There’s a peculiar phenomenon that performs an essential position in feminine genitourinary well being: the contiguity of the three orifices within the a part of the physique referred to as the perineum: vagina, urethra resulting in the bladder, and anus.
The nearness of those three orifices doubtless explains why and the way, if a girl orally consumes, say, a probiotic containing sure bacterial species, the microbes will first colonize the colon, then the vagina, after which the bladder. (No, the bladder will not be sterile, as we as soon as believed.) There isn’t any direct connection among the many three, not less than none that has been recognized. So how do microbes within the colon entry the vagina? And the way do vaginal microbes entry the bladder?
It have to be by way of contiguity, i.e., the nearness of the three orifices. It’s a bit disturbing to suppose that fecal materials can achieve entry to the vagina and bladder. This phenomenon can present wholesome results corresponding to colonization of the vagina and bladder with the bacterial species, Lactobacillus crispatus, that’s the major keystone species of a wholesome vagina that, in flip, colonizes the bladder and has been proven to cut back urge incontinence (peeing with coughing or laughing) and and cut back the variety of urinary tract infections (UTIs) in females who skilled repeated UTIs. But it surely additionally implies that unhealthy fecal species corresponding to E. coli can colonize the vagina and bladder, inflicting “vaginosis,” or vaginal dysbiosis, and urinary tract infections.
It’s tempting to invest whether or not translocation may happen, i.e., microbes depart the GI tract via the intestinal wall and one way or the other migrate (by way of blood?) to the vagina and bladder. To my information, this phenomenon has by no means been demonstrated with vagina or bladder. It has, nonetheless, been demonstrated in different areas of the physique. The oral microbe that I’ve beforehand mentioned, Fusobacterium nucleatum, that colonizes the mouth of most individuals however current at elevated numbers in folks with bleeding gums, gingivitis, and periodontitis, colonizes the colon. It has been proven that Fusobacterium doesn’t attain the colon, nonetheless, by way of swallowing however by way of the bloodstream. (Microbes have been radioactively labeled and recovered within the bloodstream.) One other oral microbe, Porphyromonas gingivalis, additionally related to poor oral well being, colonizes the mind the place it’s discovered at elevated numbers in folks with dementia. The fungal species, Candida albicans, will also be discovered densely populating the brains of individuals with dementia. The almost certainly means for fungi to colonize the mind is thru the bloodstream.
Again to the perineum. Rising insights into this little group is yielding insights which are opposite to so many earlier prevailing ideas, resulting in insights to higher handle feminine well being. This has enormous potential implications since a disrupted vaginal microbiome. a situation that afflicts round 30% of the feminine inhabitants, can result in penalties corresponding to miscarriage and untimely labor. And the important thing to lowered incontinence and UTIs seems to lie in addressing the vaginal microbiome for a lot of women.
