April 19, 2025, 12:05 pm | Read time: 6 minutes
Vaginal fungus is one of the most common and unfortunately often recurring infections in the female genital area. Around 70 percent of all women develop a vaginal infection in the course of their lives. STYLEBOOK spoke to gynaecologist Dr. Daniela Bach about the causes of a fungal infection and how you can rebalance your vaginal flora and keep it healthy.
A healthy vaginal flora has a balance of different microorganisms. First and foremost, there are Döderlein bacilli, also known as lactic acid bacteria, which ensure an acidic environment in the vagina and act as a natural protective barrier against pathogens. “We need these Döderlein sticks to protect us from pathogenic bacteria and germs. This is because the vagina is not a sterile environment. This means that it always comes into contact with other germs and there are always different germs in the vaginal flora. It is important that there are sufficient lactobacilli that can render pathogenic germs harmless,” says Dr. Daniela Bach, describing the delicate balance in the vagina.
Overview
Out of Balance? Vaginal Infections Due to Estrogen Deficiency
An imbalance in the vaginal flora is present when there are too few lactobacilli in the vaginal mucosa. The number of lactobacilli is directly linked to estrogenization in the female hormone balance. If there is sufficient estrogen in the vaginal epithelium (outermost layer of the vaginal skin), there are also sufficient lactobacilli in the mucous membrane. “Then we generally need to worry less about impending infections,” explains the gynecologist. “This also means that the immune system is cycle-dependent. Less estrogen is produced during menstruation and in the week after the period. The defenses in the vagina can then also suffer. The same applies to the peri- and post-menopause, when estrogen levels generally fluctuate and are significantly lower. This also increases the risk of vaginal infections.”
Less Is More! Hygiene in the Intimate Area
Too much hygiene or an incorrect understanding of intimate hygiene can also damage the vaginal flora. “The vaginal flora is optimally effective at an acidic pH value of around 3.8 to 4.4,” says Dr. Bach. These acid values are largely maintained if the vagina is cleaned daily with clear water only. Bach emphasizes: “Without soap.” Intimate hygiene products that are adapted to the acidic pH value in the vagina are also fine. However, regular shower gels or soap with alkaline pH values for the skin can unbalance the acidic pH of the vaginal flora. “Then the lactobacilli can no longer do their job, leading to an imbalance and subsequent infections,” summarizes the doctor.
Avoid Synthetic Underwear
Synthetic underwear can also lead to an imbalance in the vaginal flora. This is because synthetic fibres promote a warm, moist environment in the vaginal area and “fungi really like that,” according to Dr. Bach. Wet swimwear or sweaty sportswear also encourage the growth of germs and can lead to fungal infections. “So, get out of wet clothes, be it swimwear, workout clothes or sportswear and into breathable underwear, preferably made of natural fibers,” recommends Dr. Bach.
Avoid Vaginal Douching
Another possible disruptive factor for the vaginal flora is the use of vaginal douches. “There are women who use vaginal douches to be particularly clean and unfortunately flush the good vaginal flora out of the vagina. This should be avoided at all costs,” warns the expert. In her opinion, the use of intimate deodorants is also not advisable. This is because these products also have a damaging effect on the vaginal environment.
Symptoms of a Vaginal Infection: Itching, Redness, and Discharge
While the vaginal flora is out of balance, symptoms rarely occur. Only the resulting infection leads to discomfort and pain. “Depending on whether a fungus grows in a damaged vaginal flora or a bacterial vaginosis develops, different symptoms can be noticed,” explains Dr. Bach. “In the case of a fungus, the first sign is a crumbly discharge. There may also be itching, perhaps redness in the vulva and vagina area or a burning sensation. As a rule, the discharge from a fungal infection does not smell any different than usual. With bacterial vaginosis, on the other hand, it is often greenish and can smell fishy. A burning sensation is also a possible symptom here, but itching is less common. Vaginosis can also cause redness, perhaps even pain and swelling.”
Women who frequently suffer from fungal infections can obtain preparations from the pharmacy without a prescription. “Creams or vaginal ovules (suppositories) or a combination of a cream and ovules, applied over several days, provide quick relief,” says Dr. Bach. If in doubt, however, she always advises consulting a gynecologist—especially if the creams and suppositories do not work.
Build Up the Vaginal Flora with Probiotics
Antibiotic therapy, for example for a bacterial infection in the lungs, can often ruin the vaginal flora. Unfortunately, antibiotics do not differentiate between good and bad bacteria in the body. It is not only the bacteria in the lungs that suffer from the treatment, but also the lactobacilli in the vaginal flora. “It can therefore make sense not to wait until a vaginal infection occurs after antibiotic therapy, but to rebuild and support the vaginal flora directly with a probiotic,” advises the expert.
A probiotic can be taken either orally or vaginally in the form of capsules. “There are some preparations that you can get from the pharmacy,” says Bach. “What is not helpful, however, is the much-cited yoghurt-soaked tampon. Because the yoghurt cultures have absolutely nothing to do with our lactobacilli in the vagina. So there’s no need for that.”
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Lifestyle and Diet
Unfortunately, the data on nutrition as a support for vaginal flora is still quite thin. According to Dr. Bach, a balanced, anti-inflammatory, stress-reducing diet according to the motto: The best approach is to eat a varied diet. Complex fiber from fresh vegetables and fruit as well as nuts and whole grain products play an important role and should be part of your daily diet. You should also regularly eat a handful of berries, which contain antioxidants that eliminate free radicals in the body and strengthen the immune system.
Dr. Bach also refers to the Mediterranean diet, “which naturally benefits the whole body and, above all, reduces stress at the cellular level. And we know that an increased stress level can also have a damaging effect on the vaginal flora and promote vaginal infections and cystitis. This is because the vaginal flora not only protects the vagina itself from ascending infections, but also from bladder infections, which also pass through the vagina via the urethra. Thus, a robust immune response in the vaginal area and at the entrance of the urethra also provides strong protection against bladder infections.”