There’s a peculiar phenomenon that performs an vital function 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 possible explains why and the way, if a lady 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 is just not 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 through 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 fundamental 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 cut back the variety of urinary tract infections (UTIs) in females who expertise repeated UTIs. However it additionally signifies 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 take a position whether or not translocation can even happen, i.e., microbes go away the GI tract by the intestinal wall and by some means migrate (through blood?) to the vagina and bladder. To my data, this phenomenon has by no means been demonstrated with vagina or bladder. It has, nevertheless, 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, nevertheless, through swallowing however through 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, may also be discovered densely populating the brains of individuals with dementia. The probably method for fungi to colonize the mind is thru the bloodstream. 

Again to the perineum. Rising insights into this little neighborhood are yielding insights which can be opposite to so many earlier prevailing ideas, resulting in methods to raised 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 diminished incontinence and UTIs seems to lie in addressing the vaginal microbiome for a lot of girls.

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