The Curious Link Between Vaginal Infections and High Sugar Intake

That after-dinner ice cream, the bakery buns in your town, the supermarket pizzas because you don’t feel like cooking on vacation… Summer tests the discipline of the diet and spikes sugar consumption. Bad for metabolic health, for the scale, and, as a finale, for vaginal health.

Infections of the genitourinary tract can appear at any time, although their incidence multiplies with the hormonal changes of menopause. We know that maintaining hygiene is key to reducing the risk of these uncomfortable complications.

What is less known is the relationship between a diet high in sugars (sugar, carbohydrates, sweeteners and fermented products) and infections such as bacterial vaginosis or candidiasis. And the cause once again confronts us with an old acquaintance: the microbiota.

Another reason not to overdo junk food

“A diet habitually high in sugar and ultra-processed foods can disrupt your gut microbiota, which is connected to the vaginal microbiota. We know it as the gut–vagina axis: the good bacteria in your gut also influence the balance of your vagina”, notes Nekane Moreno Jurado, gynecologist of the Gynaecology and Longevity Unit of Clínica Eres.

This problem is more acute in women with diabetes or with poorly controlled glucose. There is a more direct relationship: excess blood sugar creates the perfect environment for Candida to grow, the fungus responsible for the typical ‘fungal infection’, says Dr. Moreno.

This would be the process that triggers it: “The excess sugar alters vaginal pH, causing fungi that normally inhabit the vagina to proliferate, such as Candida albicans, unquestionably aggravating their symptoms.”

A chain of deadly changes

The changes associated with perimenopause and menopause alter vaginal physiology. “Estrogens play a crucial role in vaginal health, stimulating maturation of the vaginal epithelium and local glycogen production. The Lactobacillus feed on that glycogen and convert it into lactic acid, maintaining an optimal pH (between 3.8 and 4.5) that acts as a protective shield”, explains the gynecologist.

Problems arise when estrogen levels begin to fall. “The epithelium becomes thinner and drier, the population of Lactobacillus decreases, and the vaginal pH rises (becoming more neutral or alkaline)”.

The perfect storm

A diet high in sugars disrupts the intestinal microbial ecosystem. Bacteria of one species proliferate heavily compared to others, creating an imbalance that alters the functionality of the intestinal wall. Not to mention that, more often than desirable, the ones that increase in number are the most likely to create infections.

And they encounter a vaginal cavity in a low moment. It’s the perfect storm.

On one hand, the risk of dysbiosis and/or intestinal permeability surges. On the other hand, with menopause, the vaginal cavity loses elasticity due to lack of collagen, the canal shortens and the pH varies. If there are bacteria ready to provoke an infection leaving the intestinal tract, they will have less distance to travel to reach a vagina that has lost part of its usual acidic protection.

And there’s more. “Intestinal permeability, in turn, alters the immune system, causing chronic low-grade systemic inflammation, and a reduced local immune response at the vaginal mucosa. This physiological disaster reduces its ability to defend itself against opportunistic pathogens (like Candida)”, details Ana Molina Jiménez, food industry consultant and cofounder of Ren.U, and author of the book Relationship between sugars and vaginal infections (Publicaciones Cajamar).

Opportunistic infections on the prowl

The first symptoms are easy to identify: itching, burning, and a thicker discharge.

These are the vaginal infections most linked to a sugar-rich diet:

• Candidiasis (fungal infection): “It is very tied to blood glucose levels, especially in women with diabetes and not so much with a one-off intake of sugary foods”, explains Dr. Moreno.
• Bacterial vaginosis: “High-sugar and refined carbohydrate diets are associated with more cases, due to their general inflammatory effect on the body, through a mechanism similar to the previous one”, explains the gynecologist.

And to crown it all, summer

Vaginal infections increase by 50% during the summer season, representing up to a third of total gynecological consultations in these months, according to data from the Spanish Association of Gynecology and Obstetrics (SEGO). Why? The main reasons are:

• Trapped moisture: “Spending hours with a wet swimsuit after beach or pool time is the main triggering factor. Continuous moisture destabilizes the pH of the intimate area, facilitating fungal colonization of the tissue”, says Molina Jiménez.
• Temperature and sweating: “Extreme heat increases body sweating. Wearing tight or synthetic fabrics creates an environment in the area that exponentially accelerates the reproduction of yeasts”, according to this expert.
• Diet on vacation: “In summer eating tends to worsen. The increase in sugar consumption with products like ice cream, sodas and alcohol raises glucose levels”, says the Food Industry Consultant and Co-Founder of Ren.U.

What to eat to avoid infections

The expert insists that preventive nutritional strategy is different from symptomatic. That is, when candidiasis is established, it is necessary to set up a symptomatic strategy. Thus, “the initial guidelines will be very restrictive regarding sugars, simple carbohydrates and fermented products, aimed at quickly improving symptoms, but should not be prolonged. While when we talk about preventive nutrition, the approach is different and should be oriented toward an anti-inflammatory, immune-protective and microbiota-regulating strategy, explains Ana Molina.

Foods to reduce

• Refined sugars and sweeteners: white sugar, brown sugar, honey, syrups, industrial pastry, sugary soft drinks and sweeteners. And also sweetened foods (primarily with sucralose, saccharin and aspartame) that are labeled as light, ‘diet’ or ‘0.0’.
• Ultra-processed carbohydrates: refined flours, snacks, industrial pizzas and fruit juices. “They are rapidly converted into blood glucose,” warns Ana Molina.
• Alcohol. “Because it is a rapidly absorbed sugar source, it weakens the immune system and alters both the intestinal and vaginal microbiota,” according to this expert.
• Dairy and meats. Gynecologist Francisco Carmona advises temporarily removing dairy because lactose can affect it, and also red meats, as they “may carry anabolic components that affect the hormonal system”.
• Tea, coffee and very spicy spices.

Foods to increase

Recovering anti-inflammatory foods from the Mediterranean pattern is the easiest and most direct way to boost our defenses against opportunistic infections.

• Healthy and anti-inflammatory fats: extra-virgin olive oil, avocado, nuts, seeds (flax, chia) and blue fish (rich in Omega-3).
• Sources of animal and plant protein (not added to dairy): eggs, poultry, fish, legumes, tofu, seitan or tempeh.
• Foods rich in fiber and antioxidants: varied and colorful fruits and vegetables (artichokes, endives, chicory, watercress, asparagus, alfalfa). “Aim to include four different colors on our plate every day,” advises the Food Industry Consultant and Co-Founder of Ren.U.
• Quality fermented foods (no added sugar): natural yogurt or kefir, not ‘light’ or skimmed, sauerkraut, kimchi. “These foods provide good bacteria for the microbiota,” according to gynecologist Nekane Moreno.

Other good habits

• Maintain good hydration with still or sparkling water and infusions of chamomile, fennel, cumin, ginger, basil and rosemary.
• Glycemic stability. “Avoid glucose spikes by always combining complex carbohydrates (whole grains) with sources of protein, healthy fats and fiber”, advises Ana Molina.
• Avoid restrictive diets. “When hormonal imbalance appears, the body changes; this causes a lot of worry and discomfort in women, leading them to follow overly restrictive diets that not only don’t solve the problem, but worsen it by blocking metabolism”, warns Ana Molina.
• Regular exercise.
• Zero stress: incorporate strategies to keep stress at bay, such as mindful breathing, visualization, meditation…
• Hormonal treatment: “Discuss with your gynecologist a local hormonal treatment if there is dryness or recurrent infections,” advises Dr. Moreno. As well as a probiotic treatment (oral or vaginal) with specific strains.
• Cotton clothing: try to wear cotton underwear and avoid wearing damp garments for long.
• Intimate hygiene: “This must be gentle (using gels with an acidic pH, between 4.5 and 5.0), avoiding vaginal douches and scented soaps,” advises Dr. Moreno.