Nutr 2007 85(5):1327 - 13­34

Acknowledgements

Images thank to Dr. F.C. Turner via Wikimedia Commons.

Transcript

In the same way fermented pickles, kimchi, and sauerkraut foster the growth of good bacteria like lactobacillus by maintaining an acidic environment, so does the human vagina. The normal pH of one's vagina is that of tomato juice. Once it starts creeping up to that of, coffee, though, an overgrowth of bad bacteria can take hold and cause bacterial vaginosis, which affects an astounding 29% of American women—that's nearly 1 in 3 women in the United States. That makes it the most frequent cause of vaginal complaints among younger women, affecting tens of millions. It's commonly diagnosed with the so-called whiff test, where the doctor takes a whiff of the vaginal discharge sniffing for the characteristic fishy odor.

Traditional risk factors for bacterial vaginosis include douching, which has also been associated with a wide range of problems. With no demonstrable benefits and considerable evidence of harm women should be encouraged to not douche. Medical professionals need to clearly explain that the vagina is naturally self-cleaning.

Recently, poor nutrition has been added to the list of risk factors. You appear more likely to get bacterial vaginosis if you have lower circulating levels of phytonutrients like vitamin C and beta carotene in your bloodstream, indicating a lower intake of fruits and vegetables. In recent years, though, the field of nutrition has shifted toward examining overall dietary scores as opposed to single nutrients, because it has become recognized that nutrients are not consumed in isolation, that individuals consuming one health-promoting nutrient also tend to consume many others, and that the specific source of nutrients may be of importance. What a concept!

So nutrient rich food indices have been devised to enable folks to get the most nutrients out of their calories. And the more nutrient rich one's diet, the lower one's apparent risk for bacterial vaginosis.

Why, though?  Well, it's thought that high fat intake, particularly saturated fat— which comes mostly from dairy, doughnuts, and chicken in this country--may increase vaginal pH, thereby increasing the risk of bacterial vaginosis. So now that we know, -- The next steps ahead, include sharing these findings with gynecologists, obstetricians, and general practitioners, as well as increasing the awareness of the general community to the importance of optimal nutrition to prevent infections of the genital tract, reduce associated disease, and maintain reproductive health.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

More on the detrimental effects of saturated fat in videos such as:

The fishy odor is a consequence of a compound of decay called putrescine, which is also found in certain foods. More about these "biogenic amines" in: 

Now nasal douching is another matter. See The Risks and Benefits of Neti Pot Nasal Irrigation and my answer about the "brain-eating amoeba."

More on vaginal health in Treating Genital Warts With Green Tea and more on achieving maximum nutrient density in Calculate Your Healthy Eating Score.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • Observer

    Things I learned from this video:

    1. Women have a self-cleaning oven and if you want it to smell like fish, eat Dairy and Chicken.

    2. If you want to keep your oven working optimally, don’t clean it and don’t feed it cheese, doughnuts or chicken. Give it what it really wants–A whole food Plant Based meal plan.

    • http://jolkapolkaskitchen.blogspot.com/ WholeFoodChomper

      When is the last time that you tried making baking a casserole in a vagina? :-O I’ll stick to feeding myself via my mouth and I’ll leave my vagina out of cooking altogether.

  • BB

    I had BV for 3 years I tried everything including medication and holistic remedies!!!!! I finally cured it by eating a homemade

    Sauerkraut fermented in an organic garlic-brine…GONE!!!!

    • Noni

      Any chance you could share your recipe? Have a link? Thanks!

      • http://kara-d.tumblr.com/ Kara D

        Sauerkraut fermented in an organic garlic brine

        I would approach it like this: http://holisticsquid.com/purple-garlic-sauerkraut/. you could use plain or purple cabbage and could add extra garlic to ensure its very garlicy.

        When you put it in the jar, use the awesome technique in this recipe to hold the cabbage down under the brine by placing zip lock bags fulled with salty water on top of the cabbage. You’ll find it makes it much easier than trying to fill a small jar completely or using marbles/rocks to hold it down.

        you could add whey to speed up the process. this is because whey is an effective lactobacteria food source.. Possible sources of whey include:

        -the clear liquid that sometimes separates out of plain POT-SET yogurt (impt..yogurt fermented with gelatine may not separate). Shaking the jar or pressing on the surface with a large spoon increases the release of liquid)

        -water or milk kefir

        -the clear part of curdled milk (could curdle a small amount at home yourself with lemon juice as in making simple cheeses)

  • Ilana

    So don’t eat high fat? What about high sugar? How much is “too much”? What are ways of keeping the vagina acidic?

    • fineartmarcella

      The vagina doesn’t need ‘extra’ help staying acidic it naturally stays between 3.8 – 4.2 ph, unless we eat S.A.D., then we can upset the whole thing, but eating a diet low or nil of saturated fat foods and high in raw fruits and veggies will give you a good healthy vagina, until you hit menopause, the ph will then go up and make it more vulnerable to bad bacteria, then you may want to get into fermented foods, like drink some homemade Kefir everyday, I drink about 1/2 liter every morning as my base for my breakfast smoothie :) . Remember in nature we would be eating things off the ground, the trees, seed heads, etc and getting plenty of bacteria to stock our intestines and our vagina against the ‘bad guys’ :)!

  • LaGuna

    Is this information also could be related to Vaginal Yeast infection? I have it for years now ( comes and goes) . For almost a year I am vegan. My diet is nutrition dense, whole foods and no processed foods, but I still have vaginal discharges, sometimes very heavy. I rarely drink coffee. Please, do you have an information on this.

    • http://nutritionfacts.org/ Michael Greger M.D.

      If you’ve had difficulty eradicating your vaginal yeast infections, I found the best cure for recurrent vaginal yeast infections in my practice is boric acid vaginal suppositories. They are cheap (about 2 cents each) and relatively safe. Though the mechanism is unclear, vaginal boric acid suppositories are effective in curing up to 98% of the patients who had previously failed to respond to the most commonly used antifungal drugs.

      Boric acid is toxic if taken orally (if swallowed). DO NOT EAT BORIC ACID. Also keep it away from children and open wounds. Boric Acid should NOT be used when you are pregnant.

      To make your own suppositories, fill up large empty capsules
      with boric acid (like with the tip of a knife and a baggie). Insert one capsule into your vagina before bedtime every day for 2 weeks. You may want to wear a pad as it tends to be
      runny. It can also be helpful is to take some of the loose powder and spread it on your labia and under your clitoral hood.

      Stop the treatment if you experience burning or get a bloody discharge.

      • http://jolkapolkaskitchen.blogspot.com/ WholeFoodChomper

        Back in the day, I took a Women’s Studies health class (which was fantastic btw), and one of the recommendations for treating yeast infections was plain yogurt suppositories (due to the probiotics in the yogurt). However, this is a fantastic self-treatment alternative. Thank you for sharing it with us!

        And, THANK YOU for bringing up the dangers of douching. I can’t believe that those products are still available on the market.

      • HemoDynamic, M.D.

        Invaluable treatment information! You’re like Felix the Cat–you’ve got a lot in that ‘Bag of Tricks” of yours.

        Thanks for adding to my cheap and effective treatment arsenal.

      • Wabisabi

        I’m not convinced about Boric Acid as safe in any mucus membranes. It’s MSDS states it’s quite toxic. I’ve recon firmed this other places as well. I went in search of some suppositories at my local healthfood store (which still sells questionable products) and they had discontinued due to toxicity.

  • Christina

    I have been a vegetarian for 5 1/2 years and have been dealing with BV off and on for the past 2 years. My partner thinks it gets worse when I eat a lot of butter, and I think it gets worse when he uses saliva instead of lubricant since saliva is full of bacteria.

    • “Spud” Tomsett

      I share your concern, however I can’t help but wonder if it’s better to live with the initial bacterial load of using saliva instead of dealing with the longer lasting pH alteration caused by many lubricants. And I highly suspect there my be a good number of “endocrine disrupting” chemicals in most lubricants too. Has anyone tried gel from boiled flax, chia, or psyllium seed?

  • Frank Streibel

    Dear Dr. Greger, could you, in a future video, please tell us more about this “nutrient-rich food index” as the related study is not available for the general public but sounds rather promising. This is of course only in case this index is helpful and/or contains new information for regular readers of this site. Maybe your “What is the best XXX” videos are based on better research.

  • JL

    I started eating a plant-based diet over a year ago and started having recurring yeast infections around the same time. I’ve tried everything and read a lot about it. Everybody recommends a diet low in carbs, sugars and fruits. I’m not ready to go that route yet, since I’ve never eaten healthier in my life, and I feel great eating plan-based food. But I’m getting desperate. Can a plant-based diet cause yeast infections?

    • Nicole

      Yes plant based diets will cause not only yeast infections, but diabetes, cancer, heart disease, etc. Eating processed and refined foods will make you super healthy and will ward off all of these problems!

      I’m kidding. Fruits and veggies will not cause yeast infections. From my experience though, they do bring issues you’ve always had to the surface (I always had acne, it got worse before it got better when I became a fruitarian).
      So not, a plant based diet will not cause yeast infections. :)
      30bananasaday.com

      • Wabisabi

        I would make sure you’re eliminating your waste well. Your gut can ferment foods. I use Triphala but try to find a Western company. Helped me a lot.

    • TCB Health

      Eating a lot of sugar can increase your incidence of yeast infections (I cannot quantify how much “a lot” is). Simple sugars like those found in many carbohydrates are included. Reducing sugary foods – soda, desserts, etc. – and switching to whole grain carbs can help. The benefits of fruits and vegetables outweigh any link to infections, but try and experiment to see what might be your triggers. Be sure, also, to drink plenty of water.

  • Coacervate

    It is important that, in addition to becoming healthy example individually, we need to push the message so the field workers get the message. I have tried for years now to get my GP on board. He acknowledges the truth of vegan health but he just doesn’t seem to get it. No, he gets it but, I get a subtle sense of skepticism from him. That no matter what the science is saying, it just isn’t right to quit animals and animal products. of course the fact that i live in a country whose entire economy is based on dairy may be a confounded factor.

  • painterguy

    Thirty years ago a physiology professor said something to this (self cleaning) effect. He did a few lectures on the importance of vitamins and nutrients.

  • linda

    At the end of every summer I have to visit my OBGYN for Bacterial Vaginitis. I know, it is caused from “ICE Cream”. Need to take off your wet bathing suits too and put on some dry undies too. Have a great summer.

  • “Spud” Tomsett

    Couple questions related to this. 1) What is the most healthful lubricant to use? 2) are there any “natural” lubricants that one should try using?

    Our gynecologist told us to stay away from lubricants that are touted as “natural” because apparently they are more likely to cause “problems.” I think she meant that they are more likely to cause irritation, illicit allergies, or promote infection.

    Background: My wifes pH level seems to be very sensitive to our choice of lubricants. We’ve tried most of the products lines (even the “natural” ones) of the major brands (KY, Durex, etc.) but they often seem to predispose her toward either BV and/or yeast infections. The one we keep coming back to is called “Pink Indulgence Cream” but I can’t help but to wonder if the ingredients are deleterious for longevity. http://www.amazon.com/Pink-Indulgence-Cr%C3%A8me-3-3-fluid-Ounce/dp/B004I6J6H0/ref=pd_rhf_se_p_tnr_2

  • Guest

    What about yogurt? And goat milk/yogurt? Do they contribute to the same risk factors, or are processed in a way that eliminates the presence of the hormones in question?

  • Wabisabi

    I was tormented with yeast and BVs for years! The yeast seemed very hormonally affected and the BVs seemed sexually brought on. When I married and became pregnant I could not rid myself of the BVs especially. The prescription meds didn’t keep them away and I feared in the long term use to my fetus.

    Basically I was vegetarian but did eat loads of fats with cheese and dairy. What truly kicked it was my following recipe, having the baby (hormones) and getting off my thyroid meds and on a very cautious diet of whole foods/plants, some supplements and a few other regimens. When I treated my husband, leveled my hormones, took out sat fat. I no longer get any yeast or BVs. My immune system is so much better.

    The first step was this 3-day treatment that’s much more natural than borax or even garlic etc.

    Bacterial Vaginosis Cure

    3 day peroxide douche:
    3 min full strength peroxide for 3 nights

    Start Fem-Dophilis 2x by mouth immediately for 2 weeks.
    2x vaginally after the 3-day douche for 2 weeks.

    No sex for 2 weeks.

    Increase vitamin D3 1500mg daily.

    Increase water intake!

    Buy 4% Hibiclens solution and dilute to 1%. Put some in spray bottle for partner to use in shower. Pour full glass over wet wipes to keep by toilet and use after BM’s and sex. It’s extremely important to treat partner with Hibiclens or the bacteria will simply come back.

    After the 2 weeks is up, sex can be resumed. Reduce vaginal Fem-Dophilis to 1 daily. After a month, reduce oral Fem-Dophilis to 1 daily. Treat until you’re certain immune system is strong enough. May want to continue 1 oral daily as regimen.

    After one month, reduce D3 to 500mg during summer and 1000mg during winter. Continue taking as regimen.

  • Shelly Young

    I had BV intermittently over a period of several years, sometimes extremely severely. I finally realized the culprit for me was a very high fruit diet and also an absence of good bacteria that showed on lab tests. I took antibiotics for years as a teen, prescribed by my doctor. The last bout of BV was about a year ago. No one and nothing helped until I found my own cure. It was raw garlic and oil of oregano. A severe case of BV was much better within days and gone in a week. I have not had any relapses. Since then, I take a great probiotic a.m and p.m and raw sauerkraut daily and garlic regularly. Also, I eat very little low-glycemic fruit.

    • Mrs.E

      how did you prepare the garlic and oil of oregano. I have chronic BV and I am about to drive myself crazy. Nothing has helped. I have been on everything you could possibly imagine. I have been dealing with this so long, my doctor finally said what is causing the BV is I have extra blood in in my uterus. I had the novasure (ablation) 3 weeks ago, I am still very miserable. Don’t think that was it at all. My husband just does not know how to feel. I am willing to try anything at this point.

  • Sammy

    This is very very true! After years of trying to figure the issue out, I finally caught a grasp! I woul go to the doctor every 9 days after the medication they gave me was used properly and wore off only after two days of finish! I tried everything I was told! Don’t wear tight clothes, don’t use scented stuff, wear cotton panties, douch, try yogurt, don’t douch, limit partners, don’t have sex, and the list goes on! After years of testing everything And constantly paying for treatment, I did a ton of research! No doctor ever said anything about food, diet, water or whatever! I read a million times the same preventative stuff which never helped! It gets annoying when you find out that absolutely nothing the doctor prescribed works! It gets annoying when every preventative thing you read This is very very true! After years of trying to figure the issue out, I finally caught a grasp! I woul go to the doctor every 9 days after the medication they gave me was used properly and wore off only after two days of finish! I tried everything I was told! Don’t wear tight clothes, don’t use scented stuff, wear cotton panties, douch, try yogurt, don’t douch, limit partners, don’t have sex, and the list goes on! After years of testing everything And constantly paying for treatment, I did a ton of research! No doctor ever said anything about food, diet, water or whatever! I read a million times the same preventative stuff which never helped! It gets annoying when you find out that absolutely nothing the doctor prescribed works! It gets annoying when every preventative thing you read doesn’t work! So I took it upon myself to study the ph stuff! I would measure my ph and try different foods and waters! Over time I found that alkaline food and water highly affected my oh levels and helped the Bv! Ph water and an alkaline diet is the only relief I have from it! I have not been to the doctor in over half a year! I can prevent any infection simply by drinking my ph water! No yeast, no Bv, and no bladder infections! If I feel themdoesn’t work! So I took it upon myself to study the ph stuff! I would measure my ph and try different foods and waters! Over time I found that alkaline food and water highly affected my oh levels and helped the Bv! Ph water and an alkaline diet is the only relief I have from it! I have not been to the doctor in over half a year! I can prevent any infection simply by drinking my ph water! No yeast, no Bv, and no bladder infections! If I feel them coming on and I just drink the water! I have also gone on an all alkaline diet! The alkaline directly works! We eat and need water everyday anyway so it is convenient! I figured this out on my own! No thanks to doctors and wasted money!

    • Zhu Zhu

      Hi there,
      I am curious about the alkaline diet? what does that entail and most importantly do you know why it works?
      secondly why is your message repeated so many times is that intentional?
      Lastly I also agree doctors are not very good in this area. It too specific for them to work out unless they live with you.