The first naturopathic practitioner I worked with taught me the relationship between hormones and vaginal health. She tested my levels of all three types of estrogen as well as other sex and adrenal hormones (including cortisol) and recommended treatment accordingly. She also put me on the vaginal ring, which contains localized estrogen and has been shown to decrease UTI occurrence and prolong the time between occurrences.

These helped, but my symptoms weren’t fully resolving, so she referred me to another practitioner who specialized in identifying and treating chronic infections. 

From our very first consultation, this provider’s instinct was that my mycobiome2—the small, fungal component of the microbiome, which interacts with the whole microbiome and affects vaginal health—may have been compromised from all of the antibiotics I’d taken. 

While vaginal mycobiome testing doesn’t exist (to my knowledge) and the vaginal mycobiome3 has not been fully sequenced, I do believe whatever state my mycobiome was in may have had something to do with the recurrent infections. 

Together, we worked on restoring foundational health, supporting my immune system by bolstering my gut health, and giving my body herbal antimicrobial support.

Guided by the results of a test called the GI-MAP, which sequences all of the microorganisms living in your digestive tract, we worked to rebalance my gut microbiome with different kinds and strains of probiotic bacteria, like phages and yeast, including Saccharomyces boulardii.

The botanical medicine was the most helpful. I took a powerful herbal supplement formulated for UTIs both as a prophylactic and when I felt a UTI coming on—and, in my experience, it helped to keep them at bay so I didn’t have to take more antibiotics. Among other ingredients, it contained juniper, which contains berberine, a plant alkaloid known for its antimicrobial properties4 and ability to manage dysbiosis (in the gut and urinary tract).

Eventually, I took a two-week dose of fluconazole. Since then, I haven’t experienced any more vaginal infections.

During my recovery journey, I was testing my vaginal microbiome with Evvy. According to my results, the Lactobacillus crispatus5—a protective bacteria for vaginal health—that once dominated my vaginal microbiome5 was compromised. Right now, some research is underway to develop living medicines for UTIs and reproductive health, including vaginally administered L. crispatus probiotics. What’s missing is a more complete understanding of microbial communities that promote vaginal health.