Nature versus nurture

The composition of your microbiome is largely determined by the DNA you were born with and the microorganisms you were exposed to in the birth canal and via breast milk. However, your environment, medication, diet and lifestyle choices can all affect — and potentially disrupt — the balance of a healthy microbiome.

​Eat more dirt

Humans are not the only organisms with a microbiome. The soil found in dirt contains a highly diverse array of microbial species. The human microbiome contains only 10% of the diversity that the soil microbiome contains. Because dirt contains so many different microbiota, exposure to the natural environment (including dirt) can help us to develop a more diverse and, thus, healthier microbiome.

Douching harms the vaginal microbiome

Beneficial bacteria in the vagina, such as lactobacilli, produce lactic acid, which keeps the pH balance in check and protects against pathogens. A healthy, balanced microbiome can protect against conditions such as urinary tract and yeast infections, sexually transmitted diseases and bacterial vaginosis.

Certain activities, such as douching or even using soap, can harm the delicate vaginal microbiota and overall vaginal well-being.

"Many women are surprised to learn that having a slightly acidic pH in their vagina controls whether yeast or bacteria overgrow," explained Barb Dehn, a nurse practitioner and member of the HealthyWomen Women's Health Advisory Council. "That's because the vagina is a very delicate and complex ecosystem, so if the pH becomes less acidic, then it's a setup for opportunistic yeast or bacteria to overgrow, causing symptoms."

Healthy diets improve the gut microbiome

What we eat can largely affect the balance and overall health of our microbiome. Diets high in fat and sugar have been associated with unfavorable changes to the gut microbiota. High fiber diets, with plenty of fruits and vegetables, are recommended for people looking to improve their gut microbiome. (Your diet cannot directly impact the vaginal microbiota.)

"The lactobacilli found in foods such as yogurt is not the same lactobacilli found in the vagina, so eating foods rich in lactobacilli will not replenish the lactobacilli in your vagina," Dehn said.

Probiotics and prebiotics can help balance the microbiome

Probiotics are healthy living microorganisms that can be consumed through food, such as yogurt, sauerkraut and kimchi, as well as supplements.

The research on whether these supplements can boost the microbiome is inconclusive, and Dr. Levine believes that more research is needed to clearly showcase the benefits that probiotics have for users.

It's important to note that supplements are not regulated by the FDA; however, there are situations where your medical provider may recommend using a probiotic supplement.

Certain indigestible fibers are considered to be prebiotics, which are used as a food source for some of the healthy bacteria in our microbiomes. If you want to increase prebiotics in your diet, you can turn to prebiotic supplements or prebiotic-rich foods, such as vegetables or whole grains.

Medication can disrupt the microbiome

Aging alters the microbiome

Like other parts of our bodies, our microbiomes can change as we age. This means that, for many women, menopause can be a time of a change for the vaginal microbiome.

Lactobacilli is one of the most important species of bacteria in the vagina. Because they rely on estrogen for energy, they tend to decrease when a woman goes through menopause.

"[This] leads women to have much higher pHs and much more alkaline environments, and they are much more prone to lots of different symptoms, from itching and burning to urinary tract infections, as pathogenic bacteria migrate from the vagina to the urethral opening," Dehn said.

Diversity is key

Each of us is born with our own intrinsic galaxy of microorganisms that help us function. Maintaining a healthy balance of all the diverse microbes in our body is essential. Eating a healthy diet full of nutrients, getting exposure to the natural world and monitoring medication usage are all important aspects of maintaining a balanced microbiome.

Resources:
National Institutes of Health, Human Microbiome Project