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The (un)Healthy Vagina: Does discrimination affect the vaginal microbiome? 

July 4, 2024 . jessie

Written by Daan Borrel

Welcome to the wonderful world of the vagina, where a self-contained environment of bacteria, yeasts and fungi protects you. Most people know very little about vaginal health, while a deficiency of certain bacteria in the vagina increase the risk of bladder infections, fungal infections, premature births, infertility and STIs. Currently, scientists worldwide are studying what a healthy vagina is and how it stays healthy. In this place, we will teach you everything you can already know about this in six months.  

Today in part five: does discrimination affect the vaginal microbiome? 

You are not your vagina. Nor are you your vaginal microbiome, but that composition of bacteria does make you more or less susceptible to certain diseases. Before this, I wrote about how various factors can affect the vaginal microbiome, such as estrogen levels, using birth control, penetrative sex or consuming a lot of meat and sugar. Whether those factors actually cause disease depends on the person – as well as their environment. Although much less is known about this because research does not look at a person’s living conditions.  

This past year I worked with obstetrician and scientist Dr. Bahareh Goodarzi on a book about discrimination in birth care. Pregnancy and birth is obviously a very different topic than the vaginal microbiome, but the interviews we conducted did teach me something very important about health: it’s not just our genes or biology that determines differences in health, but societal factors do as well. If you extend this to the vaginal microbiome, you could argue that societal factors such as poverty, sexism and racism (stress creators!) can also influence this. 

For example, this article in Scientic American magazine states that people identified with black skin color have a higher risk of vaginal dysbiosis; the scientific term for an imbalance in the vaginal microbiome. Research also shows that bacterial vaginosis  is more common in those identified with African or Asian ethnicity (with a vagina). What causes this, whether it is due to genetic factors or lifestyle factors, is unknown. 

In her book Womb, Leah Hazard also writes that “black and other ethnic minority women are disproportionately affected by certain gyneacological conditions, from endometrial cancer to fibroids, and other diseases, such as endometriosis, are known to often go unrecognized in them. Because there are very few reproductive health studies that include data separated by ethnicity, it doesn’t really become clear what the disparities are or what they are due to. Fortunately, some research has been done recently, Hazard writes, “and initial results provide strong evidence that Aboriginal, black and Hispanic women tend to have a strikingly different uterine microbiome than their white counterparts.”   

But why is this so? Is it due to the body, or due to factors that affect the body, but over which people themselves have little or no control? Only when research includes demographic data such as socioeconomic, household and educational information can much better interpretations and analyses be made as to why this is more prevalent among certain populations.    

So, there is still much work to be done, and improved research is also likely to give a different picture of how we view health and disease. Something that is not only genetically determined, but also lies in environmental factors. And that we also stimulate health by changing those environmental factors and not only with medical interventions or pills.   

Next week will be the last blog.

Hope to see you then! 

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