There hasn’t been significant research on stress and vaginal health. But, as any woman would advocate, there is a clear association between increased stress and intimate health. Moreover, if there are issues like erectile dysfunction and premature ejaculation present among men as a response to stress, there must also be a correlation between it and vaginal health. In this article, we’ll discuss the issue in detail through this research.
What Is Stress
Stress is your body’s attempt to adequately respond to sudden threatening events. The events could be psychological or physical, but stress hormones like Cortisol and Adrenaline are only produced abnormally when the events have the potential to threaten the equilibrium of homeostasis. In easy words, stress hormones are triggered as a fight-or-flight response.
Being complex creatures, the events could be anything from job changes to near-death experiences. However, symptoms of stress could be different depending on the nature of events or the individual.
Physical Stress
Headaches, insomnia, fatigue, back pain, skin issues, substance abuse, and low libido are common symptoms of physical stress. The extent of the symptoms may reduce or increase depending on the stress levels. Physical stress can occur due to any number of reasons that may harm you physically.
Emotional Stress
Depression, anger, anxiety, mood swings, and unhappiness are common symptoms of emotional stress. Work, relationship issues, and abuse are the most common reasons behind emotional stress among women.
Social Stress
Isolations, reduced intimacy, and loneliness are general symptoms of social stress, which is mostly caused by family issues, children’s health, and unhappy marriages.
However, irrespective of the level or category of stress, vaginal health is negatively impacted by it due to hormone imbalances.
Impact of Stress on Vaginal and Intimate Health
Vagina isn’t only a pathway for sperm, baby, and menstruum. It’s a sensitive and diverse organ rich in the microbial landscape. Potentially harmful bacteria like L. crispatus, L. jensenii, Gardnerella, Prevotella, and many more are kept in control by the acidic milieu, hydrogen peroxide, and other peptides. They keep vaginal pH between 3.5 to 4.5 to keep the pathogens in check. However, with increased stress and imbalance in hormones, the usual pH levels are decreased—promoting bacterial growth and viral infections.
Stress-Induced Vaginal Dysbiosis
Excessive psychological stress induces the release of cortisol and norepinephrine. Both of which reduce lactic acid, hydrogen peroxide, and vaginal pH through a vicious cycle. Therefore, vaginal health is jeopardized and is made susceptible to sexually transmitted diseases and the above-mentioned bacteria colonies.
Bacteria colonies can promote the growth of:
- Yeast infection
- Bacterial vaginosis
- Gonorrhea
- HIV
- Chlamydia
- And many other deadly diseases
These diseases often present symptoms like vaginal itching, burning, or rashes. Relief from vaginal itching may be possible with OTC ointments, but inflammations and STDs are more complex.
Increased norepinephrine secretion due to physical and emotional stress often results in pro-inflammatory responses—increasing cytokines and chemokines. The inflammation occurs mostly in the inner lining of the vagina (epithelium cells) and can cause severe itchiness and a burning sensation.
Cortisol also affects immune response and reduces the release of antimicrobial proteins like mucins, immunoglobulins, SLPI, and NGAL. The overall dysbiosis or imbalance of such proteins often negatively impacts the vaginal ecosystem and facilitates upper genital tract infection and other gynecological diseases.
Vaginal Glycogen Deposition
Glycogen, produced by the epithelial cells in the vagina, is observed to be associated with the growth of Lactobacillus in the lower genital tract. As the glycogen is low in pre-puberty and post-menopause, the Lactobacillus domination is also lowered.
A high count of cortisol and deoxycorticosterone, associated with higher stress, is observed to be inhibiting glycogen response. In simple words, the more stress a woman goes through, the less lactic acid is produced in the vagina—making yeast infection and BV more apparent in severe cases.
However, unsurprisingly, vaginal glycogen deposition doesn’t have a direct correlation with the fight-or-flight response that stress induces. The cortisol response is considered to be an attempt to save energy for organs such as the brain. Therefore, control over glycogen disposition is lost in the events of prolonged stress due to sickness, finances, and relationship pressures.
Bacterial Vaginosis (BV) is one of the most common issues among women in the reproductive stage. It’s caused by the overgrowth of anaerobic gram-negative bacteria. BV increases the risk of preterm labor manifolds. An increased risk of BV is associated with psychological stress. Moreover, such infections can increase the risk of urinary tract infections in females.
Stress-Induced Maternal and Offspring Gut Microbiota
Chronic psychological stress often suppresses the immune system in pregnant women. Immunosuppression is a phenomenon that reduces the ability to fight off potentially dangerous microbes. It can negatively affect the vaginal pathogen microbiota balance and cause dysbiosis. As mentioned before, vaginal dysbiosis can heighten the risk of BV and candidiasis in reproductive women.
As neonatal gut microbial colonization is dependent on the mother’s reproductive health, the compromised immune system in pregnant women often causes altered gastrointestinal tract maturation in the infant. It also can affect the immune system, metabolism, and insulin imbalance of the child.
Other chronic but less severe conditions arising in infants due to the same phenomenon are
- Inflammatory bowel disease
- Food allergy
- Atopic diseases
- Irritable bowel syndrome
An experiment on rhesus monkeys has also indicated increased cortisol levels and activated HPA axis when subjected to prolonged stress while pregnant. It reduced the concentration of gram-negative aerobes and Lactobacilli in the small intestine of the offspring.
Prevention and Treatment
While stress is almost inevitable in life, regular exercise, a healthy diet, and adequate sleep have proved to be beneficial to manage it. Avoiding smoking, drinking, and drug abuse also have similar positive effects on stress hormones.
Probiotics and prebiotics can also help maintain the balance of the chemical and microbial landscape of the vagina. It potentially can prevent BV, cervical inflammation, and preterm delivery. Over-the-counter vaginal ointments can offer relief from itching in mild symptoms.
Anti-inflammatory agents like TNF-a, IL-6, and IL-b are observed to prevent LPS-stimulated preterm birth and fetal death.
The Bottom Line
Stress is an auto-immune fight-or-flight response of the body during potentially harmful situations. Several events like work pressure, near-death experiences, and relationship issues can trigger stress hormones. The vaginal and intimate health is compromised significantly because of increased cortisol and norepinephrine secretion. Vaginal dysbiosis, vaginal glycogen deposition, and offspring gut microbiota are the major issues introduced by stress. The prevention and treatment measures often include healthy lifestyles, however, probiotics, prebiotics, ointments, and anti-inflammatory agents may also help.