There is an ongoing myth that food has a direct impact on vaginal health. Over the past twenty-five years, I have been interviewed by multiple reporters on this subject. Many times, I gave a detailed account of why a direct gut-vagina connection is biologically impossible, yet headlines such as “Eat Pineapple for a Sweeter Vagina!” or “Banish Yeast by Ditching Bread!” always appeared. It seems the truth, “Your Vagina Just Wants You to Eat a Healthy, Balanced Diet!” isn’t sexy enough.
What’s the harm, you say?
This supposed direct connection between food and the vagina is a complete misunderstanding of how the body works, and facts matter. In addition, the idea of eating food to change the way a vagina smells supports the tired and destructive trope that there is something wrong with a normal, healthy vagina. It’s simply a different spin on douches.
The other issue with vaginal food fallacies is that they can lead to severe dietary hypervigilance and restrictions—essentially, vaginal orthorexia (orthorexia is an eating disorder with extreme attention to foods perceived as healthy and avoidance of foods believed to be harmful). I have lost track of the number of women who have told me they haven’t had a slice of cake or a cookie for years, trying to rid themselves of yeast, and yet they still have their same symptoms. The exasperation in these voices is not insignificant. And really, having a slice of cake or a cookie now and then is nice.
If you have a concerning vaginal odor, you should see a doctor or nurse practitioner—the remedy is most definitely not at the grocery store.
Can bread or beer or wine cause yeast infections?
Yeast is used to make wine, beer, and bread, so it is easy to see how the myth of alcohol or bread causing yeast was started. Common sense tells us this can’t be so, as the French have been enjoying fine breads and wine for hundreds of years, and French women are not plagued with yeast infections.
Science backs up the common sense. The yeast most commonly used for bread and alcohol is Saccharomyces cerevisiae, and this is only rarely a cause of vaginal yeast infections (about 1 percent of the time). Sourdough starters scavenge wild yeasts like Saccharomyces exiguus, Candida milleri, and Candida humilis from the environment, which do not cause vaginal yeast infections (they also scavenge S. cerevisiae). If that isn’t enough reassurance, then consider that yeast in bread, wine, and pasteurized or filtered beer is dead. An unfiltered, unpasteurized beer may have some yeast that is dormant—but again, this isn’t the right type.
I understand that a woman claimed to have made bread with a sourdough starter she nourished with her vaginal yeast, and this seems as good a place as any to address this story. First of all, we have no idea if what she grew from her vagina was Candida albicans (the most common cause of yeast infections) or even any type of yeast, for that matter. Belief that you cultured something doesn’t cut it scientifically. The vagina is filled with bacteria, and any swab not cultured appropriately in a lab may grow all kinds of microorganisms, most of which will not be yeast. Second, her sourdough starter, like all sourdough starters, would have scavenged the wild yeast from the air and surface of the flour, etc., and so even if she did manage to grow yeast from her vagina, it would have added nothing to the baking except temporary internet fame—and, of course, more confusion about yeast. The next time you see this story make the rounds on the Internet, please don’t pass it along. Just ignore it.
If you want to prove that vaginal yeast can bake bread, you are going to need to add cultured C. albicans directly to the flour as you would any store-bought yeast, but that seems like a thoroughly unnecessary exercise. So let’s not.
The best foods for vaginas
There are no bad or good foods, as far as the vagina is concerned. I know this upsets a lot of people, but there are really no good or bad foods in general, with the exception of trans fats, which are modified fats linked with inflammation and heart disease. Avoid these for all kinds of health reasons (this means saying goodbye to icing from a can). There are healthy diets and less healthy diets, and eating well is good preventative medicine, but eating a specific food as treatment doesn’t apply to the vagina.
What about cranberry juice for preventing urinary tract or bladder infections? In the early 1900s, before we had modern methods to diagnose bladder infections and before antibiotics, doctors recommended cranberry juice because the hippuric acid that is released as the body metabolizes cranberries makes the urine very acidic. The theory was the acidity would make it harder for bacteria to grow. Cranberries also have a lectin (a protein) that may prevent bacteria from binding to cells in the urinary tract (bacterial adherence to cells is a necessary step in infections). While both of these hypotheses are biologically plausible and worthy of pursuit, multiple studies have looked at cranberry juice and found no benefit. In addition, juice has no nutritional value; it’s just nature’s soda. Cranberry juice, even unsweetened, has a lot of sugar, and some brands can have as much as soda.
Two small studies have linked a high dietary saturated-fat (animal fat, so meats and dairy) intake with bacterial vaginosis, but this is far from a certainty. A high-fat diet could also be a correlation, not a cause, meaning women with these diets are more likely to have other risk factors for bacterial vaginosis. How this connection might exist biologically is simply not known. There are other health reasons besides your vagina to try to avoid a diet that is very high in saturated fat.
Eating at least 25 g of fiber a day is the best preventative health advice I can offer vagina-wise, as fiber is a prebiotic, meaning it feeds good bacteria in the bowel. Fiber also draws water into the stool, softening it and helping it move along more quickly, thereby preventing constipation. Constipation can lead to straining, which can cause pelvic floor spasm (potentially causing pain with sex or pelvic pain) and hemorrhoids. The average American only eats 7–8 g of fiber a day, so I recommend a fiber count, meaning writing everything down that you eat for 1–2 days and then checking the fiber count so you know how much you are eating and can make changes if necessary. I’m a little lazy, so I just eat a cereal with 8–13 g of fiber a serving most days, so I know I’m one third to one half of the way there before I’ve even started my day.
Lots of people ask about fermented foods, such as yogurt, sauerkraut, or kombucha, to help cultivate good gut bacteria. Typically, these foods do not contain the right strains of lactobacilli for vaginal health, although they may have bacteria that is healthy for the gut. Some studies have linked fermented milk products like yogurt with a reduction in bladder cancer, heart disease, gum disease, and cardiovascular disease. Fermentation enhances the nutritional value of vegetables and may increase the iron that is available for absorption. Many women are iron deficient, so this obviously won’t hurt.
It is possible the bacteria in fermented dairy and vegetables could have a beneficial impact on normal gut bacteria after antibiotics, but we don’t have any research on the impact on vaginal health. Having fermented foods if you are on antibiotics is probably not a bad strategy to try to lessen the impact of antibiotics on your gut bacteria (this is a cause of antibiotic-related diarrhea). However, as there are no studies that prove this works, I wouldn’t sweat it if you don’t like fermented foods and that strategy doesn’t appeal to you. Personally, I despise sauerkraut and kombucha, and for me to give them a try there would need to be several very robust studies to show they definitively help protect gut bacteria after antibiotics.
Excerpted from The Vagina Bible by Dr. Jen Gunter. Copyright © 2019 Jennifer Gunter. Published by Random House Canada, a division of Penguin Random House Canada Limited. Reproduced by arrangement with the Publisher. All rights reserved.