Have you ever heard of the gut-brain connection? It’s actually pretty cool. There’s something in your digestive system called the enteric nervous system (ENS) — two thin layers of more than 100 million nerve cells lining your gastrointestinal tract (aka the stomach and intestines) from the esophagus to the rectum. If you’re experiencing something like irritable bowel syndrome (IBS), research has shown that the irritation in the gastrointestinal system may send signals via the ENS to the central nervous system. This can ultimately trigger mood changes like anxiety and depression.
For those unfamiliar, IBS is a condition that directly affects the gastrointestinal tract. Common symptoms include cramping, belly pain, bloating, gas, and diarrhea or constipation (or both; yay). While there isn’t a specific known cause for IBS, factors such as stress, infection, issues with stomach-muscle contractions, ENS issues, or gut-microbe changes can contribute to this diagnosis.
It’s that last factor, changes in gut microbes — bacteria, fungi, and viruses that live in the intestines — that could make people wonder if there’s a gut-brain-like connection between the gastrointestinal tract and the vagina. Just like the gut, the vagina contains healthy bacteria. But when there’s an overgrowth of bad bacteria in the vagina, it can result in an uncomfortable infection called bacterial vaginosis (BV). Although 84% of women who have BV don’t experience any symptoms, signs of BV can include discolored vaginal discharge (grey, white, or green), foul-smelling or “fishy” vaginal odor, vaginal itching, and burning during urination.
So is there a gut-vag connection, where a gastro condition like IBS might lead to a vaginal infection like BV? Rescripted spoke with Cordelia Nwankwo, M.D., a board-certified OB/GYN in Washington, D.C., who explained how IBS and BV are — and aren’t — related.
Can IBS cause BV?
The short answer is no. “Irritable bowel syndrome doesn’t directly cause bacterial vaginosis,” says Dr. Nwankwo. But, she does confirm “the gut bacterial environment and the vaginal bacterial environment can be related.” If you receive an IBS diagnosis, that doesn’t automatically mean you’re going to develop tell-tale BV symptoms. Still, since BV occurs when there’s a bacterial imbalance in the vagina, it is worth reassessing your diet and overall gastrointestinal health, especially if you have a condition like IBS.
Is there a gut-vag connection?
While IBS doesn’t directly cause BV, there is a gut-vagina connection that shouldn’t be discounted. “The same things that can affect the balance of bacteria in the gut can do so in the vagina, including things like diet and medications,” says Dr. Nwankwo. She goes on to say that adopting a gut-friendly diet affects not only your gastrointestinal tract, but your vagina as well: “Diets high in fiber, healthy fats, prebiotics, probiotics, and increased hydration can help maintain a healthy gut which in turn influences vaginal bacteria.”
So, what exactly is a gut-friendly diet?
Well, as Dr. Nwankwo mentioned, it contains a healthy balance of probiotics and prebiotics. Probiotics are foods or supplements that contain live microorganisms that can maintain or improve the body’s good bacteria (aka normal microflora). Prebiotics serve as food for that human microflora. While both prebiotics and probiotics are available as dietary supplements, they’re also found in several foods — prebiotics, especially.
If you’re rethinking how to take better care of your digestive system — which, in turn, can keep your vaginal bacteria healthy — the best place to start is with the foods you eat. That includes embracing fiber. Fiber is necessary for building good bacteria and maintaining strong gut health. So ditch the processed foods with extra sugar, fat, and salt. Instead, opt for probiotic-filled foods like yogurt and fermented vegetables (sauerkraut is a good example). Prebiotics, on the other hand, are easily found in high-fiber foods like whole grains, bananas, greens, onions, garlic, soybeans, and artichokes.
As for probiotic and prebiotic supplements, talk to your healthcare provider before beginning any new supplement regimen.
Preventing IBS and BV
Since there’s no known cause of IBS, prevention isn’t possible, unfortunately. By identifying your IBS triggers early on, you can stave off more frequent flare-ups. Your healthcare provider can help you determine the best approach for managing this condition, which usually includes diet modifications, medication, exercise, stress-reduction techniques, and additional types of therapy.
One of the best ways to prevent BV, however, is by maintaining a healthy vaginal bacteria balance. Yes, you can do that by washing your vagina only with warm water, avoiding scented products like pads, tampons, and soaps, and practicing safe sex. But remember, a healthy gut can also affect your vaginal bacteria. So make sure you follow a high-fiber diet chock-full of prebiotics and probiotics too. Your gut and your vagina will thank you!
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram, BlueSky, or Threads.
