What causes vaginal imbalances?

The protective vaginal microflora that make up the intimate microbiome are vital to our intimate health and wellbeing.

When they’re happily in balance, they work brilliantly, keeping harmful bacteria at bay and cleansing the vaginal tract. 

Our intimate self-care article has some useful tips on how to help your intimate area help itself. But for many reasons, our intimate microbiome can be challenged, leading to discomfort and infections. 

If you do experience discomfort, it’s worth checking our list of ‘usual suspects’ below. It may give you helpful insight into what’s triggering your imbalance and how to calm things.

Sex, penetrative and oral 

Harmful pathogens can be passed between sexual partners during any sexual contact, oral or penetrative, or through sharing sex toys. So it’s sensible to cleanse genitals and toys after any activity. 

Periods and cycles 4

Menstruation is a natural process – and the body naturally adjusts to the changes it brings –  but maintaining good intimate hygiene at this time is essential. Blood has a more alkaline pH than the vaginal microbiome, and this can disrupt the vagina’s natural acid balance, causing sensitivity. Also, oestrogen levels can drop after ovulation occurs in the menstrual cycle and some women are more prone to yeast infections at this time. 

Menopause 4

Oestrogen helps keep up the levels of good bacteria (lactobacilli) in the vagina, so when it declines, uncomfortable symptoms (such as dryness, or being more prone to yeast infections) can crop up. There are treatments (over the counter and on prescription) that can help, so don’t suffer in silence. Ask your doctor or gynaecologist for advice. 


Sometimes, medication 4 that’s vital to help with a condition can upset the vaginal microbiome and present new problems in our intimate areas. For example, while antibiotics kill bad bacteria in the body, they can also wipe out the good ones, making the vaginal area more vulnerable.

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 Our intimate self-care tips give some helpful information and suggestions for supporting the intimate microbiome.


The good news is that during pregnancy, the vaginal microbiome adjusts, offering even greater protection from infection. And there is fascinating data about how it prepares a baby for birth 10, offering a protective dose of good bacteria as the baby passes through the birth canal.

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But hormonal changes and increased blood supply can also increase body temperature during pregnancy, and the last trimester can make sleeping uncomfortable. Factors such as these can challenge our systems or increase sensitivity. Talk to your midwife or obstetrician for advice. 


Keeping active and exercising regularly is great for our health and fitness. But unfortunately, tight synthetic gym kit is not good news for our intimate areas. Harmful bacteria thrive in dark, hot and sweaty environments. 

Tip:  after exercising, always change clothes. You may want to wash your intimate area with lukewarm water or a mild intimate cleanser too. And if you’re prone to yeast infections, a change of underwear in the middle of your day can help.

Weak immune system

There is evidence that suggests there’s more likelihood of developing Bacterial Vaginosis (BV) when our immune system is compromised, or we’re suffering from inflammatory conditions. 4,11 And even if you’re just generally feeling below par, stressed or tired, your body is less resilient. So at these times, taking care of your vulvovaginal area can be even more important.

Tight underwear

As we mention in the exercise section above, our intimate areas do not respond to the heat and moisture that tight underwear creates. Ventilation is aaah! As are natural fibres, that let our bodies breathe.

Harsh laundry detergents

If detergents leave residues on clothes and underwear, these can be irritants. You may want to give underwear a second rinse in fresh water. Also, think about choosing a mild, good quality detergent.

Soaps or body washes with a higher pH level 4

The vaginal microbiome is naturally acidic, while traditional soap and some body washes are alkaline. Regular use of soaps or body washes can disrupt the acid balance and make intimate areas vulnerable to infection. 


[4] Gupta et al: Crosstalk between Vaginal Microbiome and Female Health: A review 2.5.2. Living style and habits Volume 136, November 2019, 103696


[10] Alanna Collen 10% Human: How Your Body's Microbes Hold the Key to Health and Happiness 2015; Chapter 7 From The Very First Breath p.205-207

[11]  Kerry Murphy, Caroline M. Mitchell 2019;The Interplay of Host Immunity, Environment and the Risk of Bacterial Vaginosis and Associated Reproductive Health Outcomes


Further reading