Brittany Powell-Savoy, WHNP-BC
In a world of trending topics, one of my favorite things to discuss is vaginal health. That’s because it is relevant to half of the population, and no one talks about it. Vaginal health is part of women’s health. It is important, and it doesn’t have to be a mystery.
Many women will experience vaginal symptoms at some point in life. These may include vaginal odor, discharge, vulvar itching or vulvar irritation among others. Symptoms like these can be a sign that the vaginal ecosystem has been altered or disrupted.
“Ecosystem?” Yes! The vaginal ecosystem, also referred to as the vaginal microbiome, contains healthy bacteria, opportunistic “bad” bacteria, and candida (yeast).
Lactobacillus is a healthy vaginal bacteria that produces lactic acid and helps keep the vaginal pH low. A low pH, typically 4.5 or lower, makes it difficult for candida and bad bacteria to multiply and thrive.
Opportunistic, or “bad” bacteria, may be native to the the genital tract or introduced. Many bacteria are common in the genital tract in small quantities. When there is an overgrowth of these types of bacteria, symptoms may occur.
In a balanced ecosystem, varying strains of lactobacillus account for about 90% of bacteria found (Path Advantage, 2026). When our vaginal microbiome is imbalanced, infections are more likely to occur. Here are the most common infections I see day to day:
Bacterial vaginosis
Bacterial vaginosis, or BV, occurs when opportunistic “bad” bacteria overgrows in the vagina. BV is the most common cause of abnormal discharge. “Normal” is usually clear or white discharge, without foul odor or accompanying discomfort. Abnormal discharge can vary in color and consistency. It may be excessive in amount or noticeably odorous. Bacterial infections can also be asymptomatic. When healthy bacteria are plentiful, infections are less likely to occur.
Vulvovaginal Candidiasis
Commonly known as a “yeast infection,” vaginal candida is the most common cause of vaginal itching and irritation. Yeast infections occur when there is an overgrowth of candida in the vagina. Certain antibiotics can decrease the amount of healthy bacteria, creating an ideal environment for yeast to thrive.
Cross Roads Hormonal Health and Wellness Urinary tract infection
Vaginal symptoms are often confused for UTIs. Urinary tract infections are characterized by frequent urination, pain with urination, urinary urgency, pelvic pain and/or low back pain.
Because the urethra is located directly outside of the vagina, it can easily be exposed to vaginal flora. In patients with recurrent urinary symptoms, a vaginal culture can be helpful in ruling out asymptomatic BV or candida.
Promoting vaginal health
A healthy vaginal microbiome can help keep infections at bay. Here are a few of my usual recommendations: