Vaginal Bacteria and Hormones: How Menopause Impacts the Microbiome

Understanding the Link Between Hormones and the Vaginal Microbiome

Your vaginal microbiome is a dynamic ecosystem that changes throughout life-and hormones play a major role in shaping it. During the reproductive years, high oestrogen levels support a Lactobacillus-dominant microbiome, which maintains an acidic pH and protects against infections like bacterial vaginosis (BV) and urinary tract infections (UTIs).

However, during menopause, oestrogen and progesterone levels decline, leading to a vaginal microbiome imbalance. This hormonal shift alters microbial diversity, reduces protective bacteria, and makes the vaginal environment more vulnerable to dryness, irritation, inflammation, and recurrent infections.

What Happens to the Vaginal Microbiome During Menopause?

As oestrogen levels drop, several biological changes occur:

• Glycogen production decreases: Glycogen is the primary food source for Lactobacillus bacteria. Without it, these beneficial microbes decline.
• Vaginal pH increases: The environment becomes less acidic, allowing harmful bacteria to thrive.
• Tissue thinning and dryness: The vaginal lining becomes less elastic and more fragile, leading to discomfort and higher infection risk.

These changes result in vaginal microbiome dysbiosis, which can trigger symptoms such as:

• Vaginal dryness
• Itching and irritation
• Pain or discomfort during intercourse
• Recurring UTIs or BV

Menopause-related microbiome changes are not just local-they are closely tied to systemic immune function, inflammation, and women’s health during ageing.

Why Lactobacillus Bacteria Are Essential for Vaginal Health

Lactobacillus species are the key to maintaining vaginal balance. They:

• Produce lactic acid to keep pH low
• Release hydrogen peroxide and bacteriocins to inhibit pathogens
• Strengthen the mucosal barrier to prevent infection
• Modulate local immune response

When these protective microbes decline, the vaginal environment becomes more susceptible to harmful bacteria, inflammation, and discomfort.

Clinical studies show that restoring Lactobacillus levels in postmenopausal women can improve symptoms, reduce vaginal pH, and support tissue health-demonstrating the importance of microbiome support during menopause.

Hormonal Changes, Inflammation, and Immune Function

The drop in oestrogen doesn’t only affect the microbiome-it also alters the immune landscape in the vaginal tract:

• Immune cells become less active
• Healing processes slow down
• Inflammation becomes more frequent and persistent

This contributes to a condition known as “inflammaging”-a low-grade, chronic inflammation that accelerates biological ageing. By protecting the vaginal microbiome, you support immune balance and reduce the risk of inflammation-driven health issues.

How to Support the Vaginal Microbiome During Menopause

Here are practical steps to support microbiome health in midlife and beyond:

1. Use gentle, fragrance-free cleansers: Harsh soaps can disrupt pH and kill beneficial bacteria.
2. Stay hydrated and moisturise: Use vaginal moisturisers or lubricants specifically formulated for menopause-related dryness.
3. Take probiotic supplements: Look for strains like Lactobacillus crispatus, L. rhamnosus, or L. jensenii, which promote vaginal balance.
4. Eat a phytoestrogen-rich diet: Include soy, flaxseeds, chickpeas, and legumes to naturally support hormonal health.
5. Avoid unnecessary antibiotics: These can wipe out both harmful and beneficial bacteria.
6. Consider vaginal oestrogen therapy: Speak to your doctor about local hormone therapy if symptoms are severe-it can restore tissue health and improve microbiome resilience.

Why Vaginal Microbiome Health Matters for Longevity

Vaginal health is a key indicator of women’s overall wellness. A disrupted vaginal microbiome doesn’t just cause discomfort-it can contribute to:

• Higher risk of chronic infections
• Weakened immunity
• Increased inflammation
• Poor metabolic and hormonal balance
• Lower quality of life in later years

A healthy vaginal microbiome during and after menopause supports not only reproductive health but also systemic wellbeing and graceful ageing.

Personalised Vaginal Microbiome Testing for Menopause

At Phenome Longevity, our Vaginal Microbiome Test offers personalised insights into your microbial composition. You’ll learn:

• Which bacteria are present and dominant
• Whether your pH and diversity levels are optimal
• How hormonal changes are affecting your microbial balance
• What steps you can take to restore comfort and reduce inflammation

With this information, you can create a personalised care plan that supports hormonal health, immune balance, and long-term wellbeing during menopause and beyond.

Take Control of Your Vaginal Health During Menopause

Menopause doesn’t have to mean discomfort or imbalance. With vaginal microbiome testing, targeted probiotics, and the right lifestyle support, you can restore harmony and enhance comfort at every stage of life.