Understanding the Vaginal Microbiome: An Acupuncturist’s Perspective
At The Pelvic Acu, our mission is to empower acupuncturists to successfully and sustainably support clients with pelvic health conditions. Sustainable care means more than short-term relief—it means helping clients experience long-lasting improvements in their pelvic health across every season of life.
One important piece of that work is understanding the vaginal microbiome—a complex and dynamic ecosystem that plays a key role in reproductive, urinary, and overall pelvic health.
Why the Vaginal Microbiome Matters
The vaginal microbiome is an intricate micro-ecosystem that changes throughout the menstrual cycle and across a woman’s lifespan. A healthy vaginal microbiome is typically dominated by lactobacillus, which helps maintain an acidic environment and produces antimicrobial compounds to protect against infections.
Unfortunately, imbalances in this ecosystem are common:
50–60% of women experience a UTI in their lifetime.
30% of women in the U.S. experience bacterial vaginosis (up to 50% in other countries).
75% of women will have at least one yeast infection, and nearly half will have two or more.
These statistics remind us how essential it is for practitioners to recognize signs of imbalance and support clients in restoring harmony.
The Role of pH in Pelvic Health
The vaginal environment is naturally slightly acidic, with a normal pH range of 3.8 to 4.5 during the reproductive years. This acidity helps protect against harmful bacteria.
If the pH becomes too alkaline, the risk of infections such as bacterial vaginosis or trichomoniasis increases.
If it becomes too acidic, fertility can be impacted.
Interestingly, foods with similar pH levels include tomatoes, olives, grapes, and berries—many of which are staples in Mediterranean diets. Research even shows that women in Mediterranean regions experience fewer microbiome-related vaginal disorders.
Common Vaginal Microbiome Conditions
Here are some of the most common conditions practitioners may encounter:
Yeast Infections: Often present with itching, swelling, pain during sex or urination, and thick white “cottage cheese” discharge. From a Chinese medicine perspective, this often reflects damp heat in the lower jiao.
Bacterial Vaginosis (BV): May cause itching, burning, grayish discharge, and a distinct fishy odor, though it can also be asymptomatic. BV is often connected to a mix of spleen qi deficiency and damp heat.
Trichomoniasis: Characterized by frothy yellow-green discharge and irritation. In TCM, this often ties back to spleen deficiency with dampness.
Urinary Tract Infections (UTIs): Marked by frequent urges to urinate, burning, pelvic pain, or flank pain. In Chinese medicine, UTIs are often related to kidney yin deficiency with damp heat.
Supporting Clients in the Clinic
Helping clients rebalance their microbiome doesn’t have to be complicated. Some simple, shame-free strategies include:
Vaginal pH testing: Easy-to-use strips can be provided in clinic or for at-home use, giving clients tangible feedback on their microbiome health.
Dietary support: Encouraging foods rich in lactobacillus—like sauerkraut, kimchi, yogurt, miso, or tempeh—can strengthen beneficial flora.
Probiotic supplements: Oral probiotics designed for vaginal health (such as FemEcology by Vitanica) can be a convenient and effective option.
Lifestyle recommendations: Loose-fitting clothing, avoiding thongs, and eliminating scented soaps or products can help maintain balance.
Client education: Simple reminders, like wiping front to back, can make a big difference in preventing imbalance.
And most importantly, always refer clients to a medical provider if red-flag symptoms are present or an active infection requires further testing.
Bringing It All Together
As acupuncturists, we are uniquely positioned to address pelvic health from a holistic perspective—integrating the biomedical, organ system, and spiritual-emotional layers. The pelvis is not just the physical root of the body, but also a place where emotions and life experiences are often stored. Supporting clients with pelvic health means supporting them on every level.
The vaginal microbiome is just one example of how interconnected the body truly is—and how powerful our medicine can be when we meet clients with knowledge, compassion, and the tools to restore sustainable balance.