March 3, 2025 • 42 mins
In this enlightening episode of the Ageless and Awesome podcast, we tackle the often-taboo topic of vaginal health. With expert insights from Alison Patchett, the @vag.hormone.naturopath, we uncover the complexities of bacterial vaginosis (BV), a condition that many women experience but few discuss openly.
Alison shares her expert advice on testing protocols and treatment options, emphasising the importance of holistic care that can combine both natural and medical approaches depending on the client's clinical needs. Furthermore, we discuss lifestyle factors that contribute positively and negatively on vaginal health, from dietary choices to the best clothing selections, empowering women to take proactive steps for their well-being.
Engage with us as we break down stigmas and encourage open conversations about these vital issues affecting women everywhere. Don’t miss this chance to arm yourself with knowledge and reclaim your health.
You can find Alison at thevaghormonenaturopath.com.au and if you would like her exclusive free eBook - DM her on IG @the.vag.hormone.naturopath or email her hello@thevaghormonenaturopath.com.au
Are you a woman feeling stressed, flat and experiencing the challenges of perimenopause?
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I’m here to help with my proven method.
Here's how I can support you -
1. Hit your health and wellbeing goals this year, balance your hormones and lose weight with your own personalised protocol, based on your body's biochemistry. Sounds awesome right!! Book a free 30 minute Peri Weight Loss Assessment with me so we can discuss your health and wellbeing goals and also see how I might be able to support you. Book your call here.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi, I'm Susie Garden and this is the Ageless and
Awesome podcast.
I'm an age-defying naturopathand clinical nutritionist and
I'm here to bust myths aroundwomen's health and aging so that
you can be ageless and awesomein your 40s, 50s and beyond.
The Ageless and Awesome podcastis dedicated to helping women
(00:24):
through perimenopause andmenopause with great health, a
positive mindset and outrageousconfidence.
Hit, subscribe or follow nowand let's get started.
Hello, gorgeous one, andwelcome to this week's episode
of the Ageless and Awesomepodcast.
I'm excited to have AlisonPatchett back on the pod with
(00:48):
part two, I guess talking allthings vaginal health.
Alison is the Vag HormoneNaturopath.
She's dedicated to empoweringher clients, not only managing
symptoms, but to identify andaddress the underlying cause of
those symptoms, Providing expert, integrative support for women,
online or in person.
(01:09):
She's based in Bandura inVictoria.
Alison addresses everythingfrom hormone imbalances to
intimate healthcare.
Her approach is tailored to herclients' needs.
She combines advanced testing,natural therapies and lifestyle
adjustments so you can reclaimyour health and get back your
sparkle.
(01:29):
Alison, welcome back to thepodcast.
Speaker 2 (01:32):
Thank you for having me.
Speaker 1 (01:34):
My absolute pleasure.
Last podcast we did, which wasa couple of weeks ago, it was so
popular and I just thought Imean, we talked about having you
back last time, but I thinkit's just so good to talk about
the vagina and its health andreclaim that word as well.
Yes, absolutely.
Because we just don't hearenough people talking about it.
(01:55):
So I'm going to start by askingyou, alison, how you got to
this place, where you have thisspecial interest in vaginal
health and the kind of trainingthat you've done.
Speaker 2 (02:07):
Sure, yeah.
So I guess I kind of havemeandered my way through to
vaginal health and via a numberof different areas, so starting,
I guess, looking at thyroidhealth, moving into more broadly
hormone health, and I think, asI've personally moved into
perimenopause, a lot of myclients start to move into
(02:30):
perimenopause and sort of seeingthose hormonal shifts.
That kind of has led me downthis path of looking at vaginal
health as well, because theinterplay there is so important
to understand, and last year Idid a six-month course called
Vagiversity, which was just anamazing in-depth look at what's
(02:55):
going on in the vagina differentpresentations, the vaginal
microbiome and I guess thatreally kind of opened my eyes to
the possibilities and reallythe all of the different things
(03:17):
that can happen in that area, Ithink, which we don't appreciate
on a broader scale as much.
It's kind of a bit hidden fromview in a lot of ways.
There's definitely, you know,an area that we need always need
more research into women'shealth, don't we?
But it particularly withvaginal health, and so it's
become a real passion area ofmine to make sure that every
woman feels really special andamazing, including with their
(03:39):
vaginal health.
Speaker 1 (03:41):
Yeah, that is awesome , alison, and it's such a needed
service as well, because it isa highly specialized area and
you know, vagiversity I'm veryfamiliar with.
I definitely want to do thatcourse at some stage, but it's
definitely something that Ithink needs more attention.
(04:02):
So, following on from the lastepisode that we did together,
alison is, we wanted to talktoday about bacterial vaginosis,
also known as BV, and it is abig topic.
We kind of ran out of time atthe last podcast because there
were so many things to talkabout, and it is something that
(04:22):
I'm hearing a lot of my friendstalking about it, which that's
fairly new for me, to be honest,to hear women actually talking
about it and there seems to be alot of women that have it.
Speaker 2 (04:45):
So letuced situation.
I guess that goes on in thevagina, so there's a few.
It's where there is a shift inthe flora, in the vaginal
microflora.
Sorry.
Yes, no, you're right Getting mytongue tied there and what
(05:06):
happens is that when that shiftoccurs, some particular species
start bacterial species start totake up residence.
So we start to see things likeGardnerella and Prevotella,
Adipobium, Streptococcus, anumber of different species, and
it's the combination of thespecies and when they get to a
(05:29):
certain level that we start toidentify that as being bacterial
vaginosis positive.
Yeah, and it can be a realchallenge because these species
do tend to kind of clustertogether and create what's
called a biofilm, which can makethem a little bit more tricky
(05:51):
to treat.
But it is super important toget it diagnosed and treated
properly because it can havesome quite significant long-term
health implications as well.
Speaker 1 (06:04):
Yes, and that biofilm .
They're kind of protected,aren't they within that biofilm?
You've got to break down thebiofilm in order to get to them,
to actually treat them.
Yes, that's right?
Speaker 2 (06:17):
Yes, so it can be a bit of a few steps involved in
doing that.
Speaker 1 (06:20):
Yeah, yeah, and so obviously we can test for those
microorganisms.
So can you talk a little bitabout how that testing happens?
Speaker 2 (06:30):
Yeah, so with a vaginal microbiome test, what
we're doing is we're taking aswab of the inside of the vagina
and the client does that.
The client, yes, yes,absolutely.
So the great thing with thetest kits that we use, you can
some clients will go to their GPand their GP will do the swab
(06:52):
for them.
But certainly for a majority ofmy clients, we're organising,
I'm organising a test kit to besent to them.
They do it in the privacy oftheir own home.
Ideally when they're mostsymptomatic and I think that's
an important thing to note issometimes with these conditions
that symptoms ebb and flow, andwhen their symptoms are at their
(07:14):
kind of peak is when it is thebest time to test, because
that's going to tell us a lotmore about what's going on as
well.
So it's a really simple test todo.
I have done it myself as a, youknow, to check out and see how
it all works, because I like todo that to know what I'm telling
my clients.
And, yeah, the instructions arereally clear.
(07:37):
You do it in the privacy ofyour own home, send it back off
to the pathology lab and we geta report back which is quite
detailed in telling us what'sactually going on there.
Speaker 1 (07:47):
Yeah, and it's just a swab, isn't it?
It's just inserting a swab,yeah.
Speaker 2 (07:51):
It's like a big Q-tip and you just insert it a few
centimetres into the vagina,kind of wipe off the vagina wall
and then pop it in its littlecase and send it off.
Speaker 1 (08:00):
Yeah, lovely yeah.
And so what are the symptomsthat women tend to describe when
they're in that sort of a highsymptom picture of BV.
Speaker 2 (08:12):
Yeah, the symptoms can vary a little bit, but there
certainly is a common clusterof symptoms.
So the first thing that I oftenhear about is a strong odour or
a discharge with a strong odour.
So the discharge is generallylight grey.
It can be white, but it's theodour that makes it different to
(08:32):
, as well as the colour.
The odour that makes itdifferent to the regular white
or clear discharge that youwould get through fertile.
What you would expect to seewith fertile mucus.
So the fertile mucus is notgoing to have any particular
odour, whereas the bacterialvaginosis, the BV discharge,
absolutely has an odour.
(08:52):
It might be a mild odour or itmight be quite strong, depends
on the person.
There's often burning orirritation around the vagina and
vulva and I think this is whereit often gets confused with
thrush.
Is the colour of the dischargeplus the irritation, and that's
where we can start to see someconfusion coming in.
(09:13):
There can be burning duringurination.
There's generally a vaginal pHthat's quite alkaline and you
know we need to make sure thatyou know someone might
experience one of those symptoms, or they might experience all
of them, or you know somethingin between.
So it's really about you know,taking notice of what's going on
(09:36):
down there and noticing anychanges that are occurring and
then getting tested so that weknow exactly what's going on.
Speaker 1 (09:43):
Yeah, and this is the thing is knowing what is your
normal and what is then abnormal, and not ignoring those changes
, because I think a lot of womenjust go oh gosh, I just hope
this will go away, so then Idon't have to deal with it.
Or they think nothing can bedone if they've had an
experience with a healthcareprovider where they haven't
really had a good outcome orthey feel dismissed.
(10:06):
I feel like that can be part ofthe problem as well.
Yeah, yeah.
Speaker 2 (10:11):
Yeah, yeah, I agree completely, and I actually had a
client not all that long agowho just said you know, I always
check in with my clients ontheir vaginal health, always,
always.
Whether they're seeing me forsomething else or not, that's
always something we check in on.
And they said, oh, you know,they were just getting a bit of
irritation, Wasn't really much.
If it was going to get worse,they were just going to get an
(10:32):
over-the-counter thrashtreatment.
And the more we talked about itI said, you know, we got to the
point where we said, yeah, Ithink we just need to test and
see what's going on.
And I'm so glad we did, becausethere was no candida present,
absolutely none.
It definitely was not thrush.
But what we are starting to seeis a shift in the vaginal pH,
(10:53):
the irritation, and we'restarting to see one or two of
these species that can lead toBV coming up.
So it's great we can nip thatin the bud with some really
early intervention.
Speaker 1 (11:03):
Yeah, and there's a few things I want to dive into
there.
So firstly, is thrush beingcandida?
Can you just explain whatthrush is, how it happens and
that difference?
I think you probably havecovered it there a little bit,
just a little more, yeah.
Speaker 2 (11:20):
Yeah, so it's about the pathogen that's present.
Speaker 1 (11:24):
So the microorganism that causes disease.
Speaker 2 (11:28):
Yes, that's exactly right, Sorry, yes, yeah, so
there are differentmicroorganisms that are found
naturally on the skin and thereare others that are introduced.
So everyone has a level ofcandida on their skin.
But when we are healthy and ourimmune system's working
properly in the vagina, when ourph is in its optimal level,
(11:51):
we've got good levels oflactobacilli, which are the
really healthy keeps our vaginahealthy then you know
everything's kept under control.
When one of those things startsto break down, then that's when
you know whether it's bacteriaor candida which causes thrush.
It's actually a fungus.
(12:12):
When either of those two thingsstart to get overgrown, that's
when we start to get symptomsoccurring.
So the difference is what isallowed to grow, and that really
depends on the immune system,on overall health, on dietary
factors, on lifestyle factors.
There's a whole range of thingsthat come into play there and
(12:32):
the challenge is, because thereis that similar symptom or that
symptom crossover, that we can'tjust assume what's going on.
So, yeah, so with thrush youwill get the burning and
irritation.
You can get the discharge.
It's often more cottagecheese-like.
So it is quite a slightlydifferent type of discharge With
(12:54):
the thrush Can smell a littlebit with the thrush, whereas
with the BV you've got a moredistinct smell.
You've still got the burningand irritation, but the
discharge is slightly different.
But if there's no discharge ineither case, you really don't
know what's going on.
Speaker 1 (13:10):
Yeah, yeah.
And the other thing I wanted toask about, like we talked about
, you know, going to pharmacyand getting an over-the-counter
treatment how many people do youthink women do you think go in
and ask for that from thepharmacy and then they just get
given that without too muchfurther investigation.
I can't imagine there are toomany pharmacists or pharmacy
assistants that are going intodetail to see if it's not thrush
(13:33):
, if they just assume that it'sgoing to be thrush.
Do you feel like that'sprobably happening and do you
find that many of your clientshave already been through that?
Speaker 2 (13:40):
thrush treatment when it's actually not thrush.
Yeah, yeah, I've definitely hadclients who have said to me,
you know their thrush treatmentwhen it's actually not thrush.
Yeah, yeah, I've definitely hadclients who have said to me,
you know, their thrush justkeeps coming back and I'm like,
does it, or was it not thrush inthe first place?
And yeah, I mean, I think some,some pharmacists are amazing
and they will kind of go into alittle bit more detail.
I think the challenge is in apharmacy environment where
(14:02):
there's potentially yes, it'skind of.
It's not necessarily anenvironment where there's
potentially other people around.
It's kind of it's notnecessarily an environment where
people want to disclose toomuch.
So I mean that all adds, youknow it's into the compounding
kind of effect of I'll just grabthis because it's going to be
quick and easy and be on my way,rather than actually getting
(14:22):
into the detailed nitty grittiesof getting a thorough diagnosis
.
Speaker 1 (14:28):
Yeah, okay.
So you also mentioned aboutsome different influences on the
health of the microbiome.
I guess the vagina microbiomeCan we talk a little bit more
about.
I know we talked quite a lotabout the vagina microbiome in
the last podcast, but let's talka bit more about what
(14:49):
influences it, because youtouched on a few things there,
like diet, lifestyle et cetera.
So can you tell us a little bitmore about that?
Speaker 2 (14:56):
Sure, yeah.
So there's definitely a fewthings.
So things like stress andsmoking will make a big
difference.
Smoking, smoking yes, I knowwho would have thought.
I know Antibiotics as well.
Funnily enough, you know, allof those things may play a role
in shifting the microbiome in anegative way because of
(15:20):
inflammation and, yeah,oxidation and all those sorts of
things.
Inflammation and, yeah,oxidation and all those sorts of
things.
Hygiene practices is somethingthat we, I think, goes.
I think people kind of thinkabout hygiene practices washing
hands after you go to the toilet, but actually the way you wipe,
making sure you're wiping frontto back, so away from, because
(15:43):
those, you know, the anus andthe vagina opening and the
urethra are very closelysituated.
That wiping process is reallyimportant.
But even thinking about thehygiene practices around,
anything that's inserted intothe vagina as well, so whether
that's, or even on the vulva onthe outside part.
So the vulva is the outsidepart, the vagina is the inside
(16:05):
part.
So even things that are kind ofrubbing on the vulva as well.
So whether that's menstrualproducts or masturbation
products or sexual partners, oryou know your own hands making
sure that they're, you know that, you know how many of those and
how often, and for other people, their microbiomes will all
(16:27):
influence what's going on in thevagina as well.
And dietary factors.
So things like high sugar diets, processed foods, low nutrient
status, particularly things andthis is what I found really
interesting is low iron and lowvitamins A, c and E in
particular, will negativelyinfluence the vaginal microbiome
(16:50):
.
And it's all to do with thatimmune function and the tissue
integrity.
So the integrity, how healthythe actual vaginal tissue is as
well.
And then, of course, there'shormones.
Who can forget our beautifulhormones and their influence as
well?
And then, of course, there'shormones who can forget our
beautiful hormones and theirinfluence as well.
Speaker 1 (17:09):
Yes, my gosh, and you think about our poor old peri
ladies.
A lot of them are irondeficient as well because of the
impact of the hormonefluctuations on periods and the
heaviness of flow.
So you can see that, you know,there's possibly a higher need
for education around BV inpeople that are in that sort of
(17:30):
35 plus age group, you know,assuming that you know we're
going to have some women intheir late 30s that are in
perimenopause.
So since we're there, let's talkabout how perimenopause
influences BV.
We've touched on a couple ofthings.
Speaker 2 (17:46):
Yeah.
Speaker 1 (17:47):
Yeah, let's talk a little bit more about that.
Do we know from any researchwhether there's a higher
prevalence of BV in women inperimenopause.
Speaker 2 (17:57):
From the research that I've found to date not
statistically significant.
Are they actually looking forit?
Yes that's what I was going tosay is that I think where there
is a difference and where peopleare starting to talk about it
is like a number of things inwomen's health.
(18:19):
People are more aware of it.
I think there's a growingawareness and so where people
just put up with symptoms beforethere's this slow evolution of
people actually getting testedand getting a diagnosis and no
longer the thing I really loveabout perimenopausal women is
they don't put up with stuffLike that's kind of In this
(18:41):
generation.
Speaker 1 (18:42):
In this generation.
Speaker 2 (18:43):
Yes, I think there's a real evolution in this
generation of perimenopausalwomen going I'm done, yeah, no,
nope, not today.
Speaker 1 (18:52):
I'm just not going to put up with this anymore.
Speaker 2 (18:55):
So I was going to swear then, but I pulled myself
back.
But you know, and I think youknow, you do get to a stage in
your life and I'm seeing it moreand more in my patients where
they're kind of like I've donethis, I've done this for so long
, I just cannot continue.
And so I think that is probablywhere we're seeing the shift.
(19:17):
More than it being an increasein prevalence in the community,
I think it's an increase inawareness amongst different
groups of women.
Speaker 1 (19:27):
Yeah.
Speaker 2 (19:28):
Yeah, which is really good.
Oh, it's amazing.
I love it.
I love it.
I think it's so.
If we can't advocate forourselves in this time of life,
when can we?
You know?
I think it's.
There has to be a point in timewhere we can start to do that,
and the more people do it, themore you know groundswell that
creates for women to advocatefor themselves in all areas of
(19:52):
their lives.
So yeah, for sure.
Speaker 1 (19:53):
Yeah, and that's why you know speaking about on
podcasts.
You know looking to influencersthat are in our age group, that
are going through this and thatare openly talking about it is
so valuable for all of us thatare going through it.
So, yeah, that is awesome.
So when we talk about hormoneor perimenopause influence on BV
(20:20):
in terms of the hormonal aspectof it I know we talked a lot
about hormones last week sopotentially we've covered it
already but just for people thathaven't listened to that past
podcast, can you talk a littlebit again about how the
different hormones that arefluctuating and changing in
perimenopause are influencingthe vaginal microbiome?
Speaker 2 (20:39):
yeah, and vaginal health just generally yeah, yes,
yeah.
So we have this thing calledthe genitourinary syndrome of
menopause.
I can see your eyes.
What a beautiful, I know, whata beautiful name that is.
Yes, gsm, that's much easier tosay.
Um, and it's really where, asour estrogen starts to decline,
(21:04):
the protective effect ofestrogen don't we miss estrogen
once we?
You know, the protective effectof estrogen is impacting our
vaginas in a big way.
So estrogen and you can seeshifts in this across the
menstrual cycle, at younger ages, but certainly in perimenopause
, because those swings ofestrogen become much greater.
(21:29):
As the estrogen declines, thatmain food source, or the support
for one of the main foodsources of the lactobacilli, the
really good bacteria thatprotects our vagina, starts to
decline as well.
So estrogen influences theproduction of glycogen and
(21:49):
glycogen is a really bigcomponent of that mucus membrane
, that mucus layer inside of thevagina which helps to feed and
protect that lactobacilli andkeep the vagina healthy.
So as our estrogen levelsdecline, we get less mucus being
produced, our glycogen levelsdecline and so we see a shift in
the lactobacilli levels andthat leads to a change in the
(22:13):
vaginal pH and that then givesan opportunity for all of these
other bacteria and fungi andthings to start to take over a
little bit.
Yeah.
Speaker 1 (22:25):
Yeah, so you've got the hormonal changes and if, at
the same time, your stresslevels are unchecked and you're
having, you know, all of thetakeaway food and the Uber Eats
and or not eating well, becauseyou're really busy, it's kind of
becoming a bit of a perfectstorm.
Yeah, absolutely.
Conditions popping up in thevaginal area such as BV, the
(22:52):
vaginal area such as BV yeah,it's kind of interesting.
Yeah, so let's talk a littlebit about BV and STIs or
sexually transmitted infections.
Yeah, let's get into that alittle bit.
Speaker 2 (23:00):
Yeah, so one of the challenges is that as that pH
shifts and that protectivelactobacilli kind of starts to
the levels of that start todecline, we start to get an
increase in opportunisticbacteria, like we've talked
(23:23):
about.
But it also leaves the vaginamore vulnerable to STIs herpes,
hpv, you know all of those sortsof things and then STIs can
(23:54):
then as well in and area andallowing these other pathogens
to take hold or these otherbacteria and things to take hold
, but also then that createsmore dysbiosis or imbalance in
the, the microflora, which leadsto there being more opportunity
for more bacteria to flourish.
So, yeah, so it ends up.
It can actually be quite acycle.
(24:16):
Um, yeah, yeah, yeah.
Not pleasant for for anyone atall.
Speaker 1 (24:24):
No, not at all.
Um, okay, not at all, not atall.
Okay.
So we've talked about symptoms,we've talked about the
microbiome and some otherfactors that can influence
vaginal health and BVspecifically.
So what are some of thetreatment strategies that a
naturopath can employ and howmight that vary from what you
(24:49):
might see in the medical model?
Speaker 2 (24:51):
Yeah, so the medical model is really about
antibiotics, and there are somegood reasons why you would use
antibiotics and some situationswhere you would absolutely be
looking at that as your firstline of treatment and can, in
some instances, be veryeffective In bacterial vaginosis
(25:12):
.
They may or may not beeffective it really depends on
the person and certainly, toimprove how effective they are,
there are some other things thatI would be doing alongside of
that for my patients.
From a naturopathic perspective, the first thing we want to do
is soothe the tissue.
(25:32):
So we want to soothe anyirritation, start to build up
the beneficial bacteria so thatwe can regulate their pH,
because that's going to help tocreate an environment that is
harder for that bacteria tothrive in.
Yeah, that's the first thingthat I always do.
I kind of do a bit of athree-step process.
Speaker 1 (25:52):
So the first thing I want to do is soothe everything
calm the farm, as I like to sayyes, I like to say that too, and
then we go in with someantimicrobials and I often will
use pessaries or creams, likevaginal creams that can be
applied.
Speaker 2 (26:12):
Sometimes I'll use that in combination with oral
treatments, sometimes I don't.
It really depends on theseverity and the symptoms.
And then we want to retest.
So we'll go through a process.
It might take a few months.
We'll make sure there are nosymptoms present, or if it's
going on for a little while, we,you know, and the symptoms have
shifted, we will retest, seewhat's going on, what's reducing
(26:35):
, what's not being effective,because there are often a number
of different herbalcombinations, herbal
antimicrobial combinations thatwe can use.
So you know, garlic might workreally well if it's a lower
level, but we might need some umyou know more potent herbs if
it's, you know, if it's higherdoses or, depending on the
combination of species that arethere, will kind of determine
(26:57):
that yeah, and that's takenorally uh, either in a pessary
or it can be taken orally, orsometimes it's both.
Yeah, I do a lot of localtreatments because I find that's
often will get a much fasterresult.
So we can work.
We can definitely work orally.
I've had a few clients whopessary is just a pessary is
(27:17):
basically like a um, a coconutoil capsule like, yeah, like a
tampon that you stick in thereand then it melts and the good
stuff kind of just stays inthere.
I've had a few clients who thatjust wasn't going to be a
suitable option for.
So we did some.
You know, we did some topicalcreams externally and we did a
lot of more oral work, and thatdoes take longer, but it
(27:41):
absolutely can work.
So it really depends on theperson sitting in front of me as
to what combination oftreatments specifically we'll
use.
But that's generally theprocess that I'll go through.
And then what I do find oftenwith the vaginal microbiome is
because of those lovely biofilmsthat we talked about at the
(28:02):
start.
When we start to break down thebiofilms we often see a
different level of bacteriabecause things hide in those
biofilms.
We often see a different levelof bacteria because things hide
in those biofilms, and so Ioften find on a retest it will
look quite different, and sowhich is great, because then we
can see what's.
You know even more about what'sgoing on.
(28:23):
We can adjust our prescriptionand our work accordingly and
keep going till we've goteverything.
But you know, for someone whohas mild symptoms it's often a
very short process.
For someone who's had symptomsfor a lot longer or has more
complex things going on, thenyou know it's going to take us a
little bit longer to get tothat end result.
Speaker 1 (28:45):
Yeah, so one of the key take-homes there, I guess,
just to make it clear for thelistener is sometimes you can be
tested and part of thetreatment breaks down the
biofilm, which allows, on theretest, for the bacteria that
was hiding in the biofilm to beactually then to be captured.
Speaker 2 (29:03):
I guess on the swab.
Speaker 1 (29:04):
So it's not necessarily a bad thing if
you've started treatment and yougo oh man, there's more
bacteria or different bacterianow than there was originally.
That's not a worse outcome.
It's just that we're breakingit down and accessing it so it
can be treated.
Which?
Speaker 2 (29:21):
is a good thing, yeah , and I make sure I talk to my
clients, because the worst thingif I was the patient clients,
because the worst thing I youknow as a if.
I was the patient, that wouldyou know, I'd probably freak out
a bit.
So I always make sure I tellpeople about that because I
think it's really like.
I get really excited becauseI'm like yes we know what we're
doing is working, because we'rebreaking the biofilms.
We're getting to that targetthose target bacteria.
Speaker 1 (29:43):
So yeah, which is awesome.
Yeah, and you mentioned before,like even with conventional
medical therapy, such asantibiotics, there are other
things that you would doalongside that.
Speaker 2 (29:53):
I think you might've been referring more to dietary
and lifestyle changes, but ifyou could clarify, yeah, even
intravaginally, because,particularly where there is like
Gardnerella, for example,gardnerella is one of our main
BV pathogens or bacteria, and itis a great one at producing
biofilms, and so what we can doalongside the antibiotics is
(30:17):
introduce a biofilm breaker tospecifically break down that
biofilm so that the antibioticcan do a much more thorough job
of getting rid of that bacteria.
Speaker 1 (30:28):
Amazing, amazing.
And I guess also you'd beworking with gut health as well
and making sure because we knowthat when we're on antibiotics
it just wreaks havoc with ournormal bacteria and our gut
health as well, as you knowdoing what it needs to do in the
area in this case, the vaginato make the body healthy again.
It's always a bit of a doubleedged sword, isn't it that?
(30:49):
You know, sometimes we reallyabsolutely need to take the
antibiotic, but we know at thesame time, we need to support
our healthy microbiomes thatexist all over our body to make
sure that's not getting brokendown and then potentially
causing other problems, otherproblems.
(31:12):
So, as well as using other ultra, ultra intra solutions
alongside the antibiotics, interms of dietary and lifestyle
changes, what would yougenerally and I know everyone's
different, but generally berecommending for women?
Speaker 2 (31:24):
Yeah, so definitely looking at you know, reducing
processed foods and refinedsugars in the diet.
That's not to mean that youknow they can never have a sweet
treat or anything like that.
It's about moderation andmaking sure the bulk of the diet
is whole foods and, from alifestyle perspective, we want
(31:44):
to check out what's going onwith stress.
We want to look at, you know,are they moving their body?
How's their digestive systemworking?
Are we, you know?
are we eliminating properly,removing those waste products,
all of those sorts of things,you know, because we're not just
a vagina we are a whole personand, uh, you know, and, and I
(32:08):
don't think I've ever hadsomeone come to me and say, no,
the only thing, the only thingthat is wrong with my body is
that I've got this vaginalirritation.
There is always more than onething, so we want to.
It's about realigning the wholebody and really supporting that
whole body wellness, not justlooking at the person and going,
(32:29):
okay, it's the vagina, sothat's all we're going to treat.
Yeah, it's never thatstraightforward.
Speaker 1 (32:35):
Absolutely, absolutely.
And also, like we mentioned inthe last podcast, even with
clothing and clothing choice.
Can you talk to that as well,like with activewear and
underwear and all of that?
Yeah, yes.
Speaker 2 (32:48):
So cotton and bamboo are your best friends and so,
yeah, so certainly looking atmaking sure that you know
wearing cotton and bamboounderwear with BV, particularly
if it's been going on for areally long time and with the
recurrent thrush, particularlyif it's been going on for a
really long time, actuallybuying new underwear every 12
months, line drying thatunderwear, allowing the vagina
(33:11):
to have some breathing space.
So not wearing tight clothingall the time, avoiding synthetic
clothing.
You know commando is great, soif you can avoid wearing
underwear at night, that is gold.
Speaker 1 (33:24):
You mean overnight in bed?
Speaker 2 (33:26):
yes, in bed, yes, yep , yep overnight in bed.
Yes, in bed, yes, yep, yepovernight in bed.
And yeah, natural fibres.
Natural fibres are the bestfriend.
And you know you can get cheapquite you know 100% cotton
underwear at Kmart, so like itdoesn't need to be expensive.
We're not talking aboutexpensive interventions here.
Speaker 1 (33:46):
Exactly and if we can just talk briefly about and I
don't know if there's anyresearch done on this I've heard
a little bit I think on theinternet, I'm not sure where
I've heard it that potentiallythe rise of the thong underwear
potentially could be a bit of aculprit, in that it's kind of
almost a direct route from theanus down to the vagina.
(34:09):
Now I don't know if there's anytruth to this or not, it's just
something that I've heard.
Have you seen anything You'd bemore across the literature on
this?
Even if there is any, I don'teven know if there is.
Speaker 2 (34:19):
Yeah look, I haven't looked specifically, but I think
, if you think from apracticality perspective, a
thong is going inside the buttcheek.
Speaker 1 (34:32):
So it is rubbing in that anal area.
Speaker 2 (34:35):
So there is definitely more potential for
there being somecross-contamination there.
Speaker 1 (34:44):
Might be a nice way to put it.
Speaker 2 (34:46):
Yeah, that's right, that's right.
So, yeah, I mean, part of thatcomes down to cleanliness in
general, but I haven't seenanything specifically.
That's not to say that it's notout there.
It's.
I haven't gone looking for it.
Speaker 1 (35:03):
So I will have to Just popped into my head and I
can't remember where I heardabout this and if it's even a
thing or not yeah, look, I've.
Speaker 2 (35:13):
I've heard it too and I have okay yeah, yeah, and
when I think about it, I thinkyeah, I think, yeah it.
It would make sense for thereto be, particularly in a
sensitive person that's already,you know, got some of those
risk factors going on there yeah, and if I think about I mean
I'm getting a bit graphic herebut you know, got some of those
risk factors going on there.
Speaker 1 (35:32):
Yeah, and if I think about I mean I'm getting a bit
graphic here but you know beingin Queensland, for example,
where it's pretty sweaty insummer, like we know that
bacteria really love a moist,warm environment.
So if we're providing more ofthat rather than underwear
that's not sort of sitting soclose to the skin in those areas
, you would think that it wouldprovide a bit more of that area
(35:54):
that bacteria like to reallythrive in and fungi and all of
the things, yeah, definitely.
Something to think about anyway,particularly if you're getting
recurrent, I guess, infections,it might be something to
consider avoiding the thongunderwear for a little bit and
see if that makes a difference.
Speaker 2 (36:11):
yeah, yeah, I think it's particularly where there's
any recurrent issues.
You definitely want toeliminate anything as an issue
that you possibly could, so,yeah, I'd be avoiding the thong
underwear.
Yeah, um, as much as you can.
Yeah.
Speaker 1 (36:27):
Awesome.
So I guess some of thetake-homes, and in particular, I
guess one that I wanted to kindof reinforce, was that the
natural approach to this andnatural medicine approach to
these sorts of infections canwork beautifully alongside the
medical approach and in factenhance the effectiveness of the
(36:48):
medical or pharmacy kind oftreatments, if we're talking
about thrush.
So I guess my message would be,you know, to a listener like
don't hesitate, it's not likeone or the other.
I think you'll get a much betterresponse from your body if
you're utilizing all of thenatural health methods,
particularly, you know, lookingfor a naturopath that has done
(37:11):
vagiversity, or you know Alisondoes work online as well as in
person, so she is available.
But, yeah, getting sort of thetwo pronged approach is going to
definitely get you a betterresult and particularly if you
are having recurrences approachis going to definitely get you a
better result, and particularlyif you are having recurrences,
I'm sure you know, nobody reallywants to have this going on for
(37:32):
longer periods of time thanabsolutely necessary.
So having some, having twopractitioners both your natural
health practitioner and yourmedical practitioner working to
get you well again, I think is agreat thing.
Speaker 2 (37:46):
Oh, absolutely, yep, Absolutely, 100% agree with that
yeah.
Speaker 1 (37:50):
Awesome.
Well, alison, it's just beensuch a pleasure again having you
on the podcast.
We've covered a lot today.
If you could just outline forthe listeners how they can find
you and follow you and learnmore about what you do, that
would be awesome.
Speaker 2 (38:07):
Fantastic.
Yes, I'm more than happy to dothat.
So I am at the VagHormoneNaturopath on Instagram and
Facebook and there's dots inbetween that and the
VagHormoneNaturopathcomau on theinternet.
So yeah, so you can find me atany of those places and my email
(38:30):
is hello at the vag hormonenaturopathcomau.
Speaker 1 (38:34):
Awesome.
Well, that was such a greatepisode, alison.
I really enjoyed discussingthis topic.
As I said before, I don't thinkthis part of a woman's health
is discussed enough, so I'm sohappy to get someone like
yourself that has had all ofthis additional training to
actually shine a light andprovide some really good clarity
on the differences between BVand thrush and some of the
(38:56):
things that can be done toreally help women with this.
So thank you so much for yourtime.
I really appreciate it.
Speaker 2 (39:02):
Oh, thank you so much for having me.
Speaker 1 (39:05):
Thanks so much for joining me today on the Ageless
and Awesome podcast.
If you liked today's episode, Iwould love it if you could
write me a five-star review.
It makes me so happy.
Also, make sure you click thelittle plus button if you're on
Apple Podcasts, or the followbutton if you're on Spotify, so
that you can get each newepisode delivered to you every
(39:26):
week.
If you like free stuff, thenhead to the show notes and click
the link to receive my freeRadiant Reset Hormone Detox
Guide for perimenopausal women.
Now, this will only beavailable until the end of
January 2025.
So be quick.
If you'd like to continue thediscussion we've had today, head
over to Instagram and DM me, orfollow me at the perimenopause
(39:50):
path.
There's a little dot betweeneach word just to make it a
little bit more complicated, butI would love to connect with
you over there.
Hi, I'm Susie Garden and this is the Ageless and
Awesome podcast.
I'm an age-defying naturopathand clinical nutritionist and
I'm here to bust myths aroundwomen's health and aging so that
you can be ageless and awesomein your 40s, 50s and beyond.
The Ageless and Awesome podcastis dedicated to helping women
(00:24):
through perimenopause andmenopause with great health, a
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Hit, subscribe or follow nowand let's get started.
Hello, gorgeous one, andwelcome to this week's episode
of the Ageless and Awesomepodcast.
I'm excited to have AlisonPatchett back on the pod with
(00:48):
part two, I guess talking allthings vaginal health.
Alison is the Vag HormoneNaturopath.
She's dedicated to empoweringher clients, not only managing
symptoms, but to identify andaddress the underlying cause of
those symptoms, Providing expert, integrative support for women,
online or in person.
(01:09):
She's based in Bandura inVictoria.
Alison addresses everythingfrom hormone imbalances to
intimate healthcare.
Her approach is tailored to herclients' needs.
She combines advanced testing,natural therapies and lifestyle
adjustments so you can reclaimyour health and get back your
sparkle.
(01:29):
Alison, welcome back to thepodcast.
Speaker 2 (01:32):
Thank you for having me.
Speaker 1 (01:34):
My absolute pleasure.
Last podcast we did, which wasa couple of weeks ago, it was so
popular and I just thought Imean, we talked about having you
back last time, but I thinkit's just so good to talk about
the vagina and its health andreclaim that word as well.
Yes, absolutely.
Because we just don't hearenough people talking about it.
(01:55):
So I'm going to start by askingyou, alison, how you got to
this place, where you have thisspecial interest in vaginal
health and the kind of trainingthat you've done.
Speaker 2 (02:07):
Sure, yeah.
So I guess I kind of havemeandered my way through to
vaginal health and via a numberof different areas, so starting,
I guess, looking at thyroidhealth, moving into more broadly
hormone health, and I think, asI've personally moved into
perimenopause, a lot of myclients start to move into
(02:30):
perimenopause and sort of seeingthose hormonal shifts.
That kind of has led me downthis path of looking at vaginal
health as well, because theinterplay there is so important
to understand, and last year Idid a six-month course called
Vagiversity, which was just anamazing in-depth look at what's
(02:55):
going on in the vagina differentpresentations, the vaginal
microbiome and I guess thatreally kind of opened my eyes to
the possibilities and reallythe all of the different things
(03:17):
that can happen in that area, Ithink, which we don't appreciate
on a broader scale as much.
It's kind of a bit hidden fromview in a lot of ways.
There's definitely, you know,an area that we need always need
more research into women'shealth, don't we?
But it particularly withvaginal health, and so it's
become a real passion area ofmine to make sure that every
woman feels really special andamazing, including with their
(03:39):
vaginal health.
Speaker 1 (03:41):
Yeah, that is awesome , alison, and it's such a needed
service as well, because it isa highly specialized area and
you know, vagiversity I'm veryfamiliar with.
I definitely want to do thatcourse at some stage, but it's
definitely something that Ithink needs more attention.
(04:02):
So, following on from the lastepisode that we did together,
alison is, we wanted to talktoday about bacterial vaginosis,
also known as BV, and it is abig topic.
We kind of ran out of time atthe last podcast because there
were so many things to talkabout, and it is something that
(04:22):
I'm hearing a lot of my friendstalking about it, which that's
fairly new for me, to be honest,to hear women actually talking
about it and there seems to be alot of women that have it.
Speaker 2 (04:45):
So letuced situation.
I guess that goes on in thevagina, so there's a few.
It's where there is a shift inthe flora, in the vaginal
microflora.
Sorry.
Yes, no, you're right Getting mytongue tied there and what
(05:06):
happens is that when that shiftoccurs, some particular species
start bacterial species start totake up residence.
So we start to see things likeGardnerella and Prevotella,
Adipobium, Streptococcus, anumber of different species, and
it's the combination of thespecies and when they get to a
(05:29):
certain level that we start toidentify that as being bacterial
vaginosis positive.
Yeah, and it can be a realchallenge because these species
do tend to kind of clustertogether and create what's
called a biofilm, which can makethem a little bit more tricky
(05:51):
to treat.
But it is super important toget it diagnosed and treated
properly because it can havesome quite significant long-term
health implications as well.
Speaker 1 (06:04):
Yes, and that biofilm .
They're kind of protected,aren't they within that biofilm?
You've got to break down thebiofilm in order to get to them,
to actually treat them.
Yes, that's right?
Speaker 2 (06:17):
Yes, so it can be a bit of a few steps involved in
doing that.
Speaker 1 (06:20):
Yeah, yeah, and so obviously we can test for those
microorganisms.
So can you talk a little bitabout how that testing happens?
Speaker 2 (06:30):
Yeah, so with a vaginal microbiome test, what
we're doing is we're taking aswab of the inside of the vagina
and the client does that.
The client, yes, yes,absolutely.
So the great thing with thetest kits that we use, you can
some clients will go to their GPand their GP will do the swab
(06:52):
for them.
But certainly for a majority ofmy clients, we're organising,
I'm organising a test kit to besent to them.
They do it in the privacy oftheir own home.
Ideally when they're mostsymptomatic and I think that's
an important thing to note issometimes with these conditions
that symptoms ebb and flow, andwhen their symptoms are at their
(07:14):
kind of peak is when it is thebest time to test, because
that's going to tell us a lotmore about what's going on as
well.
So it's a really simple test todo.
I have done it myself as a, youknow, to check out and see how
it all works, because I like todo that to know what I'm telling
my clients.
And, yeah, the instructions arereally clear.
(07:37):
You do it in the privacy ofyour own home, send it back off
to the pathology lab and we geta report back which is quite
detailed in telling us what'sactually going on there.
Speaker 1 (07:47):
Yeah, and it's just a swab, isn't it?
It's just inserting a swab,yeah.
Speaker 2 (07:51):
It's like a big Q-tip and you just insert it a few
centimetres into the vagina,kind of wipe off the vagina wall
and then pop it in its littlecase and send it off.
Speaker 1 (08:00):
Yeah, lovely yeah.
And so what are the symptomsthat women tend to describe when
they're in that sort of a highsymptom picture of BV.
Speaker 2 (08:12):
Yeah, the symptoms can vary a little bit, but there
certainly is a common clusterof symptoms.
So the first thing that I oftenhear about is a strong odour or
a discharge with a strong odour.
So the discharge is generallylight grey.
It can be white, but it's theodour that makes it different to
(08:32):
, as well as the colour.
The odour that makes itdifferent to the regular white
or clear discharge that youwould get through fertile.
What you would expect to seewith fertile mucus.
So the fertile mucus is notgoing to have any particular
odour, whereas the bacterialvaginosis, the BV discharge,
absolutely has an odour.
(08:52):
It might be a mild odour or itmight be quite strong, depends
on the person.
There's often burning orirritation around the vagina and
vulva and I think this is whereit often gets confused with
thrush.
Is the colour of the dischargeplus the irritation, and that's
where we can start to see someconfusion coming in.
(09:13):
There can be burning duringurination.
There's generally a vaginal pHthat's quite alkaline and you
know we need to make sure thatyou know someone might
experience one of those symptoms, or they might experience all
of them, or you know somethingin between.
So it's really about you know,taking notice of what's going on
(09:36):
down there and noticing anychanges that are occurring and
then getting tested so that weknow exactly what's going on.
Speaker 1 (09:43):
Yeah, and this is the thing is knowing what is your
normal and what is then abnormal, and not ignoring those changes
, because I think a lot of womenjust go oh gosh, I just hope
this will go away, so then Idon't have to deal with it.
Or they think nothing can bedone if they've had an
experience with a healthcareprovider where they haven't
really had a good outcome orthey feel dismissed.
(10:06):
I feel like that can be part ofthe problem as well.
Yeah, yeah.
Speaker 2 (10:11):
Yeah, yeah, I agree completely, and I actually had a
client not all that long agowho just said you know, I always
check in with my clients ontheir vaginal health, always,
always.
Whether they're seeing me forsomething else or not, that's
always something we check in on.
And they said, oh, you know,they were just getting a bit of
irritation, Wasn't really much.
If it was going to get worse,they were just going to get an
(10:32):
over-the-counter thrashtreatment.
And the more we talked about itI said, you know, we got to the
point where we said, yeah, Ithink we just need to test and
see what's going on.
And I'm so glad we did, becausethere was no candida present,
absolutely none.
It definitely was not thrush.
But what we are starting to seeis a shift in the vaginal pH,
(10:53):
the irritation, and we'restarting to see one or two of
these species that can lead toBV coming up.
So it's great we can nip thatin the bud with some really
early intervention.
Speaker 1 (11:03):
Yeah, and there's a few things I want to dive into
there.
So firstly, is thrush beingcandida?
Can you just explain whatthrush is, how it happens and
that difference?
I think you probably havecovered it there a little bit,
just a little more, yeah.
Speaker 2 (11:20):
Yeah, so it's about the pathogen that's present.
Speaker 1 (11:24):
So the microorganism that causes disease.
Speaker 2 (11:28):
Yes, that's exactly right, Sorry, yes, yeah, so
there are differentmicroorganisms that are found
naturally on the skin and thereare others that are introduced.
So everyone has a level ofcandida on their skin.
But when we are healthy and ourimmune system's working
properly in the vagina, when ourph is in its optimal level,
(11:51):
we've got good levels oflactobacilli, which are the
really healthy keeps our vaginahealthy then you know
everything's kept under control.
When one of those things startsto break down, then that's when
you know whether it's bacteriaor candida which causes thrush.
It's actually a fungus.
(12:12):
When either of those two thingsstart to get overgrown, that's
when we start to get symptomsoccurring.
So the difference is what isallowed to grow, and that really
depends on the immune system,on overall health, on dietary
factors, on lifestyle factors.
There's a whole range of thingsthat come into play there and
(12:32):
the challenge is, because thereis that similar symptom or that
symptom crossover, that we can'tjust assume what's going on.
So, yeah, so with thrush youwill get the burning and
irritation.
You can get the discharge.
It's often more cottagecheese-like.
So it is quite a slightlydifferent type of discharge With
(12:54):
the thrush Can smell a littlebit with the thrush, whereas
with the BV you've got a moredistinct smell.
You've still got the burningand irritation, but the
discharge is slightly different.
But if there's no discharge ineither case, you really don't
know what's going on.
Speaker 1 (13:10):
Yeah, yeah.
And the other thing I wanted toask about, like we talked about
, you know, going to pharmacyand getting an over-the-counter
treatment how many people do youthink women do you think go in
and ask for that from thepharmacy and then they just get
given that without too muchfurther investigation.
I can't imagine there are toomany pharmacists or pharmacy
assistants that are going intodetail to see if it's not thrush
(13:33):
, if they just assume that it'sgoing to be thrush.
Do you feel like that'sprobably happening and do you
find that many of your clientshave already been through that?
Speaker 2 (13:40):
thrush treatment when it's actually not thrush.
Yeah, yeah, I've definitely hadclients who have said to me,
you know their thrush treatmentwhen it's actually not thrush.
Yeah, yeah, I've definitely hadclients who have said to me,
you know, their thrush justkeeps coming back and I'm like,
does it, or was it not thrush inthe first place?
And yeah, I mean, I think some,some pharmacists are amazing
and they will kind of go into alittle bit more detail.
I think the challenge is in apharmacy environment where
(14:02):
there's potentially yes, it'skind of.
It's not necessarily anenvironment where there's
potentially other people around.
It's kind of it's notnecessarily an environment where
people want to disclose toomuch.
So I mean that all adds, youknow it's into the compounding
kind of effect of I'll just grabthis because it's going to be
quick and easy and be on my way,rather than actually getting
(14:22):
into the detailed nitty grittiesof getting a thorough diagnosis
.
Speaker 1 (14:28):
Yeah, okay.
So you also mentioned aboutsome different influences on the
health of the microbiome.
I guess the vagina microbiomeCan we talk a little bit more
about.
I know we talked quite a lotabout the vagina microbiome in
the last podcast, but let's talka bit more about what
(14:49):
influences it, because youtouched on a few things there,
like diet, lifestyle et cetera.
So can you tell us a little bitmore about that?
Speaker 2 (14:56):
Sure, yeah.
So there's definitely a fewthings.
So things like stress andsmoking will make a big
difference.
Smoking, smoking yes, I knowwho would have thought.
I know Antibiotics as well.
Funnily enough, you know, allof those things may play a role
in shifting the microbiome in anegative way because of
(15:20):
inflammation and, yeah,oxidation and all those sorts of
things.
Inflammation and, yeah,oxidation and all those sorts of
things.
Hygiene practices is somethingthat we, I think, goes.
I think people kind of thinkabout hygiene practices washing
hands after you go to the toilet, but actually the way you wipe,
making sure you're wiping frontto back, so away from, because
(15:43):
those, you know, the anus andthe vagina opening and the
urethra are very closelysituated.
That wiping process is reallyimportant.
But even thinking about thehygiene practices around,
anything that's inserted intothe vagina as well, so whether
that's, or even on the vulva onthe outside part.
So the vulva is the outsidepart, the vagina is the inside
(16:05):
part.
So even things that are kind ofrubbing on the vulva as well.
So whether that's menstrualproducts or masturbation
products or sexual partners, oryou know your own hands making
sure that they're, you know that, you know how many of those and
how often, and for other people, their microbiomes will all
(16:27):
influence what's going on in thevagina as well.
And dietary factors.
So things like high sugar diets, processed foods, low nutrient
status, particularly things andthis is what I found really
interesting is low iron and lowvitamins A, c and E in
particular, will negativelyinfluence the vaginal microbiome
(16:50):
.
And it's all to do with thatimmune function and the tissue
integrity.
So the integrity, how healthythe actual vaginal tissue is as
well.
And then, of course, there'shormones.
Who can forget our beautifulhormones and their influence as
well?
And then, of course, there'shormones who can forget our
beautiful hormones and theirinfluence as well.
Speaker 1 (17:09):
Yes, my gosh, and you think about our poor old peri
ladies.
A lot of them are irondeficient as well because of the
impact of the hormonefluctuations on periods and the
heaviness of flow.
So you can see that, you know,there's possibly a higher need
for education around BV inpeople that are in that sort of
(17:30):
35 plus age group, you know,assuming that you know we're
going to have some women intheir late 30s that are in
perimenopause.
So since we're there, let's talkabout how perimenopause
influences BV.
We've touched on a couple ofthings.
Speaker 2 (17:46):
Yeah.
Speaker 1 (17:47):
Yeah, let's talk a little bit more about that.
Do we know from any researchwhether there's a higher
prevalence of BV in women inperimenopause.
Speaker 2 (17:57):
From the research that I've found to date not
statistically significant.
Are they actually looking forit?
Yes that's what I was going tosay is that I think where there
is a difference and where peopleare starting to talk about it
is like a number of things inwomen's health.
(18:19):
People are more aware of it.
I think there's a growingawareness and so where people
just put up with symptoms beforethere's this slow evolution of
people actually getting testedand getting a diagnosis and no
longer the thing I really loveabout perimenopausal women is
they don't put up with stuffLike that's kind of In this
(18:41):
generation.
Speaker 1 (18:42):
In this generation.
Speaker 2 (18:43):
Yes, I think there's a real evolution in this
generation of perimenopausalwomen going I'm done, yeah, no,
nope, not today.
Speaker 1 (18:52):
I'm just not going to put up with this anymore.
Speaker 2 (18:55):
So I was going to swear then, but I pulled myself
back.
But you know, and I think youknow, you do get to a stage in
your life and I'm seeing it moreand more in my patients where
they're kind of like I've donethis, I've done this for so long
, I just cannot continue.
And so I think that is probablywhere we're seeing the shift.
(19:17):
More than it being an increasein prevalence in the community,
I think it's an increase inawareness amongst different
groups of women.
Speaker 1 (19:27):
Yeah.
Speaker 2 (19:28):
Yeah, which is really good.
Oh, it's amazing.
I love it.
I love it.
I think it's so.
If we can't advocate forourselves in this time of life,
when can we?
You know?
I think it's.
There has to be a point in timewhere we can start to do that,
and the more people do it, themore you know groundswell that
creates for women to advocatefor themselves in all areas of
(19:52):
their lives.
So yeah, for sure.
Speaker 1 (19:53):
Yeah, and that's why you know speaking about on
podcasts.
You know looking to influencersthat are in our age group, that
are going through this and thatare openly talking about it is
so valuable for all of us thatare going through it.
So, yeah, that is awesome.
So when we talk about hormoneor perimenopause influence on BV
(20:20):
in terms of the hormonal aspectof it I know we talked a lot
about hormones last week sopotentially we've covered it
already but just for people thathaven't listened to that past
podcast, can you talk a littlebit again about how the
different hormones that arefluctuating and changing in
perimenopause are influencingthe vaginal microbiome?
Speaker 2 (20:39):
yeah, and vaginal health just generally yeah, yes,
yeah.
So we have this thing calledthe genitourinary syndrome of
menopause.
I can see your eyes.
What a beautiful, I know, whata beautiful name that is.
Yes, gsm, that's much easier tosay.
Um, and it's really where, asour estrogen starts to decline,
(21:04):
the protective effect ofestrogen don't we miss estrogen
once we?
You know, the protective effectof estrogen is impacting our
vaginas in a big way.
So estrogen and you can seeshifts in this across the
menstrual cycle, at younger ages, but certainly in perimenopause
, because those swings ofestrogen become much greater.
(21:29):
As the estrogen declines, thatmain food source, or the support
for one of the main foodsources of the lactobacilli, the
really good bacteria thatprotects our vagina, starts to
decline as well.
So estrogen influences theproduction of glycogen and
(21:49):
glycogen is a really bigcomponent of that mucus membrane
, that mucus layer inside of thevagina which helps to feed and
protect that lactobacilli andkeep the vagina healthy.
So as our estrogen levelsdecline, we get less mucus being
produced, our glycogen levelsdecline and so we see a shift in
the lactobacilli levels andthat leads to a change in the
(22:13):
vaginal pH and that then givesan opportunity for all of these
other bacteria and fungi andthings to start to take over a
little bit.
Yeah.
Speaker 1 (22:25):
Yeah, so you've got the hormonal changes and if, at
the same time, your stresslevels are unchecked and you're
having, you know, all of thetakeaway food and the Uber Eats
and or not eating well, becauseyou're really busy, it's kind of
becoming a bit of a perfectstorm.
Yeah, absolutely.
Conditions popping up in thevaginal area such as BV, the
(22:52):
vaginal area such as BV yeah,it's kind of interesting.
Yeah, so let's talk a littlebit about BV and STIs or
sexually transmitted infections.
Yeah, let's get into that alittle bit.
Speaker 2 (23:00):
Yeah, so one of the challenges is that as that pH
shifts and that protectivelactobacilli kind of starts to
the levels of that start todecline, we start to get an
increase in opportunisticbacteria, like we've talked
(23:23):
about.
But it also leaves the vaginamore vulnerable to STIs herpes,
hpv, you know all of those sortsof things and then STIs can
(23:54):
then as well in and area andallowing these other pathogens
to take hold or these otherbacteria and things to take hold
, but also then that createsmore dysbiosis or imbalance in
the, the microflora, which leadsto there being more opportunity
for more bacteria to flourish.
So, yeah, so it ends up.
It can actually be quite acycle.
(24:16):
Um, yeah, yeah, yeah.
Not pleasant for for anyone atall.
Speaker 1 (24:24):
No, not at all.
Um, okay, not at all, not atall.
Okay.
So we've talked about symptoms,we've talked about the
microbiome and some otherfactors that can influence
vaginal health and BVspecifically.
So what are some of thetreatment strategies that a
naturopath can employ and howmight that vary from what you
(24:49):
might see in the medical model?
Speaker 2 (24:51):
Yeah, so the medical model is really about
antibiotics, and there are somegood reasons why you would use
antibiotics and some situationswhere you would absolutely be
looking at that as your firstline of treatment and can, in
some instances, be veryeffective In bacterial vaginosis
(25:12):
.
They may or may not beeffective it really depends on
the person and certainly, toimprove how effective they are,
there are some other things thatI would be doing alongside of
that for my patients.
From a naturopathic perspective, the first thing we want to do
is soothe the tissue.
(25:32):
So we want to soothe anyirritation, start to build up
the beneficial bacteria so thatwe can regulate their pH,
because that's going to help tocreate an environment that is
harder for that bacteria tothrive in.
Yeah, that's the first thingthat I always do.
I kind of do a bit of athree-step process.
Speaker 1 (25:52):
So the first thing I want to do is soothe everything
calm the farm, as I like to sayyes, I like to say that too, and
then we go in with someantimicrobials and I often will
use pessaries or creams, likevaginal creams that can be
applied.
Speaker 2 (26:12):
Sometimes I'll use that in combination with oral
treatments, sometimes I don't.
It really depends on theseverity and the symptoms.
And then we want to retest.
So we'll go through a process.
It might take a few months.
We'll make sure there are nosymptoms present, or if it's
going on for a little while, we,you know, and the symptoms have
shifted, we will retest, seewhat's going on, what's reducing
(26:35):
, what's not being effective,because there are often a number
of different herbalcombinations, herbal
antimicrobial combinations thatwe can use.
So you know, garlic might workreally well if it's a lower
level, but we might need some umyou know more potent herbs if
it's, you know, if it's higherdoses or, depending on the
combination of species that arethere, will kind of determine
(26:57):
that yeah, and that's takenorally uh, either in a pessary
or it can be taken orally, orsometimes it's both.
Yeah, I do a lot of localtreatments because I find that's
often will get a much fasterresult.
So we can work.
We can definitely work orally.
I've had a few clients whopessary is just a pessary is
(27:17):
basically like a um, a coconutoil capsule like, yeah, like a
tampon that you stick in thereand then it melts and the good
stuff kind of just stays inthere.
I've had a few clients who thatjust wasn't going to be a
suitable option for.
So we did some.
You know, we did some topicalcreams externally and we did a
lot of more oral work, and thatdoes take longer, but it
(27:41):
absolutely can work.
So it really depends on theperson sitting in front of me as
to what combination oftreatments specifically we'll
use.
But that's generally theprocess that I'll go through.
And then what I do find oftenwith the vaginal microbiome is
because of those lovely biofilmsthat we talked about at the
(28:02):
start.
When we start to break down thebiofilms we often see a
different level of bacteriabecause things hide in those
biofilms.
We often see a different levelof bacteria because things hide
in those biofilms, and so Ioften find on a retest it will
look quite different, and sowhich is great, because then we
can see what's.
You know even more about what'sgoing on.
(28:23):
We can adjust our prescriptionand our work accordingly and
keep going till we've goteverything.
But you know, for someone whohas mild symptoms it's often a
very short process.
For someone who's had symptomsfor a lot longer or has more
complex things going on, thenyou know it's going to take us a
little bit longer to get tothat end result.
Speaker 1 (28:45):
Yeah, so one of the key take-homes there, I guess,
just to make it clear for thelistener is sometimes you can be
tested and part of thetreatment breaks down the
biofilm, which allows, on theretest, for the bacteria that
was hiding in the biofilm to beactually then to be captured.
Speaker 2 (29:03):
I guess on the swab.
Speaker 1 (29:04):
So it's not necessarily a bad thing if
you've started treatment and yougo oh man, there's more
bacteria or different bacterianow than there was originally.
That's not a worse outcome.
It's just that we're breakingit down and accessing it so it
can be treated.
Which?
Speaker 2 (29:21):
is a good thing, yeah , and I make sure I talk to my
clients, because the worst thingif I was the patient clients,
because the worst thing I youknow as a if.
I was the patient, that wouldyou know, I'd probably freak out
a bit.
So I always make sure I tellpeople about that because I
think it's really like.
I get really excited becauseI'm like yes we know what we're
doing is working, because we'rebreaking the biofilms.
We're getting to that targetthose target bacteria.
Speaker 1 (29:43):
So yeah, which is awesome.
Yeah, and you mentioned before,like even with conventional
medical therapy, such asantibiotics, there are other
things that you would doalongside that.
Speaker 2 (29:53):
I think you might've been referring more to dietary
and lifestyle changes, but ifyou could clarify, yeah, even
intravaginally, because,particularly where there is like
Gardnerella, for example,gardnerella is one of our main
BV pathogens or bacteria, and itis a great one at producing
biofilms, and so what we can doalongside the antibiotics is
(30:17):
introduce a biofilm breaker tospecifically break down that
biofilm so that the antibioticcan do a much more thorough job
of getting rid of that bacteria.
Speaker 1 (30:28):
Amazing, amazing.
And I guess also you'd beworking with gut health as well
and making sure because we knowthat when we're on antibiotics
it just wreaks havoc with ournormal bacteria and our gut
health as well, as you knowdoing what it needs to do in the
area in this case, the vaginato make the body healthy again.
It's always a bit of a doubleedged sword, isn't it that?
(30:49):
You know, sometimes we reallyabsolutely need to take the
antibiotic, but we know at thesame time, we need to support
our healthy microbiomes thatexist all over our body to make
sure that's not getting brokendown and then potentially
causing other problems, otherproblems.
(31:12):
So, as well as using other ultra, ultra intra solutions
alongside the antibiotics, interms of dietary and lifestyle
changes, what would yougenerally and I know everyone's
different, but generally berecommending for women?
Speaker 2 (31:24):
Yeah, so definitely looking at you know, reducing
processed foods and refinedsugars in the diet.
That's not to mean that youknow they can never have a sweet
treat or anything like that.
It's about moderation andmaking sure the bulk of the diet
is whole foods and, from alifestyle perspective, we want
(31:44):
to check out what's going onwith stress.
We want to look at, you know,are they moving their body?
How's their digestive systemworking?
Are we, you know?
are we eliminating properly,removing those waste products,
all of those sorts of things,you know, because we're not just
a vagina we are a whole personand, uh, you know, and, and I
(32:08):
don't think I've ever hadsomeone come to me and say, no,
the only thing, the only thingthat is wrong with my body is
that I've got this vaginalirritation.
There is always more than onething, so we want to.
It's about realigning the wholebody and really supporting that
whole body wellness, not justlooking at the person and going,
(32:29):
okay, it's the vagina, sothat's all we're going to treat.
Yeah, it's never thatstraightforward.
Speaker 1 (32:35):
Absolutely, absolutely.
And also, like we mentioned inthe last podcast, even with
clothing and clothing choice.
Can you talk to that as well,like with activewear and
underwear and all of that?
Yeah, yes.
Speaker 2 (32:48):
So cotton and bamboo are your best friends and so,
yeah, so certainly looking atmaking sure that you know
wearing cotton and bamboounderwear with BV, particularly
if it's been going on for areally long time and with the
recurrent thrush, particularlyif it's been going on for a
really long time, actuallybuying new underwear every 12
months, line drying thatunderwear, allowing the vagina
(33:11):
to have some breathing space.
So not wearing tight clothingall the time, avoiding synthetic
clothing.
You know commando is great, soif you can avoid wearing
underwear at night, that is gold.
Speaker 1 (33:24):
You mean overnight in bed?
Speaker 2 (33:26):
yes, in bed, yes, yep , yep overnight in bed.
Yes, in bed, yes, yep, yepovernight in bed.
And yeah, natural fibres.
Natural fibres are the bestfriend.
And you know you can get cheapquite you know 100% cotton
underwear at Kmart, so like itdoesn't need to be expensive.
We're not talking aboutexpensive interventions here.
Speaker 1 (33:46):
Exactly and if we can just talk briefly about and I
don't know if there's anyresearch done on this I've heard
a little bit I think on theinternet, I'm not sure where
I've heard it that potentiallythe rise of the thong underwear
potentially could be a bit of aculprit, in that it's kind of
almost a direct route from theanus down to the vagina.
(34:09):
Now I don't know if there's anytruth to this or not, it's just
something that I've heard.
Have you seen anything You'd bemore across the literature on
this?
Even if there is any, I don'teven know if there is.
Speaker 2 (34:19):
Yeah look, I haven't looked specifically, but I think
, if you think from apracticality perspective, a
thong is going inside the buttcheek.
Speaker 1 (34:32):
So it is rubbing in that anal area.
Speaker 2 (34:35):
So there is definitely more potential for
there being somecross-contamination there.
Speaker 1 (34:44):
Might be a nice way to put it.
Speaker 2 (34:46):
Yeah, that's right, that's right.
So, yeah, I mean, part of thatcomes down to cleanliness in
general, but I haven't seenanything specifically.
That's not to say that it's notout there.
It's.
I haven't gone looking for it.
Speaker 1 (35:03):
So I will have to Just popped into my head and I
can't remember where I heardabout this and if it's even a
thing or not yeah, look, I've.
Speaker 2 (35:13):
I've heard it too and I have okay yeah, yeah, and
when I think about it, I thinkyeah, I think, yeah it.
It would make sense for thereto be, particularly in a
sensitive person that's already,you know, got some of those
risk factors going on there yeah, and if I think about I mean
I'm getting a bit graphic herebut you know, got some of those
risk factors going on there.
Speaker 1 (35:32):
Yeah, and if I think about I mean I'm getting a bit
graphic here but you know beingin Queensland, for example,
where it's pretty sweaty insummer, like we know that
bacteria really love a moist,warm environment.
So if we're providing more ofthat rather than underwear
that's not sort of sitting soclose to the skin in those areas
, you would think that it wouldprovide a bit more of that area
(35:54):
that bacteria like to reallythrive in and fungi and all of
the things, yeah, definitely.
Something to think about anyway,particularly if you're getting
recurrent, I guess, infections,it might be something to
consider avoiding the thongunderwear for a little bit and
see if that makes a difference.
Speaker 2 (36:11):
yeah, yeah, I think it's particularly where there's
any recurrent issues.
You definitely want toeliminate anything as an issue
that you possibly could, so,yeah, I'd be avoiding the thong
underwear.
Yeah, um, as much as you can.
Yeah.
Speaker 1 (36:27):
Awesome.
So I guess some of thetake-homes, and in particular, I
guess one that I wanted to kindof reinforce, was that the
natural approach to this andnatural medicine approach to
these sorts of infections canwork beautifully alongside the
medical approach and in factenhance the effectiveness of the
(36:48):
medical or pharmacy kind oftreatments, if we're talking
about thrush.
So I guess my message would be,you know, to a listener like
don't hesitate, it's not likeone or the other.
I think you'll get a much betterresponse from your body if
you're utilizing all of thenatural health methods,
particularly, you know, lookingfor a naturopath that has done
(37:11):
vagiversity, or you know Alisondoes work online as well as in
person, so she is available.
But, yeah, getting sort of thetwo pronged approach is going to
definitely get you a betterresult and particularly if you
are having recurrences approachis going to definitely get you a
better result, and particularlyif you are having recurrences,
I'm sure you know, nobody reallywants to have this going on for
(37:32):
longer periods of time thanabsolutely necessary.
So having some, having twopractitioners both your natural
health practitioner and yourmedical practitioner working to
get you well again, I think is agreat thing.
Speaker 2 (37:46):
Oh, absolutely, yep, Absolutely, 100% agree with that
yeah.
Speaker 1 (37:50):
Awesome.
Well, alison, it's just beensuch a pleasure again having you
on the podcast.
We've covered a lot today.
If you could just outline forthe listeners how they can find
you and follow you and learnmore about what you do, that
would be awesome.
Speaker 2 (38:07):
Fantastic.
Yes, I'm more than happy to dothat.
So I am at the VagHormoneNaturopath on Instagram and
Facebook and there's dots inbetween that and the
VagHormoneNaturopathcomau on theinternet.
So yeah, so you can find me atany of those places and my email
(38:30):
is hello at the vag hormonenaturopathcomau.
Speaker 1 (38:34):
Awesome.
Well, that was such a greatepisode, alison.
I really enjoyed discussingthis topic.
As I said before, I don't thinkthis part of a woman's health
is discussed enough, so I'm sohappy to get someone like
yourself that has had all ofthis additional training to
actually shine a light andprovide some really good clarity
on the differences between BVand thrush and some of the
(38:56):
things that can be done toreally help women with this.
So thank you so much for yourtime.
I really appreciate it.
Speaker 2 (39:02):
Oh, thank you so much for having me.
Speaker 1 (39:05):
Thanks so much for joining me today on the Ageless
and Awesome podcast.
If you liked today's episode, Iwould love it if you could
write me a five-star review.
It makes me so happy.
Also, make sure you click thelittle plus button if you're on
Apple Podcasts, or the followbutton if you're on Spotify, so
that you can get each newepisode delivered to you every
(39:26):
week.
If you like free stuff, thenhead to the show notes and click
the link to receive my freeRadiant Reset Hormone Detox
Guide for perimenopausal women.
Now, this will only beavailable until the end of
January 2025.
So be quick.
If you'd like to continue thediscussion we've had today, head
over to Instagram and DM me, orfollow me at the perimenopause
(39:50):
path.
There's a little dot betweeneach word just to make it a
little bit more complicated, butI would love to connect with
you over there.
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