The Vaginal and Vulval Microbiome

The community of microbes that live in and around the vagina plays an important role in everyday comfort.  

A healthy microbiome is usually dominated by Lactobacillus species, which help maintain a slightly acidic environment and support the thin mucosal lining. When this balance shifts, the tissues may feel more reactive or unsettled. Research in this area is growing, but it remains underdeveloped compared with other fields, and much of what we understand comes from drawing reasonable inferences from studies on similar tissues elsewhere in the body. 

How Diet Influences Microbial Balance 

Research into how diet affects the vaginal microbiome is still emerging. A handful of observational studies suggest there may be links between overall diet quality and the stability of Lactobacillus species, but findings are inconsistent and too early to form clinical recommendations. 

What we know with confidence is that diet has a well‑established influence on the gut microbiome, and the gut in turn affects immunity and mucosal function more broadly. Fibre supports beneficial gut bacteria, which produce short‑chain fatty acids known to help maintain epithelial and mucosal tissues elsewhere in the body. Hydration also contributes to the conditions these tissues rely on. 

It is reasonable — though not yet proven — to think that the internal environment supported by a plant‑rich, minimally processed diet may also contribute to stability in the vaginal microbiome, but this remains an area of active research rather than established fact. 

Micronutrients and Mucosal Tissues 

Nutrients such as vitamins A, C, D and E, folate and certain long‑chain fatty acids have been shown to support epithelial or mucosal health in the gut, skin and other body tissues. These nutrients help maintain barrier function and support normal cell turnover. 

There is very little direct research on the vulval or vaginal epithelium itself, so any application of this knowledge to vulval comfort is an informed inference rather than established evidence. It is possible these nutrients help the vulval and vaginal lining cope with everyday wear and tear, but this has not yet been studied in a focused way. 

Fermented Foods and Live Cultures 

Fermented foods such as live yoghurt, kefir, kimchi and miso traditionally been associated with digestive health.  

A recent systematic review suggests they may have a role in supporting vaginal health, but human studies are few and exploratory. Their effects are better understood in the gut than in the genital tract. 

If people enjoy these foods and tolerate them well, including small amounts can be a simple way to support general microbial diversity after illness or antibiotics, though they should not be relied on to restore vaginal balance or to manage specific symptoms. This remains an early area of research. 

Sea Buckthorn Oil 

Sea buckthorn oil is one of the few nutritional interventions studied directly for vaginal mucosal health.  

A controlled trial in postmenopausal women found improvements in certain measures of vaginal mucosal integrity compared with placebo. This suggests a possible role for sea buckthorn oil in supporting mucosal tissues, particularly where oestrogen cannot be used. 

Even so, research is limited to a small number of studies, and sea buckthorn oil is not a substitute for medical assessment or treatment when dryness has a clinical cause. 

Foaming Washes and the Microbiome 

Many commercial intimate washes — including familiar brands such as Femfresh and Vagisil — are sold as pH‑balanced, yet they often contain surfactants, fragrance and foaming agents that can unsettle the vulval microbiome and irritate the skin. 

The issue is less about pH and more about detergent action. Even mild surfactants can remove protective lipids from the vulval skin and disrupt the fragile equilibrium Lactobacillus species rely on. Dermatologists and gynaecologists generally advise keeping washing simple: warm water or a very mild, non‑foaming cleanser if needed.  

Foaming intimate washes are rarely recommended in clinical settings, even when marketed as pH‑appropriate. 

Supporting the Microbiome

Because formal guidance on diet for the vaginal microbiome does not yet exist, a grounded approach is to focus on habits known to support general gut and mucosal health. These include eating a variety of plant foods, staying well hydrated and limiting alcohol and heavily processed foods. 

These habits do not act on specific symptoms directly, and they cannot be relied upon to influence the vaginal microbiome in a predictable way. They simply help maintain a wider internal environment that may support comfort and microbial steadiness. 

Keeping Perspective 

Both the vulva and vagina are under‑researched areas, and many of the mechanisms we discuss here are still being studied. What we know is often drawn from related tissues, broader mucosal research or early microbial studies.  

These areas deserve more attention, and until that research develops, cautious interpretation and modest language serve readers best. 

Diet, washing routines and overall health all play a part in creating the conditions for comfort, but none replace medical assessment when hormones, medication or other health factors are involved.